New Tactic to Prevent AIDS Spread

The idea that people with HIV should take steps to prevent passing along the infection may seem self-evident. But health officials have long understood that a host of factors -- stress, a craving for intimacy, fear of rejection, drug and alcohol abuse -- can cause lapses in judgment and self-restraint that lead people to have unsafe sex. So AIDS educators, alarmed at the continuing spread of HIV, have now added a crucial weapon to their prevention arsenal: educational campaigns encouraging infected people to take responsibility for not transmitting the virus.

The CDC, which estimates that 900,000 people in the United States now have HIV, hopes to reduce the number of new infections to 20,000 a year by 2006, from 40,000. As part of that effort, the agency is spending $3.8 million a year for "prevention for positives" programs in California, Maryland and Wisconsin. Other states and cities have started such programs on their own.

One high-profile effort is an advertising and Internet campaign called "HIV Stops With Me," which began in San Francisco two years ago and has been expanded to several other cities, including Los Angeles and Boston. It features people with HIV who appear on television commercials and billboards, tell their stories on the campaign's Web site and respond to e-mail messages.

The new educational efforts have not pleased everyone. Billy Curtis, a San Francisco youth counselor, said he was horrified when he first saw the "HIV Stops With Me" advertisements because he thought they made scapegoats of people with the virus and absolved the uninfected of having to think about protecting themselves. "You're saying to people you have irresponsible HIV-positive people infecting these innocent HIV-negative people," said Curtis, who is gay. "But ultimately I am responsible for whether I seroconvert or not." But supporters of the campaign say that a vast majority of prevention efforts still focus on those who are not infected, and that the intent is not to pass judgment but to offer emotional support to people with HIV.

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