Short Takes On News & Events

The Good, The Bad, And The Costly News On HIV

By Shefali S. Kulkarni

August 3rd, 2011, 4:47 PM

Source: Centers for Disease Control and Prevention

New data from the Centers for Disease Control and Prevention show that while the overall number of people who are infected with HIV each year is relatively steady — approximately 50,000 new infections each year — there was a 48 percent increase in the number of young HIV-infected African American men who have sex with men from 2006 to 2009.

“We are very concerned about this trend for this group and as they age in the future,” said CDC Director Thomas Frieden. Of the 1.2 million people infected with HIV in the U.S., more than 500,000 are black, according to the Kaiser Family Foundation. (KHN is a program of the foundation).

The new numbers, which are published in PLoS One, are able to dissect the spread of HIV across race and gender better than previous data. This multi-year estimate is the first time that the CDC used information from a new test that distinguishes between long-standing or recent infections.

 “While we are glad that number [of new infections per year] is not increasing … the number of HIV infections remains far too high,” Frieden said during a telephone briefing today. According to the study, “the largest number of new HIV infections was among white men who have sex with men.”

In a fact sheet, the CDC seemed pessimistic about the future: “The current level of HIV incidence in the United States is likely not sustainable. Prevention efforts in recent years have successfully averted significant increases in new HIV infections, despite the growing number of people living with HIV and AIDS who are able to transmit the virus. However, an analysis by CDC and Johns Hopkins University researchers indicates that the growing population of people with HIV and AIDS will lead to significant increases in new HIV infections if current prevention efforts are not intensified.“

In June, the CDC launched a five-year, targeted-prevention program called “High Impact Prevention,” that will distribute $358.8 million to state and local health departments in just the first year. This month, states and localities are applying for the funding, but each state’s health department will get at least $750,000 to help fund prevention activities.

“We are overhauling how we give out money to states and localities to make sure that we are giving money to where it’s needed most for the populations groups that need it most, for the interventions that are most effective, particularly things like testing linkage to care, availability of low cost simple effective preventions such as condoms,” Frieden said.

Carl Schmid, deputy executive director for the AIDS Institute, a Washington-based national advocacy group, says it’s about time more money gets allocated to prevention. “It’s cost effective,” he said. “It costs a lot more to treat someone who has HIV than it does to prevent the case. … That’s the argument we are using on The Hill.”

Schmid says that consistently, the U.S. allocated only 4 percent of its HIV/AIDS spending on prevention. In May, Schmid testified before Congress, saying, “Preventing all the new 56,000 cases in just one year would [save] an astounding $20 billion in lifetime medical costs.”

One Response to “The Good, The Bad, And The Costly News On HIV”

  1. CSuite says:

    I believe this has a great deal to do with a combination of socio-economic and cultural factors. It’s controversial, so observers with have a proclivity towards disagreement; even if, privately, they agree.
    (To start, I point to an OKCupid research study that outlines the dynamics of communications among members of online dating sites; additionally, one should keep in mind the various other Q Marketing, trend analyses, and consumer sentiment survey/research.)

    - Blacks are considered among the least attractive groups of people in the United States; ranking among Native American/Alaskan native groups, in terms of messages sent/replied, length of conversation, and the general approach one takes to a member of this group. Note, also, impression-based research, such as Harvard’s “Project Implicit”, where images of black men are regularly associated with lower “positive feelings” among participants.
    - Black men, as it’s widely understood, face higher rates of incarceration; where, once incarcerated, face the greatest likelihood of male-male sexual intercourse, whether due to rape or other factors. Likely a phenomenon based on power, while just as likely attributable to a “what happens in Vegas…” mentality to the emotional/sexual needs men have.
    – Paralleling this, among prison populations exist a high concentration of men with HIV-AIDS, whether known or not. An exacerbating factor involves the culture of shame that underpins the degree individuals remain silent or avoid screening/treatment, for fear that “the community” will cast them as weak (which, in “cultures of poverty” [see wiki on this social-psychological phenomenon] is a scarlet letter, putting one at risk for violence)
    - This mentality follows one outside of prison, where opportunities for employment and social mobility are greatly reduced (due to a great number of factors, among which includes the sentiment that blacks are not capable of completing higher-level work).
    - Women prefer men who have jobs; for a variety of important reasons. Additionally, the more advanced the education, the greater the expectations for future suitors. The opposite is true, as well; where the less advanced the education, or self-esteem, the lower the expectations in future suitors – all based upon one’s sense of self worth and the degree to which a partner shares their social/economic/human capital.
    - Men, out of prison and unable to find work, have difficulty attracting higher-earning women – who tend to relocate from urban (largely minority) areas – increasing the concentration of low-income individuals in a community.
    – With a higher population of lower-income women, less likely to question the “capital” underpinning advances, men with HIV/AIDS transmit the disease among the women of these communities.
    – More importantly, it’s important to note the cost and risk of dating/relationships; where partners often have differing/competing/paralleling priorities. Men, who often want sex more often/readily than women, must find ways to cope with the urges.
    - A few minutes on craigslist, one can see how many/often “straight” individuals seek out “quickies” from other men – again, citing the “what happens in Vegas” mentality that exists among individuals wishing to keep a mutually impactful secret.
    - Ultimately, men are willing to set aside preferences in women to satisfy a largely visceral urge to copulate, by engaging in sexual actions with other men who have similarly visceral urges.

    In other words, though attracted to women, men find that the barrier to sex is a great deal less, with other men, than with women – where the risks associated with dating women (loss of income, likelihood of impregnation, likelihood of diseases) is reconcilable with the risks with dating other men (likelihood of catching diseases) when the end desire is sex.