The U.S. HIV epidemic continues to evolve with
increased diagnoses being reported in cities and states
where HIV is traditionally has been more common. Earlier
this month, officials at the Idaho Department of Health
and Welfare announced that the number of HIV infections
in their state have increased by 23 percent since last
year. Over a dozen of those newly diagnosed were under
25 years of age.
The
news from Idaho comes months after a worrying
report from Iowa, which recorded the highest number
of HIV diagnoses since 1998, when the State began HIV
reporting. Each of these state’s public health leaders
responded to these increases by encouraging residents to
get tested for HIV.
These reports from America’s heartland underscore the
need for continued attention to the HIV epidemic in
traditionally low-incidence areas. With new HIV
incidence data now available, we have one of the
clearest pictures of the HIV epidemic to date. In
settings with a small number of HIV cases, state and
local programs need the tools necessary to address their
HIV epidemic.
In low-incidence states, general and targeted HIV
education and awareness programs are needed to promote
early diagnosis -- See Idaho’s
The Naked Truth
campaign as an example. Consistent provider education
and mobilization efforts are also needed to increase
physician awareness and the screening of patients.
Finally, robust disease surveillance systems are
essential for accurate diagnosis and reporting of
disease.
Opportunities for integrating prevention approaches
(HIV, STD, and Hepatitis prevention and family planning
services) towards better sexual health may also enable
public health departments and health care providers to
make available more efficient and holistic service.
So I ask you to share your ideas on how we can work
address the HIV epidemics and other syndemics in
low-incidence states such as Idaho and Iowa given
available resources? How can communities assist states
and rural areas with their HIV prevention and program
integration activities?
Submit a comment -
Comment Policy
Dr. Fenton,
What is CDC's definition of preventing?
My definition is similar to the one offered by
the Merriam-Webster dictionary:
1 a: to be in readiness for, b: to meet or
satisfy in advance, c: to act ahead of, d: to go
or arrive before;
2: to deprive of power or hope of acting or
succeeding;
3: to keep from happening or existing;
4: to hold or keep back.
This is why reading, "In low-incidence states,
general and targeted HIV education and awareness
programs are needed to promote early diagnosis "
in Dr. Fenton's blog concerns me.
For the last several years, CDC has placed a
huge emphasis on secondary prevention: routine,
opt-out, pretest counseling free screening with
the hopes of identifying as many new positives
as possible. I do not have an issue with
identifying those who are infected and ensuring
they receive appropriate medical care. I do take
issue with using HIV prevention dollars to
achieve these goals to the detriment of being
able to fund services designed to actually
prevent the disease from being transmitted in
the first place.
In our current period of flat funding, HIV
prevention dollars should be focused on primary
prevention through targeted HIV education and
awareness programs that promote reducing each
person's risk of acquiring the infection.
I would like to see CDC do more to encourage the
use of HIV prevention funding for the purpose of
Health Education/Risk Reduction and Health
Communication/Public Information activities.
April Ivey
South Dakota
Received from April Ivey, on Tuesday,
November 4,
2008 at 10:34 am ET
Comment
Dr. Fenton,
I couldn’t agree more with our colleague about
the need for primary prevention of HIV,
including enhanced efforts with youth.
Let’s remember history and let’s also look
toward the future. It’s partnerships. From
1988-1996, CDC had a consistent focus on primary
prevention. With a large number of partners from
different sectors- for-profit, non-for-profit,
government, faith based groups and others-there
was a symphony of programs and messages through
multiple channels for primary prevention. As a
CDC leader in partnership development during
that time, I found that trusted partners could
get programs out better-and faster- than the
government. The vast networks of CDC’s
partnerships created synergies- leveraging of
resources, utilizing networks and expanding our
reach, beyond limited government funding.
Since that time, some people, including some
politicians, may have forgotten CDC’s mission
and focus as the Nation’s prevention agency, in
HIV as well as other areas. Over the last few
years, flat Congressional funding for HIV/AIDS
has been utlized to address a wide variety of
new treatment issues, new testing technologies
and better incidence measures. Now, is the time
to refocus the efforts in prevention. We should
remember that Treatment is NOT Primary
Prevention; it’s secondary and tertiary
prevention.
Prevention is Prevention. Primary prevention is
the most cost effective way to address any
public health issue, and HIV/AIDS is no
exception.
Now is the time to refocus efforts on primary
prevention through social networks with broad
based partners who are needed to reinforce CDC’s
primary prevention efforts.
In a time of constrained government funding and
harder economic times, the future of primary
prevention of success in combating AIDS is
engagement of broad partnerships from a wide
variety of sectors. Now, social media,
partnership networks with speedy internet
connections, tools that work, and old fashioned
relationship building can be utilized for
primary prevention for no new cases of HIV/AIDS.
How can we best help you address CDC’s mission
in primary prevention? It’s a new day, and we
need to find our way back to primary prevention.
Thank you for the opportunity to address the
need for renewed efforts for primary prevention
of HIV/AIDS.
Margaret Scarlett,
President, Scarlett Consulting International an
8 (a) company
Received from Margaret Scarlett, on Tuesday,
November 4,
2008 at 1:02 pm ET
Comment
