Prevention for Positives: What Is It?
Even after 20 years of hearing various HIV prevention messages, hundreds of news stories, and countless warnings about unprotected sex and IV drug use, approximately 40,000 individuals in the US will become infected with HIV this year. Shocking? Probably not.
As much as we would like to think that HIV/AIDS is on the downswing, and rates are declining, unfortunately they continue to persist. Even though we've led a valiant fight, it just hasn't been enough. America's own beliefs and attitudes about HIV continue to get in the way of successfully dealing with the epidemic. In many communities the rate of new HIV infection is on the rise. What could be the cause of this? Prevention burnout? Maybe so. I know that during a recent speaking engagement at a local high school, several students remarked how tired they were of hearing about HIV. And, you know what, they probably are. AIDS has been around longer than they've been alive.
Human NatureMost of us over 30 still think of HIV as a "new" disease. It's hard to think that twenty years have past since the first reports came out. Many can remember the fear and the hysteria just like it was yesterday. So, after years of trying to warn people, why does it still persist? The most logical answer is human nature. Unfortunately many people still have the dangerous idea that "it can't happen to me." As many of us who harbored that attitude at some point have come to know, it can . . . and it does.
Take a look at some of the tactics that have been used in HIV prevention: Remembering some of the fear-based messages over the years that were meant to scare folks into protecting themselves, it's not hard to understand why some people still refuse to take an HIV test. I've heard on more than one occasion the statement. "If I have it, I don't wanna know." In an effort to frighten people into submission, we effectively alienated some of them. Not wanting to know is an easy form of denial, but unfortunately it doesn't work with this disease. With HIV, what you don't know, can hurt you . . . and possibly a lot of other people as well. Besides, it's a little easier to deal with what you know than the unknown.
Combat ComplacencyGenerally, as many of us already know, there is an underlying feeling of complacency in this country right now about HIV. The news media reports on all the wonderful medications we have, and some people think that getting infected is "no big deal anymore." Many folks view HIV as a "manageable disease." As my good friend Scott says (referring to the side effects from his HAART regimen), "I don't think there is anything manageable about crapping on myself!" I think Scott speaks for most of us who have been on meds, there is still nothing manageable about it!
Those of us who work in both the prevention and treatment arenas are caught in a difficult space. To an HIV-negative person who may be at risk of contracting the disease, we tell them how horrible and devastating it is to have HIV ". . . so they better not get infected!" And then when an HIV-positive person walks in to the office we tell them, "Hey don't worry, you'll be fine." These conflicting messages mirror the mainstream opinion on HIV prevention. As we head into the third decade of the epidemic here in the US and rates of new infections seem to be either stable or rising, the Centers for Disease Control (CDC), AIDS service organizations, and community groups have begun to look for alternative ways to stop the spread of HIV. Part of the CDC's five-year plan to reduce the rates of new infections by half is to test the theory of "Prevention for Positives." Although this is not a new concept among many ASOs who have been doing this kind of work all along, this is the first time that the CDC has put a real financial commitment toward it. Prevention for Positives is a new generation of prevention programs targeted at individuals who have already tested positive for HIV and who may be at risk of transmitting the disease to someone else. It's about helping positives to feel better about themselves, decrease the stigma associated with HIV and help them take responsibility in their own lives to stop the spread of HIV. By providing supportive services such as peer-based workshops, one-on-one counseling, mental health, and skills-building programs, the participants will gain a higher level of self-esteem and coping skills, which in turn will lower their risks of transmitting HIV.
Positive ImagesOne such program launched several years ago by the City of Los Angeles is the "Positive Images" program. Recently revamped with funding from the Office of AIDS Programs and Policy (OAPP) and a host of community agencies on board, the Positive Images program is ready to begin its exciting work. Similar to the "HIV Stops with Me" campaign that launched last year in San Francisco, the Positive Images program will reach those positives who need a little help and support to come to terms with this disease in their lives. Utilizing a toll-free anonymous telephone chat line in combination with an Internet Web site and chat room (both of which are facilitated by HIV-positive peers from various community agencies including those that cater to women, Latinos and Asian Pacific Islanders), the program will be able to reach many people who may not normally access services. In addition, the Positive Images program will reach persons who are infected with HIV, but unaware of their status. They will do this through outreach and on-site testing at locations throughout the county including the streets and the parks.
Women Alive is excited to be a part of this new focus in prevention, and is planning special activities and workshops geared to the needs of positive women in the community. (See the Positive Images schedule.)
As we realize now, prevention programs that only focus on the HIV-negative population seem to have reached their full potential. As the stigma around HIV continues to pervade our society, there will always be a few people who we cannot reach, no matter what the message is. In order to stem the overwhelming trend of new infections among women, we must deal with the predominant source of those infections, heterosexual and bisexual men.
Socially AcceptableIt is hoped that through programs such as this we can give positive people the skills they need to take control over this disease in their lives. It is hoped that in the future the CDC will find it appropriate to fund more social-marketing campaigns such as the "HIV Stops with Me" and "Positive Images" programs. By making it more acceptable in society to be HIV-positive, the easier it will be for people to disclose their status to others. It's unfortunate that so many new infections continue to occur at a rapid rate (especially among women of color). If we are to find an answer to this disturbing trend, we have to look "outside of the box." These new programs we hope will not only benefit those who participate in them, but may possibly set a new standard for all prevention policy in the future.
We, the positive people, have the power to end this epidemic. Take back your power and help to stop the spread of HIV/AIDS.
Call 1.888.600.4767: Chat room #1. The chat room is totally anonymous. We don't ask your name, zip code, or proof of status. Give it a try. Talk to other women who share your concerns, hopes, and strengths.
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