December 1 is World AIDS Day
Stop me if you’ve heard this one.
Perhaps nowhere is the mystery of human behavior more puzzling than in the unfolding of the HIV/AIDS pandemic. Here, we have a life-threatening illness for which we have no cure or medical vaccine. It is preventable, yet for the past twenty years it has continued to spread worldwide. There is no end in sight.
The statistics are hard to fathom. Over 5 million people were newly infected with HIV in 2004. That amounts to about 570 infections per hour. Particularly worrying is the fact that over half of all new HIV infections worldwide are now appearing in young people between the ages of 15 and 24. Each day 6,000 young people are diagnosed with AIDS.
Over 20 million people have died of AIDS complications since the beginning of the epidemic. Each illness and death affects countless others, resulting in financial hardship, families without a breadwinner, children without parents, intensely personal loss, and heartache.
Early in the pandemic, Thailand distinguished itself by providing a model for successfully fighting the disease. Then Prime Minister Anand Panyarachun, Senator Mechai Viravaidya, and other courageous Thai leaders are generally credited with stabilizing, and then reversing an alarming trend in new HIV infections.
One key element of Thailand’s effective response to HIV/AIDS was to initiate a massive public education campaign. A 100% condom program was launched with the support of the Kingdom’s existing health infrastructure. Rather than attempting to suppress Thailand’s commercial sex industry, authorities wisely chose to aggressively promote condom use among sex workers and their clients. After reaching a peak of 143,000 new HIV infections in 1991, the number fell steadily to about 21,000 in 2003.
Despite these early successes, there are worrying signs on the horizon. The United Nations Development Program has reported that HIV continues to spread among diverse groups within Thai society, posing new challenges for detection and prevention efforts. About 600,000 people nationwide are now living with HIV, and they require care and support. HIV/AIDS is a major killer among young adults.
Experts warn that prevention efforts have not kept pace with the rapid changes that have occurred in the epidemic. Public concern has diminished, as AIDS spending has failed to keep up with the growing threat. Public education and awareness campaigns are on the decline. Today we hear more about the threat of a bird flu epidemic, which has yet to materialize in human populations, than we do about HIV/AIDS.
Like many modern health problems, HIV infection is produced by certain modifiable behavior. The most common method of transmission is through unprotected sexual intercourse with a partner who is HIV+. Another way is by sharing needles or other contaminated injection or skin-piercing equipment with others who are HIV+.
HIV can also be transmitted through blood and blood products, for example, through infected blood transfusions. An infected mother can also transmit the virus to her child in the womb or during delivery, and through breastfeeding. In all of these cases, transmission can be easily prevented. Through effective prevention we could eradicate the disease within a generation.
If we know how to prevent HIV infections, why does the epidemic continue to grow? Why are certain groups of people so poorly informed about the risks and methods of avoiding HIV infection? Why do educators resist making comprehensive sex education an urgent priority? Why do knowledgeable individuals nevertheless engage in risky behavior? Why do we place a stigma upon those who are living with HIV? Why do we permit discrimination against such people?
It would seem that finding solutions to these issues would be considerably less problematic than building a bridge from California to Hawaii, whether two lanes or four.
While strolling along a California beach, a psychologist stumbles upon an antique lamp. He picks it up, rubs it, and out of a plume of smoke, there appears a genie.
The genie says, “Because you have released me, out of gratitude, I will grant you one wish.”
The psychologist thinks for a moment, and then replies, "I've always wanted to go to Hawaii, but I hate to fly, and I get seasick on ships. Would you build me a bridge to Hawaii so that I can drive there to visit?"
The genie grimaces and says, "Are you kidding? Think of the logistics! How would the supports ever reach the bottom of the Pacific Ocean? Think of the concrete, the steel, the shipping hazards. I’m sorry, but I can’t do that. Please think of another wish."
“OK,” says the psychologist. “Forget about the bridge. Just answer some questions concerning my patients. Why do some of my patients continue to smoke cigarettes and eat in ways that severely compromise their health? Why do they engage in risky behavior and maintain unhealthy lifestyles, knowing that they significantly increase their chance of resulting disability, illness, or premature death?”
Why do some of my patients do such things as sexually abuse their children, physically assault their wives, cheat, lie, and steal? In short, why do my patients think, act, and feel the way they do?
The genie thinks for a moment. Then with a sigh, he replies, “That bridge you wanted; would you prefer two lanes or four?”
Perhaps nowhere is the mystery of human behavior more puzzling than in the unfolding of the HIV/AIDS pandemic. Here, we have a life-threatening illness for which we have no cure or medical vaccine. It is preventable, yet for the past twenty years it has continued to spread worldwide. There is no end in sight.
The statistics are hard to fathom. Over 5 million people were newly infected with HIV in 2004. That amounts to about 570 infections per hour. Particularly worrying is the fact that over half of all new HIV infections worldwide are now appearing in young people between the ages of 15 and 24. Each day 6,000 young people are diagnosed with AIDS.
Over 20 million people have died of AIDS complications since the beginning of the epidemic. Each illness and death affects countless others, resulting in financial hardship, families without a breadwinner, children without parents, intensely personal loss, and heartache.
Early in the pandemic, Thailand distinguished itself by providing a model for successfully fighting the disease. Then Prime Minister Anand Panyarachun, Senator Mechai Viravaidya, and other courageous Thai leaders are generally credited with stabilizing, and then reversing an alarming trend in new HIV infections.
One key element of Thailand’s effective response to HIV/AIDS was to initiate a massive public education campaign. A 100% condom program was launched with the support of the Kingdom’s existing health infrastructure. Rather than attempting to suppress Thailand’s commercial sex industry, authorities wisely chose to aggressively promote condom use among sex workers and their clients. After reaching a peak of 143,000 new HIV infections in 1991, the number fell steadily to about 21,000 in 2003.
Despite these early successes, there are worrying signs on the horizon. The United Nations Development Program has reported that HIV continues to spread among diverse groups within Thai society, posing new challenges for detection and prevention efforts. About 600,000 people nationwide are now living with HIV, and they require care and support. HIV/AIDS is a major killer among young adults.
Experts warn that prevention efforts have not kept pace with the rapid changes that have occurred in the epidemic. Public concern has diminished, as AIDS spending has failed to keep up with the growing threat. Public education and awareness campaigns are on the decline. Today we hear more about the threat of a bird flu epidemic, which has yet to materialize in human populations, than we do about HIV/AIDS.
Like many modern health problems, HIV infection is produced by certain modifiable behavior. The most common method of transmission is through unprotected sexual intercourse with a partner who is HIV+. Another way is by sharing needles or other contaminated injection or skin-piercing equipment with others who are HIV+.
HIV can also be transmitted through blood and blood products, for example, through infected blood transfusions. An infected mother can also transmit the virus to her child in the womb or during delivery, and through breastfeeding. In all of these cases, transmission can be easily prevented. Through effective prevention we could eradicate the disease within a generation.
If we know how to prevent HIV infections, why does the epidemic continue to grow? Why are certain groups of people so poorly informed about the risks and methods of avoiding HIV infection? Why do educators resist making comprehensive sex education an urgent priority? Why do knowledgeable individuals nevertheless engage in risky behavior? Why do we place a stigma upon those who are living with HIV? Why do we permit discrimination against such people?
It would seem that finding solutions to these issues would be considerably less problematic than building a bridge from California to Hawaii, whether two lanes or four.
posted by Michael | Friday, November 25, 2005
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