About AIDS

"The AIDS epidemic continues because HIV-positive individuals keep infecting HIV-negative people through their behaviors."

This statement of fact seems simple enough, but in truth, it is loaded with nuance -- and no small amount of philosophical, practical, and political baggage and controversy.

Policywise, it is the linchpin of a major change in the nation's approach to HIV prevention. Since the beginning, most prevention messages have been directed toward HIV-negative people, urging them to make choices that would keep them uninfected; only minor effort has been devoted to effecting safer behaviors among HIV-positive folks. Unfortunately, that initially successful approach seems to have run out of steam. So, the Centers for Disease Control and Prevention recently shifted its HIV prevention efforts to identifying HIV-positive people and engaging their participation in stopping the virus' spread.

The data support this change. Up to a third of HIV-positive Americans do not know they are infected and thus have little impetus for behavior change. Numerous studies say that most HIV-positive persons -- once they know their status -- change behaviors; only a minority continue in their previous risky activity. That minority, however, coupled with those that do not know their status, serves to perpetuate the U.S. AIDS epidemic: The same 40,000 to 50,000 new infections are occurring annually now as in 1990.

The CDC's new approach will promote getting at-risk individuals to seek testing; if infected, then counseling and support, it is hoped, will result in behavior choices that do not place others in jeopardy. The recognition that "risk" is, like the tango, a mutual endeavor will not be abandoned, but the emphasis will change.

Meanwhile, every effort must be taken to end the stigmatization of HIV-positive status, or the fear of discrimination and rejection will triumph, and those who should consider getting tested will avoid it.

Will this work better than the efforts of the recent past? Only time will tell, but it's worth a try. Are you -- or someone you know -- one of those individuals that ought to think about HIV testing? Call 972-5580 or 458-AIDS to find out.

Sandy Bartlett

Community Education Coordinator, AIDS Services of Austin