HIV Prevention is a Failure

HIV Prevention is a Failure
By Michael Weinstein
The new numbers from the Centers for Disease Control showing a 50 percent rise in HIV infections in the United States prove two things conclusively: Abstinence-only education along with censoring prevention materials is a prescription for disaster, and that when people think HIV is as easy as popping a pill, we get sloppy.
The verdict is in: HIV prevention in the United States is a failure. At the rate we are going, we will double the number of people with HIV over the next 10-12 years.
Do the math: A condom costs 5 cents, an HIV test costs $20, and lifetime infection with HIV costs $600,000. So safer sex and routine testing are a great buy financially, not to mention personally. However, condoms are still the unwelcome guest at the party, and HIV testing is largely inaccessible. We know what to do to control HIV, but we are unwilling to do it.
The CDC has been unwilling to release the new official numbers, but many major publications have already published articles indicating that infections are now in the 60,000 per year range, up from earlier estimates of 40,000.
There are many contributing factors to the rise, but the heaviest burden of responsibility must rest with the Bush administration' s policies:
* For the last seven years, the Christian right has been determining HIV-prevention policy in this country. Despite the fact that there is no scientific basis for abstinence-only education, it received a hefty increase in funding this year.
* The CDC regularly censors safer-sex ads, which they say promote sex—as if sex needs promotion.
* Despite supporting routine testing in principle, the federal government has done virtually nothing to make it a reality.
* Prevention funding in general is down on an inflation-adjusted basis.
* Condoms are still not advertised on TV to any great extent. A wonderfully clever ad for Trojan condoms was rejected entirely by Fox and CBS. Most of the safer-sex messages we see are lame and restricted to the gay press. Condoms are seldom visible in gay or straight bars.
Gay organizations, politicians and celebrities seldom speak out about the culture of self-destruction in the gay community—a culture that includes a mixture of meth abuse, unregulated sex venues and bareback sex. “Party and play” ads are prominent in publications and on-line. AIDS organizations are still beneficiaries of circuit parties where untold numbers of people are getting infected.
The people most at risk of HIV are avoiding testing, and they are not routinely tested in emergency rooms or community clinics. A third of people who are HIV positive don't know it and represent 50-70 percent of new infections. Many more who know they are positive are not on medication and are not seeing a medical provider on a regular basis.
People of color with HIV are routinely diagnosed long after they are infected and shortly before they develop full-blown AIDS.
All in all we are a sorry mess.
So what is the reaction of CDC to all of this? Delay giving out the information.
Instead of giving us the bad news right away so that we can do something about it, they have sent it off to a medical journal for peer review. In the meantime, the budget for next year will already be introduced, and the nominees for the presidency will already be decided. Obviously, the academic exercise is more important than mobilizing the community.
This is another cover-up by the Bush administration of its incompetence — which we should loudly protest.
However, the dirty secret that we all know is that gay men are still the largest group of people becoming infected with HIV, and hardly anyone in our community wants to talk about it—it’s boring. So the price we will pay is that a very large portion of another generation or two of gay men will become infected.
So when the history of this period is written, how will we account for ourselves? Why were we silent? Why didn't we care? Was it because we can just pop a pill for it? Was it because we got tired of thinking about it? Was it because we were bought off by all the people who profit from the spread of the disease?
Now that we know for sure how bad it is, shame on us if we do nothing.
Personally, I refuse to accept that becoming HIV positive is the normal rite of passage for gay men. I hope this wake up call will cause others to feel the same way.
Michael Weinstein is president of AIDS Healthcare Foundation.