Why HIV is Still Spreading in the USA

Alex Webb

The first approved drug for HIV/AIDS came out as early as 1987. Soon after, it was discovered the most effective treatment method is ‘combination therapy’, where the patient takes a “cocktail” of different drugs which prevents the HIV virus from weakening the patient’s immune system.

These drugs are called antiretrovirals, and there are currently over 20 available to fight the different strains of HIV; but advances in addressing HIV/AIDS don’t stop there.

People with HIV/AIDS are also being taught how to stay healthy and keep the disease under control. There is even brand new research in bone marrow transplants as a potential cure. On the prevention front, education programs have been established in schools, community centres, doctors’ offices, and the general media, Awareness and treatment successes are at an all-time high.

Yet, in 2010 there were an estimated 2.7 million new cases around the world. With all the progress the world has made with awareness and treatment, why is HIV/AIDS still so prevalent?

Antiretroviral Drugs for the treatment of HIVThe History of HIV/AIDS

When the disease first began spreading in the 1970s, contracting HIV/AIDS was an instant death sentence. No one even knew about the existence of the disease until doctors began to link unrelated deaths in the ‘70s. After its discovery, it was all over media – particularly in the US. Despite that, since the first cases diagnosed and publicized had all been cases involving homosexual Caucasian males, the majority of people felt they had no chance of being infected.

By the mid 80s, the main causes for transmission of the disease were more or less established as being needle sharing, sexual relations (not limited to homosexual ones), and mother-to-child transmission. Politicians and health professionals around the world saw clearly that they were dealing with an epidemic and many programs began to emerge to slow the transmission rate. However, the stereotype that AIDS was a “white gay man’s disease” prevailed amongst the public, and people outside that demographic remained unconcerned for themselves. Though less quickly after these advances, the disease continued to spread.

Flash Forward: Present-Day HIV Crisis

It is well known that in much of the world there is still a major lack of funding and social infrastructure to prevent the transmission and treat HIV/AIDS. A culture of multiple partnerships and a high incidence of rape in many areas of Africa contribute to its transmission as well. The difficulties in controlling the spread of the disease in developing countries are being tackled by governments, NGOs, and international bodies alike. In a country as developed as the US, however, the fact that the transmission rate has been all but stalled at around 8% for over 20 years is alarming.

Number of AIDS Cases by State

So What’s the Problem?

There are many reasons that are contributing to this continued epidemic. The “it won’t happen to me” thought process is still a major contributor to transmission. While there is a higher prevalence of the disease in Black, Hispanic, and homosexual communities, many people are misinformed in thinking that they are not at risk, especially when social stigmas lead people not to get tested (therefore are unaware they are positive), or not to disclose to potential partners that they have the disease. There are also cases where complacency about protection in relationships leads to transmission. These are all factors which involve those who are positive or at risk not taking the necessary steps to stop the transmission of the disease, but there are also factors at the governance level which are having an effect.

‘No-Sex’ Ed and Other Backfiring Rules and Laws

In many schools, sexual education courses do give extensive information on HIV/AIDS and other STDs, however the majority of them are mandated by their State or County to teach an abstinence-based curriculum for these courses, meaning there is no discussion on how these high-school students should protect themselves if they are having sex. They are not taught about being tested for STDs, the various ways they can protect themselves, or which ones are the most effective against HIV/AIDS.

These students are not being given vital information for protecting themselves when they do become sexually active – which often times is in high school. Even if they are waiting longer, there is not often another time when students are formally educated about sex before they become sexually active. This means there is very little chance that they ever will be given that information.

Another major of transmission which is not being properly addressed by the majority of governments is transmission through injection. In the 80s and 90s, there was a massive upsurge in the use of crack and injection drugs. Instead of dealing with the problem of addiction using social programs, the government implemented new laws which sent many more people to jail. This caused HIV to spread in numerous ways. First of all, the laws against carrying “drug equipment” meant people were ‘renting’ or borrowing needles to avoid being caught with their own. This meant that there could be tens of people using the same needle, and if just one of them was HIV positive, they could infect all those people, who would then bring the disease back to their partners, children, or other people.

HIV Transmission in the USA

The Effect on the Black Community

Part of the reason why there has been such an upsurge in the prevalence of the disease in Black Americans is also a result of this law. Many of the people being sent to jail on these drug charges were black men, which cause an imbalance between the number of men and women in the black community. This caused many women who wanted to have a relationship with a male from the Black community to put themselves at risk. They felt they needed to be more “flexible” about self-protection as their men had so many other ‘options’ in all the other single black women. There was also transmission amongst the men in prison. Many states refuse to provide condom there since they deny that the inmates have sexual contact, so having a few HIV-positive men in prison oftentimes caused many more men to contract the disease and spread it to their home communities when they did eventually get out.

A Call to Reason

Governments, doctors, and the public now have almost all the puzzle pieces to stop the transmission of HIV in developed countries – knowledge, treatment options, media interest, political concern, and funding. However, these pieces will never be put together into a proper solution if governments refuse to act based on outcomes rather than ideologies. Governments and institutions need to work together to give youth the proper information to be able to protect themselves, to make testing more available and less stigmatized, and to stand behind safe injection sites. The world can only hope the new generation of politicians and policy makers can learn from mistaken outcomes of past choices to craft legislation and develop these types of social and educational programs that can once and for all eliminate the epidemic here, so we can start to get a grasp on the epidemic in countries where most of these pieces are still missing.