Prevention Must Continue!

Past prevention efforts have resulted in behavior change for many individuals and have helped slow the epidemic overall. However, according to the U.S. Centers for Disease Control and Prevention (CDC), many studies find that high-risk behaviors, especially unprotected sex, are continuing at far too high a rate, even among people who have been counseled and tested for HIV, including those found to be infected. HIV/AIDS information must be accessible to every demographic group to ensure that all Americans are informed about the methods of HIV/AIDS transmission and prevention.

Consistent and Correct Use of Condoms

If your sexual behavior puts you at risk of HIV infection or any other STD, using latex condoms consistently and correctly can greatly reduce, but not completely eliminate, your risk.

Consistently means using a latex condom from start to finish each and every time you have anal, oral or vaginal sex.

Correctly mean following these steps:

1. Use a new condom for each act of intercourse.

2. Put the condom on after the penis is erect and before any genital contact (vaginal, oral or anal). If the penis is uncircumcised, pull the foreskin back before rolling on the condom.

3. Hold the tip of the condom and unroll it onto the erect penis, pinching the tip of the condom to ensure there is no air trapped in the condom's tip.

4. Withdraw the penis immediately after ejaculation, holding the condom firmly at the base to keep it from slipping off.

5. Stop and replace immediately (with a new one) any condom that breaks or slips off during sex.

Other Tips for Condom Use:

• Use latex condoms. Look for the words "latex" or "for disease protection" on the package. Lambskin and natural membrane condoms are not an effective form of disease prevention because the material contains pores that may allow the passage of viruses.

• Use only water-based lubricants, such as glycerin or lubricating jelly. NEVER use oil-based lubricants, such as petroleum jelly, cold cream, hand lotion or baby oil.

• Store condoms in a cool, dry place out of direct sunlight. If you want to keep one with you, put it in a loose pocket, wallet or purse for no longer than a few hours at a time.

• Do not use expired condoms. Check the date.

• Do not use condoms that are sticky or torn.

For more information contact the CDC National Prevention Information Network at 1-800-458-5231 or the CDC National HIV/AIDS Hotline at 1-800-342-AIDS.

For information on the female condom, "Reality," contact the Female Health Company at 1-800-274-6601.

Prevention for Various Groups

Although various population groups are affected by the HIV/AIDS epidemic differently, the basic methods of preventing infection and controlling the spread of HIV remain constant:

• Abstain completely from sex or limit yourself to one, uninfected, monogamous partner.

• If you use injection drugs, NEVER share any drug equipment.

• Use a latex condom every time you have oral, anal or vaginal sex.

Young Adults

In the United States it is estimated that half of all new HIV infections are among people under 25, and the majority of young people are infected sexually. Prevention methods targeted toward teenagers and young adults are imperative.

• All groups that exert influence over young people must be involved, including families, schools, peer groups and social systems, youth-serving agencies, and faith-based organizations.

• Research has clearly shown that the most effective school-based programs are comprehensive ones that include a focus on delaying sexual behavior AND provide information on how sexually active young people can protect themselves.

• Prevention efforts targeted toward young people need to address both sexual and drug-related risks, as many students report using alcohol or drugs when they have sex, and one in 50 high school students reports having injected an illegal drug.

• Young people should be made aware that (1) unless they practice total sexual abstinence and completely refrain from using injection drugs, they are at risk of contracting HIV, and (2) there are youth-friendly organizations available throughout the United States to help young adults find information on HIV/AIDS transmission, prevention, testing and support services.

Women

Women accounted for 22% of all new AIDS cases among adults and adolescents in 1997, and the number of women becoming infected is steadily increasing each year.

In order to protect themselves from becoming infected with HIV, women should:

• abstain from or limit sexual contact to one uninfected partner. In 1997, new AIDS cases among women were predominantly caused by heterosexual contact.

• use a female condom or male latex condom.

• get routinely tested and seek early treatment for sexually transmitted diseases (STDs). STDs not only increase susceptibility to HIV but also identify women who consistently engage in high-risk sexual behavior.

• never share injection drugs or equipment.

• be aware that they are vulnerable to sex crimes and any sexual assault can place them at risk for contracting HIV.

African Americans

Although the overall number of AIDS cases and deaths in the United States have begun to decrease, AIDS incidence among African American men, women and adolescents remain high. Among African-American populations, inadequate health care, education and social benefits limit the amount of HIV/AIDS information available. However, as the numbers of infected African Americans continue to rise, prevention efforts are increasingly critical. Because current epidemiological surveillance does not take into account the social, cultural, economic, geographic and religious groups that fall under the "African American" heading, very little information is available on risk factors specific to the African-American communities.

• African-American women need to be aware of the high-risk behaviors in which their sexual partners engage. Over the course of the 1986-1996 decade, AIDS incidence among African-American women increased most dramatically among women infected heterosexually. A large proportion of HIV-positive African-American women who are infected heterosexually are infected by male injection drug users.

• Homophobia among peers inhibits African-American men who have sex with men (MSM) from seeking out HIV/AIDS information and testing more so than MSM in other population groups.

The American Red Cross African American HIV/AIDS Program aims to prevent the spread of HIV by training people to make culturally appropriate, nonjudgmental, interactive presentations to African-American audiences. For more information contact your local American Red Cross Chapter or the National Office at (703) 206-7120. For more information on AIDS organizations that offer support services for African Americans, contact the CDC National Prevention Information Network: 1-800-458-5231.

Latinos

The Latino population living in the United States is diverse, representing multiple ethnicities and countries of origin. Overall, the nation's Latino population is younger, disproportionately poor and has lower educational attainment than the U.S. population as a whole. The population includes different waves of immigration, and for many a language barrier still exists.

Values and traditions unique to Latino culture play an important role in shaping attitudes and behaviors with respect to sex, sexuality, drug use and HIV/AIDS. These attitudes and behaviors may affect risk for HIV/AIDS as well as diagnosis and treatment.

While race and ethnicity alone are not risk factors for HIV infection, underlying social and economic conditions (such as language or cultural diversity, higher rates of poverty and substance abuse, or limited access to health care) may increase the risk for infection in some Latino communities.

Latinos continue to die from AIDS at a rate two and a half times that of non-Hispanic whites. Today, HIV is the fourth leading cause of death for Latinos and the eighth leading cause in the general population. Improved prevention efforts for Latinos will require focusing on several key challenges. To reduce the risk of infection for Latino women, efforts to prevent drug use and HIV must be better integrated. To address the prevention needs of Latino gay and bisexual men, homophobia must be confronted on a national, societal and community level. The impact of HIV/AIDS on Latinos should thus be considered in the context of broader disparities in access to health care services, education and social benefits.

The American Red Cross Hispanic HIV/AIDS Program aims to prevent the spread of HIV by training people to make culturally appropriate, nonjudgmental, interactive presentations on HIV/AIDS issues to Latino audiences. For more information, contact your local American Red Cross Chapter or the National Office at (703) 206-7120.

The National Catholic AIDS Network serves as a clearinghouse of information, provides education and technical assistance, and acts as a source of referral. Contact the organization at 707-874-3031.

For more information or the names of Latino HIV/AIDS sup-port services contact the CDC National HIV/AIDS Hotline: English 1-800-342-AIDS, or Spanish 1-800-344-SIDA.

Men Who Have Sex with Men

According to CDC, men who have sex with men (MSM) are the single highest-risk population group in the United States. MSM account for 49% of all adult/adolescent AIDS cases. Although there has been a decrease in the overall numbers of MSM AIDS cases, MSM still accounts for nearly 40% of all new male HIV infections. Prevention efforts among the gay and bisexual communities have shown improvements, yet they remain crucial in slowing the spread of HIV, particularly among young MSM.

• Support for safer sex among MSM's peers and in settings where they meet and socialize with partners may be critical to further reduce risk among gay and bisexual men.

• Prevention programs to reduce risk among young MSM should include a focus on altering peer norms and reaching young men at highest risk in bar settings.

• There are several organizations across the country that focus on providing gay and bisexual men with HIV information, testing, counseling and support services. For a listing in your area, contact the CDC National Prevention Information Network at 1-800-458-5231 (English/Spanish) or 1-800-243-7012 (TTY).

Dignity/USA is an organization that provides assistance for gay, bisexual and transgendered Catholics and their families. Contact the organization at 1-800-877-8797.

HIV-Positive Pregnant Women

According to CDC, 91% of all pediatric AIDS cases reported in 1997 were infants born to HIV-positive mothers. Women in minority groups and those who inject drugs are less likely to be tested for HIV or to seek prenatal care. Recent research shows that mothers can reduce the risk of perinatal (mother-to-child) HIV transmission by two thirds if they are administered the drug AZT (zidovudine) during pregnancy, birth and delivery, and if the infant receives AZT during the six weeks following birth. Pregnant women who are infected with HIV or who have put themselves at high risk of contracting the disease should seek immediate medical care.