A Little Attention to Domestic AIDS Prevention
Think of a billion oranges, or of a trillion dollar bills. It is tough even to conceive or to fully appreciate of quantities so large. Humans find it difficult to understand such enormous sums simply because most of us lack the terms to comprehend them. But try. Try to perhaps imagine something besides oranges or currency. Try to imagine humans….
In the past year alone, three million humans died of a disease worldwide (Holbrooke). This disease is known as AIDS, or Acquired Immune Deficiency Syndrome (“Automatic, systematic.”). Every day, 12,000 new people get infected, and, perhaps worse, 90% of them will not even know that they have been infected until 2013 (Holbrooke). Just in America, an estimated 1,039,000 to 1,185,000 people are living with HIV/AIDS, with 24-27% of them undiagnosed and unaware of their HIV infection (“Basic Statistics”). This can safely be called a pandemic of the worst variety, and there is no cure.
AIDS was first recognized as a specific condition only 25 years ago, in 1981, and it was not until 1984 that the cause was identified (“Document 1: An Introduction to HIV/AIDS”). Tragically, it has flourished since then.
The disease is known to be transmitted through both heterosexual and homosexual sexual intercourse, blood contact (as that that occurs with the communal use of needles), and from mother to child during pregnancy, birth, and breastfeeding (“Document 1: An Introduction to HIV/AIDS”).
HIV/AIDS is relatively unique amongst epidemic diseases in that it has a remarkable long incubation period which is estimated to last 5 to 15 years (Bacchetti et al.). This means that, not only do many people who get the disease fail to take measures to treat themselves, but infected people also unconsciously spread the disease to others.
As for the carriers of the disease, the outlook is bleak. It starts as HIV at the time of infection, and generally, after the HIV becomes more active in an infected person, progresses to AIDS when an AIDS specific disease is caught (“Disease Progression”). A carrier generally will go through periods of sickness which increase in severity, duration, and frequency, until the carrier dies (“Document 1: An Introduction to HIV/AIDS”).
This is not to say that there are no treatment methods available to carriers of the disease—there are. Zidovudine is one of these (“HIV/AIDS Prevention Today”). Zidovudine treatment, originally developed to fight cancer, effectively reduces the development of AIDS to zero, if initiated early enough (“Zidovudine”). However, drugs like Zidovudine are incredibly expensive, and the treatment is notoriously time consuming. Therefore, prevention is the clear rout towards combating the ills of HIV/AIDS.
Prevention has a long way to go in the United States. Approximately .6% of the population is infected with AIDS, and the disease can be seen in every part of American society (“AIDS in America”).
Geographically AIDS tends to be most prevalent in urbanize, metropolitan areas. While is does exist in every state in the good ole U S of A, California and New York top the list for states with the highest prevalence (“AIDS in America”).
There are some considerable social issues concerning the American AIDS epidemic. Because the disease was first noticed among the gay population, it is often associated with the gay population. This has made some people nervous about confronting the problem (“AIDS in America”). That concern is not made better by the fact that injection drug users are prevalent among those who transmit and receive the disease. And, as if the black community doesn’t have enough problems as it is, they are the leading race that carries the drug with 50% of AIDS cases belonging to African Americans; though, it should be noted that race doesn’t play a factor in transmission probability (“NAACP Calls for Support of National Black HIV/AIDS Awareness Day”).
Even without these stigmas, AIDS tends to foster discrimination. The term “treated like a leper” is very applicable. There is a certain fear—an understandable one—that healthy people hold against the “unclean”. This type of discrimination actually precipitated the AIDS awareness movement, when people, such as Ryan White, a 13 year old boy who was asked to leave his High School because he had the illness, became widely disposed to the public after their problems (“Ryan White”). This even prompted the “Ryan White Care Act” of 1990, which was administrated by the U.S. Department of Health and Human Services (DHHS) (“Ryan White Care Act”).
Good news can be noted in the success thus far in American AIDS prevention programs. Since the US government recognized the problem, steps have been taken to control the spread of the disease. Measures taken have included effective community planning processes, epidemiological and behavioral surveillance, HIV testing campaigns, health education, diagnosis and treatment, and HIV prevention capacity-building activities. The rate of new HIV infections has slowed from 150,000 per year in the mid 1980’s to 40,000 per year now (“HIV/AIDS Prevention Today”).
The US has responded very well to Mother to Child Transmission or MTCT. The chances of a mother passing the virus to her child can be reduced to 2% or less and because of that ability the amount of children born with AIDS in America was reduced to 58 in 2003 (“AIDS in America”).
However, there are some logical steps that the US Government has far from spearheaded. Condom distribution, for example, has been shown to be an effective prevention method for AIDS, and other Sexually Transmitted Diseases (“AIDS in America”). But instead of condom distribution, abstinence only methods are all the craze. Abstinence Only methods are abysmal failures at trying to prevent STD transmission. One reason for this is people are human. In one Texas high school that employed the abstinence only method, 1 out of every 17 girls became pregnant (“Franken”). This trend is reflected in a Texas Study, which noted that, among 10th graders, the percentage of boys who had ever had sexual intercourse jumped from 24 percent to 39 percent after participating in an abstinence program (“Study: Texas abstinence plan not working”). Needless to say, sex within teen populations is prevalent. Prevalent enough to warrant some action, STD ridden as this world is. That action reasonably manifests itself in condom distribution.
The US government, in recent times, has been regressing in its efforts to distribute condoms especially overseas (“The ABCs and HIV Prevention: How the U.S. Government Limits Youth’s Access to Health Information”). The government seems to be bending to the critics who suggest condom distribution advocates sex and encourages sex. To theses charges, one must admit that life itself encourages sex, and really television and your average Calvin Klein ad are a little more tantalizing than a pack of rubbers.
Condom distribution is not the only AIDS prevention that has been met with disdain. The needle exchange programs have generated a comparative furor since their conception. As it is, injection users, their partners, and children account for 36% of AIDS infections (“HIV/AIDS Prevention Today”). Needle exchange programs attempt to increase the availability of sterile needles in an effort to reduce needle sharing. By allowing for syringe users to exchange dirty needles for clean ones, the chances of encountering an AIDS infected needle are reduced. In addition to reducing the spread of AIDS and other diseases, the program often helps drug addicts find treatment (“AIDS in America¬¬¬¬¬”). It is like killing two birds with one projectile syringe.
Critics of these programs sing generally the same tune as they do for condom distribution—“condones drug use” and so forth. But at least six government studies contradict these unfounded, though understandable, critiques (“AIDS in America¬¬¬¬¬”).
But more work has to be done. 40,000 people per year virtually condemned to death because of a disease is too much. One is too much. The American government must do more because the nature of the problem necessitates our continued attention and efforts.
In what ways can we give increased attention? Well, for starters we can stop worrying so much about the “decency” of effective methods. What is indecent is the tendency to hold higher regard for “tradition” than the prevention of human suffering. But one can’t legislate that—moving on.
The American government must make taking preventative actions more appealing. One might say “Well, shouldn’t not dying be incentive enough?” The answer is: “Yes it should.” However, unfortunately it is not. People tend to want to sweep dirt under carpets rather than actually dealing with the mess. The same is true for AIDS. Many do not want to confront the issue simply because they fear the results.
Now, to do this, a number of steps must be taken beginning with tax incentives. New tax code should be written to include tax breaks for people who get tested every six months for it is approximately six months after infection that the virus can be detected in the blood stream. This helps reduce the number of unwitting carriers, and, thus, unwitting transmissions.
Next, Congress must appropriate funds to create more AIDS facilities at which people can, among other things, learn about AIDS, get tested for AIDS, acquire condoms, exchange needles, and examine treatment options for little or no cost. These facilities should be dispersed throughout the country based on AIDS prevalence.
Congress then needs to revamp public education’s approach to the dilemma in what will be largely unwelcome but necessary ways. School clinics should be stocked with condoms. Clinics should also be stocked with needles for exchange, but with the requirement of treatment for what I would hope are the few who would use that service.
These institutions are likely to generate criticism beyond decency for it is true that they are expensive. But they are not nearly as expensive as treating the disease and they are not nearly as expensive as the human capital it costs to not do these things.
Like many fights, AIDS prevention is an uphill battle, but one that we cannot afford to loose. Though today the front may bleak, we must as always hope for a better tomorrow.
