CDC Underestimates US HIV Cases by 40%

by Randy on August 4, 2008 · Comments

Somehow the huge increase has always been there and not known so that equals the same old same old just more of it … right? I love spin doctors (emphasis mine): More thoughts after the jump.

The improved science will allow more real-time monitoring of HIV infections. Now, CDC officials say, the estimate will likely be updated every year.

Yearly estimates allow better recognition of trends in the U.S. epidemic. For example, the new report found that infections are falling among heterosexuals and injection drug users.

Some experts celebrated that finding, saying it’s a tribute to prevention efforts, including nearly 200 syringe exchange programs now operating in 36 states despite a federal ban on funding for such projects.

But they also lamented the CDC’s finding that infections continue to increase in gay and bisexual men, who accounted for more than half of HIV infections in 2006. Also, more than a third of those with HIV are younger than 30.

Some advocates say that suggests a need for more prevention efforts, particularly targeting younger gay and bisexual men.

For years, AIDS was considered a terrifying death sentence, and since 1981, more than half a million Americans have died. But medicines that became available in the 1990s turned it into a manageable chronic condition for many Americans, and attention shifted to Africa and other parts of the world.

[From CDC Underestimates Number Of US HIV Cases | 365 Gay News hat tip: Joe.My.God (gay blog)]

The article goes on to state:

But some advocates complain that CDC’s annual spending on HIV prevention in the United States has been held to roughly $700 million since 2001, while costs have risen. (That’s about 3 percent of what the federal government spends on AIDS; much of the rest is on medicines, health care and research.)

The new estimate is “evidence of a failure by government and society to do what it takes to control the epidemic,” said Julie Davids, executive director of the Community HIV/AIDS Mobilization Project.

A third of those living with HIV are under 30? 40% more than previously reported? 700 million dollars is only 3% of what is spent by the government on AIDS and people are saying that is a failure to control the epidemic?

Since when did it become the government’s duty to make sure we keep our pants on and take personal responsibility for our sexual activity?

The following is an honest question, not a rhetorical statement disguised with a question mark: Could it be that people are desensitized to the idea of being willing to live with a “chronic condition” and the federal government is enabling risky behavior by being there to clean up the mess?

I don’t blame the CDC. Science is science and technological advance is its own little monster/blessing. You can’t report what you don’t know and when you do know something to report … do it. Which they did.

This situations is just heart breaking and it is obvious that the answers, the *expensive* answers, aren’t doing a whole lot to change things.

Share on ...
  • Facebook
  • Google
  • TwitThis
  • Pownce
  • Print this article!
  • E-mail this story to a friend!
  • SphereIt
  • Digg
  • Technorati
  • Yahoo! Buzz

    Related posts (automatically generated)

Tagged as: , , , , , , , , , , , , , , , ,

Viewing 9 Comments

    • ^
    • v
    Bear with this, 'cause it's actually related ;)

    I'm at a very high risk for skin cancer because I have extremely fair skin that cannot tan (it comes with red hair, I've lived in LA my entire life and have never gotten a tan). Consequently I do everything that I can to avoid getting sunburnt. My best friend is a blonde-haired, blue-eyed Swede, with very light skin that can tan a little. She is in about the same place as me as far as risk of skin-damage from the sun, as well as having one more risk-factor for skin cancer than I have because she has moles, and I don't.

    She has grown up watching me protect my skin from the sun via sunscreen, hats, long sleeves in August, etc, and knows all of the risks that sun-exposure brings for her as well as me. However, she chooses to go without sun protection, and to purposefully go tanning. I'm always shocked every time she refuses my offer of sunscreen, or tells me she's going to lay out in her backyard, and then says, "sure, I'll probably get skin cancer someday, but by that time they'll have found the cure, and it'll be no big deal." Her perfect tan now is worth more than actually considering the problems she'll face later.

    That sentiment basically sums up what people my age think about most medical issues: 'There's not a problem right now because we're too young to get that disease/condition, and when/if it is a problem 'they' will have come up with a cure, so it won't be a big deal.' I think we can see that played out in teen and twenty-something sex issues. It's pretty obvious that it is possible for sexually mature women/girls to get pregnant, so young straight couples use protection for 'traditional' intercourse, and then skip the condoms for anything that doesn't incur a pregnancy risk (search for the articles 'oral is normal' and 'a** backwards' in Slate if you're interested in the statistics). And of course, young gay couples don't have a pregnancy risk at all. And what's going through everyone's mind is, 'we're too young to have STDs so we can do what we want, and when/if they are an issue, 'they' will have come up with a cure.'

    Which basically means that a lot of people between the ages of, say, 15-22, will do some pretty stupid thngs health-wise because they're overly optimistic about their own immunity, and the likelihood of there being solutions when the risks they've taken finally catch up with them.
    • ^
    • v
    "Since when did it become the government’s duty to make sure we keep our pants on and take personal responsibility for our sexual activity?"
    I whole-heartedly agree with you. There is a rampant attitude of personal irresponsibility in our country. I hear [it] when I go out on my patio and have to hear several neighbors [three-five houses away] who are playing music, beyond normal limits outside, with no respect for themselves, much less for others; I see [it] in traffic when people ride a lane that everyone knows is going to run out, suddenly cuts off an oncoming driver by forcing their way in ... all done under 3-mph.
    And the same attitude is carried into the sexual arena as well. There are subgroups in within the gay culture that have tens of thousands of members to websites, clubs (cyber and real) that promote sexual activity that has no[sexual] boundaries... except the wearing of cologne! And when others [within the gay culture] know and see these groups and think "I can do what I do because I don't go that far' or "I'm not that extreme" or "I'm going to die [with HIV] anyway, I might as well do all I can before I'm gone", they deny their personal responsibility to themselves and to others . It seems with all the freedom that the gay culture has obtained in the last 30 years, that increased wisdom, maturity and personal responsibility should have been gained.
    • ^
    • v
    I wonder the same thing myself and I'm not sure I've come up with answer yet. The tension between the need for personal responsibility and for systematic support is tough.

    On one hand, it seems so easy to just "keep our pants on;" on the other hand, years, decades, and sometimes centuries of tradition bear down upon us. I'm not certain we can easily dismiss the effects of racism, sexism, homophobia, and sexual repression when dealing with issues.

    Yes, black fathers should not abandon their families, but slave owners forced that model for centuries.

    Yes, children should graduate college and get a job, but often times impoverished children have never seen that model, nor been told that financial independence is something they can dream for.

    Yes, gay men should take their relationships and sex lives seriously, but they've been told that they are incapable of commitment, a prevision, and disgusting and so sadly, some act accordingly.

    What is encouraging is that when we identify the systems that bear down upon us and make an effort as a society to address them, we can empower individuals to take personal responsibility upon themselves. I'm not exactly sure how government programs and personal responsibility interact but my mom used to be a social worker in Maryland and I saw the positive impact those programs had on the lives of young women and abused children and so I think that there is a way for us to help those who feel helpless.
    • ^
    • v
    @Brian - @Greg P. - @Ellie -

    Great thoughts everyone. I kind of would like to see you all respond to each other. I think it would be a great dialog. For now, your analogy is pretty good Ellie and I had not considered the "they" will find a cure factor. I guess that would fit in with the consumer mindset we (as a culture) tend to have toward life in general.

    Greg I agree with your overall feeling of disrespect and complete lack of personal responsibility. I don't know what I could add to what you summed up very well.

    Brian... I just think that is a lot of deflection. In this day and age it is indulgent to justify irresponsible behavior on some nebulous allegedly oppressive group. When I identified as gay, I went through and created a lot of drama. But I also knew I was responsible to behave appropriately and eventually I started to get help (pro-gay and gay 12 step support groups) and started making amends and learn better social skills before I ever came to Christ. Around 20 years later, there is no reason for young gay identified (or old for that matter) men, today, to shirk personal responsibility in the name of an unproven pattern of effects caused by perceived/real "oppression".

    Just my humble opinion ;-)
    • ^
    • v
    @Randy -

    I think we're saying the same thing. We see need for personal responsibility but we also see a need for outside help. Sometimes that help comes in the form of local 12-step programs. Sometimes the problem is prevalent on such a large scale that small, local organizations cannot adequately address it. Sometimes governments are uniquely suited to address problems, epidemics are one of those times. We ask the government to help us deal with smallpox, avian flu, and a host of other diseases. We even help nations in Africa deal with HIV. The government can help Americans stave off HIV.

    We could simply say "don't commit crimes" but the government gives organizations such as Breakpoint funding to help convicts become ex-cons and tries to provide secular options as well. Do I think it is solely the government's responsibility to stop individuals from committing crimes? Of course not, but they can help.

    Do I think it is the sole responsibility of the CDC to eradicate HIV? Of course not. But the government can help people of all stripes--gay men, Hispanic women, elderly singles--stay safe.

    @Ellie -
    I see where you're coming from but I'm not sure it's exactly the same. Your friend is fully aware of the risks but she's choosing to ignore them and is fully conscious of her decision-making. I agree, there are some young people brazen enough to say of HIV "even if I get it, there will be a cure by the time it's a problem." However, it's not always the case. There are some straight couples that think HIV is a gay disease. There are others that only think to worry about pregnancy and not STDs. There are gay men trying desperately to be suppress their same-sex attractions who loose control of their bottled emotions and engage in unsafe activities. There are still other gay men who seek out risky behavior as a form of self-punishment for their supposedly perverse and sinful attractions. There are straight men oversees who have been told that having sex with a virgin will cure them of HIV. There are boyfriends of ex-girlfriends of drug users. There's a whole host of times in which personal responsibility, while necessary, must be supported by social action.

    @Greg P. -
    I'm intrigued by your reflection that some young gay men think
    “I’m going to die [with HIV] anyway, I might as well do all I can before I’m gone”

    I agree that happens sometimes. People may also think, perhaps subconsciously, "I can't ever hold down a relationship, why try," "My parents don't love me, how could anyone."

    As a Christian, I feel called to counter these destructive messages. "HIV is not synonymous with homosexuality." "Look around at the endless happy, stable, and productive gay couples around the world." "God loves you more than any human ever could." These are the messages I hope other Christians are shouting loudly at every oppurtunity.

    The government can also help. During health education classes. teachers can emphasize that STDs are not inherent in being gay but are the cause of personal decisions. Unfortunately, some Christian groups advocate against addressing homosexuality in classrooms. Do gay men think they way you've described because we've taught them to think that way?

    How many young people have that thought you because a teacher never said "No, you're not!"?

    @Randy -
    How's that for starting a dialouge? ;)
    • ^
    • v
    Brian

    I was kind of directly addressing the idea of young people in America(the 'under 30' of the study, but high schoolers and/or young college students specifically) and one particular factor that I think influences a lot of poor decision making. I'm not trying to paint that as the one and only reason anyone anywhere ever gets HIV.

    But I think it's a factor for people between the ages of maybe 15 and 22. Basically, we know that people that age (myself included), especially the teenagers, do not have a very strong grip on concepts like their own mortality or how long it will really be before they are 'old' (like, 35 or 40, say). So they are much more likely to make risky decisions like driving too fast to show off for friends, or having unprotected sex, or doing too much tanning. It's much easier for them to write off the risk than it is for someone older. (There was actually a study that came out last year where researchers asked teens whether they would allow their own hair to be lit on fire. Most of the teens had trouble deciding if that would be a bad idea or not! Plus, I'm sure, having been a male teenage driver, that you know which age/gender bracket has to pay the most for car insurance and why.)

    What I think is most significant about the example with my friend is that I know, for a positive fact, that she is a very smart girl. I know for a positive fact that she understands the risks that suntanning poses to her health (I've actually heard her explain it to other people, when they ask why I dress so funny). And yet she chooses to do it, and writes off the risk with the statement, "well, I know I'll probably get skin cancer someday, but by the time that happens they'll have come up with a cure." That's not a vague summary of what she's said to me, she has actually said basically those exact words to me, more than once.

    I think you see very similar calculations being carried out by teens/twenty-somethings when it comes to sex, although not so baldfaced. There are ideas like 'well we're too young to have an STD' running through kids heads, so STDs are not what anyone's worried about. Straight couples can't get around the fact that it's possible for the girl to get pregnant, so vaginal intercourse demands a condom, but for many teens it's now avoided in favor of intercourse that doesn't carry a pregnancy risk and therefore doesn't need a condom (again, those articles I mentioned in my first post include or lead to a lot of stats on that subject). Gay teens don't even have to make the pregnancy calculation. So suddenly we have a bunch of kids willing to have unprotected sex because they aren't considering the likelihood of death and inconvenience from these diseases because they figure that the danger is down the road, or if they do get something, medical science will have come up with a solution by the time it's really a dangerous issue.
    • ^
    • v
    @Ellie -
    As a male former-teen driver, I'd like to go on record saying I only received one speeding ticket (it was a trap! and I was going with the flow of traffic! they pulled over every single car on the road in both directions, no seriously!) and was never in an accident! In fact, most of my teenage friends were better drivers than our parents. But I digress...

    I totally get where you're coming from, Ellie. I used to BRISTLE at AIDS-related fund raisers thinking, "They should have known better, I'd rather spend money helping others." Though, I'm not questioning that attitude. As an affluent, white, suburban teen who attended school in Montgomery County, Maryland, I was given comprehensive sex education--which included abstinence. We did reports on various types of birth control and safer-sex methods, STDs, etc.

    I then went to the University of Southern California which had multiple LGBT groups and counseling programs. RAs on every floor have a bucket of candy and condoms. I was educated and I had access (though, I was also not sexually active but... if I were, I could have protected myself).

    I took a Broadway musical class with my friend Jessica and the professor managed to work a lesson in by one of the Health Center staff (the tie-in was Rent). She went to Catholic school and had never been taught about this. Not condoms, not birth control pills, not different STDs and how you get them, not anything. Thankfully she wasn't sexually active, but imagine if she! She's a responsible person too.

    Another friend of mine went to Notre Dame, which unlike USC does not distribute condoms. She told me that many of her (straight) friends ended up having unprotected sex because they weren't planning on it, didn't have access to any, and were taught to keep such things secretive.

    A recent study found that over 90% of Americans 15-44 had premarital sex ... including individuals born in the '40s! It's not "kids these days" or "those type of people" that are having sex before marriage. Nearly everyone is. Should we teach kids to wait to have sex? Should we teach them how to be responsible with it? Absolutely.

    But what about Jessica and her school friends, we've sent them into the world without talking about. What about all of the kids at Notre Dame, we're not talking about it with them either. What about those in districts were health classes don't include a frank discussion of sex and sexual orientation?

    It is my hope that every child in Americas receives the quality education that I was blessed with but I know it's not the case today. There are young people in America who have HIV because they were taught to worry about pregnancy and thus went on the pill instead of using a condom. There are young people in America who were never told that it's OK to be gay and act out in shame and secrecy. There are young people in America who were simply never taught about HIV, the real risks, how to get it, and how to prevent.

    What do you propose we do with them?
    • ^
    • v
    Brian,

    If it makes you feel any better, I have not recieved any speeding tickets or been in any accidents, either. This is largely because I have never passed the behind-the-wheel test. The scary thing: I'm a much better driver than the average LA driver (I'm sure you know what I mean), so I'm really wondering how everyone else managed to pass. This is also why I'm a big fan of public transportation, even if it means raising sales tax to do it (I'm fiscally conservative, so it hurts just a little to say that).

    I think you're kind of missing the point of my example. My friend and I are both super well educated on the topic of skin cancer. If we were talking safe sex, her sun exposure practices are equivalent to somebody who had your school's sex-ed course deciding to have casual, unprotected sex whenever they wanted. I, on the other hand, would be waiting until marriage, and still using condoms after the fact (unfortunately, I will never get to stop using sun screen, and I'm trying to be true to the analogy). So how come I made the wise choice, and she made the totally foolish one? She's not significantly less smart than I am. We both scored well enough on the PSAT to qualify for the National Merit contest, we both got good scholarships to good schools. We both are very well educated.

    You might say that she is an isolated case, and most people like us would make the right decision regarding safer sex as long as they have effective sex-ed. But in point of fact, people like us make the decision to have unprotected sex all the time. In the HIV/AIDS edition of JAMA (Vol. 300 No. 5, August 6th 2008) where the CDC study Randy is quoting was published, there's an editorial called "A Person of Status" written by a young black female physician. By being a young, black female she is in one of the highest risk categories for HIV infection, and yet she'd only been tested for HIV once, years ago in med school in response to an accidental needle stick. But since then she had put herself at risk for HIV, which presumably means that she had unprotected sex. And to compound this fact, even though she often exhorts patients, especially high risk patients, to get themselves tested, she hasn't been tested since med school (the rest of the article is about how she does get herself tested again, and her experience with that process). This is a doctor; she knows all about STDs and protection, not from sex-ed but from med school. And yet she's having unprotected sex. And a whole lot of other well educated people choose to have unprotected sex, all the time, even though they are fully informed about what they are risking.

    You seem to be calling for more widespread sex-ed. I'll admit that this would probably result in slightly lower new-infection rates, because the highest increases in the CDC studies are among young black males and usually if something that isn't obviously genetically determined hits the black population harder it is a good bet that it's because there is a lack of education on the subject; eg, more black men die of prostate cancer, largely because they don't get screened as often as white men, and more black people die of drowning, largely because less can afford swim lessons as children.

    So if people who are clearly smart and well educated and who have recieved sex-ed training choose to have unprotected sex, then what about people who are less smart, and less well educated? I'm sure you've seen the amount of college students who have never quite figured out who George Washington was, or which continent the U.S. is on. Do you really think they'll absorb the lessons of comprehensive sex-ed any better?

    I also have a question about the 'recent study' you quoted as saying that 90% of Americans aged 15-44 have had premarital sex, including those born in the '40s. By my calculations, and assuming that you're considering something published in 2003 as recent, the people in the 44 to 15 age bracket would have been born between 1959 and 1988 (my birth year). In order for this study to have included 44 year olds born in 1949, it would have to have been recent circa 1993 (when you were what, 7?). So, what study are you quoting?
    • ^
    • v
    I should also add that I think this is a problem that is much broader than just HIV infections. There are many other STDs which lead to many other problems, most of which enjoy much, much high rates of infection within the adult U.S. population. And heterosexual sex has been known to lead to pregnancy. A teenage pregnancy can be incredibly devastating to not one but two lives.

    But how to fix the problem? I have some ideas, but I doubt you'd agree with them. And besides, it'd probably be good if people could decide on the underlying problems first.
 

Trackbacks

(Trackback URL)

close Reblog this comment
Powered by Disqus · Learn more
blog comments powered by Disqus

Previous post: Good Writing Day

Next post: Aliens in Creation - Just Go Play Outside