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Why is the prevalance of HIV increasing among the young and gay populations?
Dec 2, 2007

Hi Dr. Bob,

I just saw this really troubling article on Yahoo News and thought you might have some feedback on it. In particular, it's really troubling that the rate of HIV infection among youth and gay men has increased so significantly over the past few years. The article points to a possible rise in infection due to the advent of HAART (so people don't feel like it's really a deadly disease anymore and are, thus, more prone to act like they're invincible)...also, I was interested in how advertising in gay media has made it seem like HIV is no big deal...they always show fit, healthy guys in ads who are thriving with HIV...perhaps it's actually hurting efforts to curb the spread of the disease bc, again, gay men are led to believe HIV is no big deal adn they can easily live with it if they get it? The article lists many other possible reasons for the rise in infecion rates...I'm curious what you think of the potential causes of this tragic trend...what do you think has to be done to improve the situation? I know sex education and the availability of condoms is important, but there seems to be a wide swath of the population who are aware of the risks but play with their lives anyway. How do you address this?

Response from Dr. Frascino

Hello,

This is a highly complex issue and I could write a thesis on all the factors potentially contributing to these epidemiological trends. They would include such disparate issues as biology, sociology, politics, religion, perception, funding priorities, condom-fatigue, advertising (sure, plenty of buffed healthy looking poz folks in the advertisement for new HIV drugs, but when's the last time you saw a condom or safer sex ad on prime time TV?), medical advances, increased testing and better reporting, etc., etc., etc. Some of the obvious contributing factors were touched on in the article. A full discussion by yours truly is beyond the scope of this forum. Today is World AIDS Day and there are numerous articles in the press addressing this and other critical issues. Have a look.

Perhaps equally alarming to the spike in new infections noted in teens, young adults and MSM is that the U.S. Government is soon going to announce that the total number of Americans who become infected with HIV/AIDS each year is 50 percent higher than previously believed. For 14 years, the CDC has used "informal" methods to estimate that about 40,000 people per year in the United States are newly infected with HIV. New testing techniques, which are more accurate, reveal the true number of new infections in the US is somewhere between 55,000 and 60,000!!! (The CDC hasn't announced the new higher estimates yet, but I'm fairly sure they will shortly.) Chances are this new higher estimate is the reflection of a trend that's been occurring for a number of years here in the U.S. but only recently recognized due to the better testing methods and the push by some epidemiologists to make the CDC look a bit harder at their "evidence" for their 40,000-new-infections-per-year statistic. The increase in new HIV infections in MSM from 2001 to 2005 was 13%. There can be little doubt that our HIV-prevention messages are not effective. The rise in new cases in young adults also parallels the rise in "abstinence-only-until-marriage education" programs, another interesting correlation. Stay tuned; you'll be hearing much more about these topics (I hope) in the near future.

Dr. Bob



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