American HIV Prevention in an Era of False Security - an Investigative Study
AIDS is one of the most dangerous diseases to affect humankind. AIDS awareness is best-funded and best-taught in the United States of America. This realization is especially apparent when HIV rates are examined in African countries and some Asian countries such as India. Education levels about sexually transmitted diseases in general - and funding for prevention and treatment programs - are very low in many foreign countries.
Americans, on the other hand, have been very fortunate to enjoy a high level of free and public education and impressive levels of funding for prevention and treatment programs. Almost every urban center in America has clinics that offer free HIV testing and counseling. This awareness and general academic and emotional acceptance of AIDS has, during the last two decades, fought hard against the spreading of the disease. The entire gamut of health promotion workers in America is to thank for this improvement.
However, this year, for the first time in several years, the incidence of HIV infections has grown in America. Many doctors and health promotion professionals attribute this recent growth to a lifestyle shift in which Americans have grown lax in their concern about AIDS. More and more Americans are living productive lives even though they are HIV positive because of very expensive drugs that are quite toxic as well. Erwin Magic Johnson, the legendary basketball player, is a perfect example. Johnson is at the center of an advertising campaign that seeks to encourage HIV positive patients that all is not lost, that life is still livable with the disease.
Though this is a positive message, the backlash, as health promotion experts note, is that Americans have stopped worrying as much about the disease and are again regressing to lifestyle patterns that increase the spread of the disease. Although many people still continue to live with HIV, many others die from AIDS, and that is what Americans have, to a certain degree, forgotten.
This paper will examine the changes that need to be made, and their relative effects and unintended side effects, from a health promotion perspective to increase awareness of AIDS and HIV in an era when people are once again lowering their guard against the disease.
Also this paper will make recommendations that will contribute to fundamental health promotion ideals in reducing the incidents of the AIDS virus in America. The recommendations will be made in the Data Analysis Chapter, and then summarized and listed in the Summary Chapter as well.
The recommendations will be based mainly on the data researched in this paper, but will also be structured around the basic definition of health promotion and lifestyle change.
Chapter 1, Introduction
State The Problem
Importance of the Study
Scope of the Study
Rationale of the Study
Definition of Terms
Overview of the Study
Chapter 3, Review of Related Literature
Chapter 2, Methodology
Identify the Data Gathering Method
Database of Study
Comment on Validity of Data
Comment on Originality and Limitation of Data
Summary of Methodology
Chapter 4, Data Analysis
Chapter 5, Summary, Conclusions
Health promotion is the science and art of helping people change their lifestyle to move toward a state of optimal health. Optimal health is defined as a balance of physical, emotional, social, spiritual, and intellectual health. Lifestyle change can be facilitated through a combination of efforts to enhance awareness, change behavior and create environments that support good health practices. Of the three, supportive environments will probably have the greatest impact in producing lasting change."
That is the gist of the concept behind health promotion. Health promotion basically takes preventative medicine to a more advanced stage. Where preventative medicine deals primarily with physical attainment of "optimal health," health promotion concerns the nexus between the physical, emotional, social, spiritual and intellectual contributing factors to a person's health.
The additional focus of health promotion is creating lasting change. It is not satisfactory to improve societal health only to later experience declines in those same areas.
That is why health promotion experts are so concerned about the recent growth in HIV cases in America. Gains were realized throughout the 1990s in AIDS prevention, but with a new lifestyle practice among sexually active Americans, the numbers are ominously on the rise again.
The challenge, then, is not only to educate and help people to change their lifestyles on the physical, emotional, spiritual, social and intellectual levels, it is also to provide the knowledge base and the means to make sure those changes stick and make a permanent positive impact on health promotion with regard to HIV.
State The Problem
The issue this paper will tackle stems from the following data: "While the number of AIDS cases is declining, the number of people living with HIV infection is growing. This increased prevalence of HIV in the population means that even more prevention efforts are needed, not fewer. For individuals at risk, increased prevalence means that each risk behavior carries an increased risk for infection. This makes the danger of relaxing preventive behaviors greater than ever."
For instance, heterosexual females have been contracting HIV on an accelerated basis, recently: "AIDS cases related to heterosexual contact represent an increasing proportion of cases in North America. Heterosexual contact is the most common mode of transmission among women diagnosed with AIDS in the U.S., and has doubled as a proportion of female AIDS cases in Canada since 1991. While a large proportion of these cases reported sexual contact with an IDU, a substantial proportion of women who acquired their infection heterosexually were unaware of their partner's risk status. In addition to injection drug use, the use of crack cocaine in the United States has been associated with an increased risk of HIV transmission through sexual contact in both urban areas and the rural South."
These statistics bear out exactly why health promotion is important: A group of people heretofore less affected by the AIDS virus are now contracting the virus at a higher rate: This can only be because of a lapse in lifestyle carefulness, a relaxing of the guard with respect to the now long-inculcated rules of safe sex and not sharing intravenous needles. The knowledge is out there, as HIV has been decreasing among other population sets, so it is not necessary that the virus gain ground with heterosexual women.
For instance, between 1990 and 1995, heterosexual HIV cases grew by five percent in large urban areas such as New York, Miami and Washington, DC. Of course, with urban living comes poverty and hardship, so it seems natural that the lifestyle habits of people living in those areas may give rise to the higher AIDS rates.
But health promotion advocates see little reason for this. Their goal, as far as HIV is concerned, is to make prevention information as readily available as possible such that even the poorest segments of our population have the same tools - emotional, spiritual, intellectual, physical and social - to maintain their good health.
Steps are being made with regard to a vaccine for AIDS. Just recently, a company known as VaxGen claims to have developed a vaccine that reduces the chance of infection in Asian and black people.: However, the expected infection rate for the 314 black volunteers who received the vaccine was reduced by 78% -- a finding the researchers said was unexpected. The rate was reduced by 67% for all nonwhite volunteers other than Hispanics.
This is the first time we have specific numbers to suggest that a vaccine has prevented HIV infection in humans," VaxGen vice president Phillip Berman said in a prepared statement Sunday night. "We're not sure yet why certain groups have a better immune response." step forward, without a doubt, but also a clear indication that much has yet to be accomplished on a scientific level before American can count on science alone to insulate them from HIV. In the mean time, and that time promises to be a long and windy road, only a lifestyle shift via health promotion ideals can slow the spread of the virus.
Perhaps the best indication of this comes from the critics of the VaxGen tests. They feared that even testing humans with the vaccine might encourage unsafe behaviors under a false cloud of invincibility. The critics essentially feared that the testees would throw away their knowledge base of lifestyle practices that would insulate them from HIV in favor of willing dependency on an unproven vaccine.
That is a microcosm of what America is facing today. As more and more people are able to live with HIV, and as the fear of the virus becomes almost old-hat, Americans are once again beginning to take those risks that were so carefully minimized during the 1990s. Teens, for instance, report alarmingly high incidents of unprotected sex again, feeling that HIV could not possibly happen to them; that it is a disease of "others."