Increasing HIV in Low Incidence Areas
October 27
2008
5:00pm ET
by Kevin
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
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