July 12, 2012
The 15th in a series of articles about the Road to AIDS 2012, a 17-city tour that seeks to define the state of the U.S. epidemic and that leads up to the International AIDS Conference in Washington, D.C., in July 2012. The 14th installment reported on the Dallas meeting.
If the National HIV/AIDS Strategy (NHAS) is to be successful, more attention must be paid to identifying risky behaviors and helping people make lasting lifestyle changes, according to participants at a town hall meeting in Baltimore.
An audience of approximately 17 participants gathered at the University of Maryland School of Medicine Teaching Facility for the meeting, which was designed to discuss Baltimore's challenges and successes in managing the HIV/AIDS epidemic. Among the attendees were representatives of community-based organizations (CBOs), medical service providers and faith-based service providers.
"When someone comes in and says he's a substance abuser or depressed or bipolar, I want to see them treated for their behavior disorders concurrent with treatment for HIV," said Warren Hewitt, an AIDS coordinator at the Substance Abuse and Mental Health Services Administration and a panelist at the event. If the individual's behavior disorder isn't addressed, he or she isn't likely to remain in treatment, Hewitt added.
While a person with hypertension or diabetes hurts only himself when he falls out of treatment, nonadherence to an HIV-treatment regimen has public health implications, town hall participants said.
Community members at the town hall also expressed frustration that social factors that contribute to the HIV/AIDS epidemic have been largely unaddressed. "We've made incredible biomedical advancements, but we have not made advancements socially," one participant said. Factors such as education, housing and drug use put the entire community at risk and must be made as big a priority as the clinical aspects of HIV.
Another reason for the thousands of new infections each year is that many people underestimate their risk, town hall participants said. While many people point to injection drug users as being at higher risk than the general public of acquiring HIV, more people engage in risky behavior as a result of recreational drug use and alcohol consumption.
"We don't talk about the important contribution of alcohol and other drugs and how they impact inner-city communities like Baltimore and Washington, D.C.," Hewitt said. He then went on to describe a private study that found that people who ingested recreational drugs and alcohol were more likely to engage in unprotected sex. "With alcohol, marijuana and amphetamines, you take a couple of puffs and reappraise your risk profile," he said. "That happens on a routine basis in communities. To turn the corner with the National HIV/AIDS Strategy, we must address this."
But in order to get the message out about risky behaviors and the need to change them, HIV/AIDS advocates must find different ways to reach more members of the community. "There's a lot of research in Baltimore, and researchers are looking for innovative ways to get before audiences and new groups," said Marsha Martin, director of the Urban Coalition for HIV/AIDS Prevention Services and a panelist at the event.
Participants discussed using music to get the message out. "We should have an HIV concert with Jay-Z," one participant said. "That's what is going to move people."
Likewise, one town hall participant described the work of his organization in distributing safer-sex boxer shorts that have become a hit in the community. "Parents are buying them for their children," he said.
Social media can also be used to get young people involved. "We have high school students using Facebook and doing HIV prevention through social media," one participant said.
While the NHAS has laid out guidelines for managing the epidemic, the implementation really falls on the community. "The president's strategy is a master plan, but things are done locally -- change is community-based," said Hewitt.
The entire Road to AIDS 2012 tour is a joint effort between the Washington, D.C.-based Community Education Group, the Urban Coalition for HIV/AIDS Prevention Services, pharmaceutical company Merck and AIDS 2012. The Road to AIDS 2012 will seek community input in cities across the country. That input will be shared at AIDS 2012 in Washington, D.C., when the International AIDS Conference is on American soil for the first time in more than 20 years.
Tamara E. Holmes is a Washington, D.C.-based journalist who writes frequently about emotional health and wellness.