Question of the Week

December 1, 2003

What do you know about AIDS? Why (and how) do you know as much as you do? Why don't you know more, or less?

"A doctor from Afghanistan stunned a conference on AIDS this month by revealing that he didn't know what the symptoms of the disease were. Dr. Baz Mohammad Shirzad's statement underscored a lack of awareness in many parts of Asia -- even among health professionals -- that experts say is still undermining the global war on AIDS, 15 years after the first World AIDS Day galvanized the planet. In a small step to reduce the ignorance ahead of World AIDS Day 2003 on Monday, U.N. and Thai officials brought 11 doctors and field workers here from Afghanistan, Sri Lanka and East Timor -- the kind of areas of recent conflict that experts say are particularly vulnerable to the virus.... 'Thailand is the only country that has had clear success,' said Hakan Bjorkman, deputy resident representative of the United Nations Development Program. 'This is why Thailand has so much to offer other countries.'"

Why do people need information? What will it take to get them the information they need?

"Health workers hit the streets of China's capital Monday, marking World AIDS Day by teaching prevention in a country whose leaders have promised an aggressive fight against the disease -- and a new openness learned during the battle against SARS. The government has been sluggish for years about disclosing the extent of AIDS here, or broaching the topic in the media. But the harsh international response after the government's initial secrecy during the outbreak of severe acute respiratory syndrome this year has apparently prompted more openness. State-run newspapers were filled with articles on AIDS, and the government's national midday newscast highlighted the event."

How can knowledge help to slow the spread of AIDS? What do people need to know?

"Currently, the greatest problem confronting the people of Swaziland is the HIV/AIDS pandemic. In 2002, the HIV/AIDS infection rate of adults (ages 15 to 49) was 33.4 percent, and approximately 35,000 children have been orphaned as a result of AIDS."

What do you know about AIDS as an international problem? What do you know about what AIDS is doing in the United States? What do you need to know? China? Swaziland? Thailand? Afghanistan? What does that have to do with high school and college life for your typical teen from the United States?

"HIV infection leading to AIDS has been a major cause of illness and death among children, teens, and young adults worldwide. Nationally, AIDS has been the sixth leading cause of death in the United States among 15- to 24-year-olds since 1991. In recent years, AIDS infection rates have been increasing rapidly among teens and young adults. Half of all new HIV infections in the United States occur in people under 25 years of age; thousands of teens in the United States become infected each year. According to the Centers for Disease Control and Prevention (CDC), the majority of new HIV cases in younger people are transmitted through unprotected sex; one third of these cases are from injection drug usage - the sharing of dirty, blood-contaminated needles."

If half of all new cases affect those under the age of 25, then what about the other half?

"Older people are at increasing risk for HIV/AIDS and other STDs. About 10% of all people diagnosed with AIDS in the United States´┐Żsome 75,000 Americans´┐Żare age 50 and older. Because older people don't get tested for HIV/AIDS on a regular basis, there may be even more cases than we know. Many factors contribute to the increasing risk of infection in older people. In general, older Americans know less about HIV/AIDS and STDs than younger age groups because the elderly have been neglected by those responsible for education and prevention messages. In addition, older people are less likely than younger people to talk about their sex lives or drug use with their doctors, and doctors don't tend to ask their older patients about sex or drug use. Finally, older people often mistake the symptoms of HIV/AIDS for the aches and pains of normal aging, so they are less likely to get tested."

Those over 50 and those under the age of 25 tend to have their differences. Different lifestyles, different ways of viewing the world, and different needs when it comes to AIDS education. Age is not the only issue making a one-size-fits-all education program impractical.

"The United States has a large and growing Hispanic population that is heavily affected by the HIV/AIDS epidemic. In 2000, Hispanics represented 13% of the U.S. population (including residents of Puerto Rico), but accounted for 19% of the total number of new U.S. AIDS cases reported that year (8,173 of 42,156 cases). The AIDS incidence rate per 100,000 population (the number of new cases of a disease that occur during a specific time period) among Hispanics in 2000 was 22.5, more than 3 times the rate for whites (6.6), but lower than the rate for African Americans (58.1)."

In some cases, different cultures (locally and internationally) have communication styles that affect how (if at all) information is spread.

"Also, many sufferers hide that they are sick because of the social stigma attached to having a disease that many in China deem is caused by
'immoral' behavior, the U.N. agency said in a report released Monday....Cambodia marked World AIDS Day on Monday with calls to fight the stigma of the disease, which keeps many people with HIV -- the virus that causes AIDS -- from seeking treatment to prolong their lives."

Last year for World AIDS Day, the Question of the Week asked:
"Why is there more of a stigma associated with HIV/AIDS than with other contagious diseases? What could this generation do to help the next generation have more of a rational understanding of the disease and less fear of the people who carry it?"

So what's next? What can this generation do to help the next?

"March 24, 2003 --U of T researchers are heading an international collaboration to develop innovative strategies for educating youth about
HIV/AIDS prevention. Called Gendering Adolescent AIDS Prevention (GAAP), the project involves young people in participatory research designed to tailor prevention messages to the different social and political contexts faced by youth around the globe....'HIV rates are rising in youth -- and particularly in girls -- and we see youth as the best resource for changing the course of what's become a worldwide epidemic,' said June Larkin, GAAP's principal investigator and a lecturer in the Institute for Women's Studies and Gender Studies at U of T. She noted girls may be particularly at risk for HIV infection because of both biological and social factors."

What groups do you consider yourself to be a member of? Cultural groups? Age groups? Gender groups? Other groups?

Questions of the Week:
What do people need to know about AIDS? Keeping in mind that each individual person cannot have their own private information presentation, how could this information be presented in a way that could reach the most people? How should this information be presented differently to different groups? How would you present the information to groups with which you are familiar?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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