Wednesday, September 06, 2006

Where the epidemic is now

CDC Prevention News cites the following research study:

"Epidemiology of HIV and AIDS Among Adolescents and Young Adults in the United States" Journal of Adolescent Health Vol. 39; No. 2: P. 156-163 (08..06):: MarĂ­a C. Rangel, MD, PhD; Loretta Gavin, MPH, PhD: Christie Reed, MD, MPH, FAAP; Mary G. Fowler, MD; Lisa M. Lee, PhD

The study's conclusion:
National case surveillance data for people ages 13-24 revealed that the burden of HIV/AIDS falls most heavily on the Southern region of the country and disproportionately on black and Hispanic youth, the study found. "The observed increases in the number of HIV cases among men who have sex with men are congruent with recent reports that suggest a resurgence of HIV among these young men," the authors noted. "Our findings highlight the need for intensified HIV prevention efforts within minority communities and among men who have sex with men as well as strengthened efforts to encourage at-risk youth to get tested for
HIV," the researchers concluded.

The epidemic is now hitting young people, especially young men who have sex with men, especially black and hispanic youth. Trends show a decline in reported HIV cases among women. In some ways, there might be a tendency to say "we're back where we started." I, however, am thinking that the whole thing is rather like whack-a-mole. You hit it here, and it pops up there. Without a comprehensive approach to prevention, one that goes beyond "just say no," any strong emphasis on one demographic group may lead another group to think that it is not at risk.

Maybe we shouldn't talk about where the epidemic is now, but emphasize that the epidemic shifts. It gains a foothold in one social network and spreads there; awareness and prevention may reduce or eliminate (we can wish) the infection rate in that community, but the virus can easily spread to another where individuals have been less vigilent. Just a thought.

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