Why doesn't anybody care about HIV/AIDS in the US anymore?
June 22, 2006 6:57 AM   Subscribe

Why doesn't anybody care about HIV/AIDS in the US anymore?

Here in DC, the statistics are alarming:
1 out of 20 District residents is infected with HIV.
1 out of 50 District residents is already living with AIDS
I was told that if DC were a country, it would rank between the Congo and Rwanda in terms of HIV infection rates.

The media generally focuses on Africa when talking about HIV/AIDS.

But it's like the media and politicians don't care anymore? Why is that?
posted by onepapertiger to Health & Fitness (31 answers total)
Maybe because people with access to first-world medicine don't tend to die from AIDS nearly as often?

And that DC is not typical for the US in any way.
posted by smackfu at 7:10 AM on June 22, 2006

Best answer: I think we've been overloaded with information about it because of the AIDS scare, and as smackfu says, our access to medicine is much better.

At this point, we've heard how we have to protect ourselves a zillion times, and we all know the drill. I think we're desensitized from the media flood that came about in the late 80's and early 90's.
posted by twiggy at 7:14 AM on June 22, 2006

In your questions you say "anyone". In the inside, you say "the media".

"The media" does not equal "everyone".

There was over $20 billion of cheese production in 2001. Just because you didn't hear about it in the media doesn't mean people don't care about it. It takes more than a few people to generate $20 billion dollars worth of economic activity.

(Note to angry flamers: no, I am not comparing AIDS to cheese. The issue is correlating media coverage with the number of people who are actually involved with some activity. There's simply no correlation.)
posted by GuyZero at 7:18 AM on June 22, 2006

Keep in mind that DC has no representatives in Congress, so there's really no way to force them to deal with it.
posted by oaf at 7:19 AM on June 22, 2006

Because AIDS--unlike most cancers, diabetes and other serious and/or fatal illnesses--is totally preventable and thanks to the work of activists throughout the 80s, safer sex and needle exchanges have dramatically reduced the transmission rate of HIV. AIDS is not a health crisis in America the way heart disease is.
posted by gsh at 7:21 AM on June 22, 2006

This is an old chart, but here's why I don't talk about AIDS:

Goverment and nonprofit research spending per case and per death on AIDS far, far, far outstrips other, less "fashoinable" diseases.

According to this chart - which mind you only covers the National Cancer Institute, not government spending as a whole, for which these disparities are MUCH greater - lung cancer, from which more than 10 times as many people die each year than AIDS, recieves 1/10th the funding per death.

For a more isomorphic comparison, Non-Hodgkins Lymphoma has about the same fatality rate as AIDS and kills about the same number of people each year, yet recieves 1/4th the funding. From the National CANCER Institute.

Granted these issues more complicated than research funding/death ratios. That said, in my opinion AIDS gets more than its fair share of attention in the US as it is.
posted by ChasFile at 7:25 AM on June 22, 2006 [1 favorite]

Best answer: >But it's like the media and politicians don't care anymore? Why is that?

I would expect that, as wrong as it may be, since AIDS is virtually 100% preventable by not having sex unprotected with the infected and that the stigma attached to doing so is is not good, that it isn't a problem for the media / politicians, since they (LOL... well, they pretend) don't do that sort of thing so they'll never get it.

And, of course, again, it may be wrong, but a lot of people will look at someone with AIDS and immediately judge that promiscuity got them into that position, and that it's simply the "punishment" from some higher power that they got AIDS.

With those two surprisingly strong factors against it, coupled with the fact that if people were truly monogamous as it seems a huge majority of people wish everyone were there could be no AIDS epidemic.

So, basically, why bother with another piece that won't get the proper point across, but instead will ignite the majority bigoted people against the station?
posted by shepd at 7:26 AM on June 22, 2006

AIDS is still a very serious health crisis in the US and perhaps the media isn't focusing enough attention on the topic. But I have some doubts about that 1 in 20/50 statistic.

According to this page, DC's AIDS rate in 2004 was about 1 in 550 (which is about 10 times the national average).
posted by justkevin at 7:27 AM on June 22, 2006

I would echo the sentiments about not confusing media coverage with public effort. Here in Chicago, I believe we have about $15 million in publicly funded HIV/AIDS prevention programs alone, not to mention those that are funded through private non-profit activites. I don't know what we spend on treatment, but I bet it's a lot higher than that. Could we do more? Sure. But it's pretty clear that lots of people (including lots of health departments and lots of researchers and lots of caregivers and lots of patients, and yes, even lots of politicians, still care about HIV/AIDS.
posted by j-dawg at 7:29 AM on June 22, 2006

WTF? The district of Rwanda with the *lowest* HIV infection rate is Ruhengeri, where the infection rate is 9.8%. That is, nearly 10% of the population has the infection.

In Congo the rate is around 8% (depends which source you look at). How you think DC compares with these figures is beyond me.

HIV in developed countries is not pleasant but neither is it the scourge and killer that it used to be - antiretrovirals have extended both quality and quantity of life. It is HIV in Africa that should be the real focus of attention.
posted by altolinguistic at 7:39 AM on June 22, 2006

Best answer: Outrage fatigue?
posted by hoverboards don't work on water at 7:42 AM on June 22, 2006

Best answer: No one has forgotten or decided to ignore it on a national stage. If you think that the media based in D.C. has, start a campaign, write letters, etc. One of the news channels, 7, ends their morning show right out on the sidewalk outside their office in Rosslyn. Make a sign, then go stand behind them when they broadcast.
posted by Atreides at 8:00 AM on June 22, 2006

What happens with the media is they cover a story over and over (think the environment in the early 90s), than it reaches a point where they've covered it so much that they've pretty much suffocated the story and for many years, the media will barely touch the issue. In the back of people's minds it will seem as if it's not a problem anymore.

In short, it's outrage fatigue.
posted by drezdn at 8:42 AM on June 22, 2006

Plus, people just aren't dying in the numbers they used to, because of the antioretrovirals available nowadays.
posted by tristeza at 9:05 AM on June 22, 2006

Best answer: FWIW, my partner is an HIV survivor and has been living with HIV since 1984. We are always aware of the disease and don't need the media to tell us whether or not it's important.

Having said that, I do see a lot of stories about, for example, the shift in focus of the deisease from gay men in general to minority communities. I also see stories expressing concern about rising HIV infection rates among younder gay men.

A search on my local newspaper's web site revealed 8 stories about HIV/AIDS in the last month, some dealing with research being conducted locally, others dealing with prevention and awareness efforts.

I think that what we're seeing is that now -- 25 years into this -- the story of HIV/AIDS in the developed world treated more like the story of other diseases. Or, taking it from the general to the personal, my partner is more likely to die now of heart disease or diabetes than he is of AIDS.

By contrast, in many African communities AIDS has devastated a generation, and the needed treatments which are widely available in the US are not available. That's why Africa is the bigger focus of the story now.
posted by Robert Angelo at 9:08 AM on June 22, 2006 [1 favorite]

Keep in mind that DC has no representatives in Congress

Eek. Don't tell that to Eleanor Holmes-Norton.
posted by JekPorkins at 9:09 AM on June 22, 2006

Best answer: The reason you don't hear more about it is because the epidemic (and it is an epidemic) is largely affecting the lower classes.

A few years ago I wrote an article about HIV/AIDS rates among African American men and women living in South Carolina. I don't remember the exact figures - but they were close to the highest rates in the nation at the time (perhaps still are.)

The causes came down to a few factors: stigma against homosexuality within the black community, black churches which refused to address the subject, submissive women who allowed their partners to have unprotected sex, black men who are on the "down low", and of course general poverty and drug abuse.

In short - for most of the country - HIV/AIDS has ceased to be a health concern and has become just another social-economic problem for the black, the poor, the disenfranchised, etc.

Sadder still is the fact that the media (both national and local) are still largely white establishments catering too white consumers... so there is very little economic incentive in focusing on an issue that isn't relevant to their readership.

You could draw a parallel to gun violence if you wanted. For instance my adopted city of Chicago has an unacceptably high rate of gun murder... but so long as the victims are young, poor, and perceived as a "criminal class" by the white establishment little is being done about it. (Well, that's not true - real inroads have been made recently - but much work remains.)

Now if 40 year old, BMW driving, suburb dwelling, white bankers started turning up HIV+ you'd definitely hear about it...
posted by wfrgms at 9:10 AM on June 22, 2006

JekPorkins, you know she can't vote, right?
posted by mzurer at 9:14 AM on June 22, 2006

JekPorkins, you know she can't vote, right?

I know she's a representative in congress, and that she can vote in committee, but not on the House floor. She can also speak on the House floor on behalf of The District, and can work with her fellow reps. to help The District. That said, DC needs a real vote now. No taxation without representation!
posted by JekPorkins at 9:19 AM on June 22, 2006

Also, onepapertiger, do you have any citations to support those numbers?
posted by mzurer at 9:20 AM on June 22, 2006

I think some of it may be hype-backlash. AIDS activists in the past have cried "wolf!" so often that a lot of people now ignore new cries of crisis. As mentioned above, AIDS already gets a disproportionately large amount of government medical funding compared to other diseases which kill as many, or more, Americans. And some of the early warnings about AIDS, to the effect that it could potentially cause a new human die-off comparable to the Black Death, were so hysterically over-wrought, that for a lot of people now the attitude is: we're already giving enough attention (read "government money") to AIDS and now we're going to stop breathing heavily about it.
posted by Steven C. Den Beste at 10:24 AM on June 22, 2006

Response by poster: I got my stats from this site. Is it wrong? Inaccurate?
posted by onepapertiger at 10:41 AM on June 22, 2006

Best answer: Most of what needs to be said has already been covered. DC does not have a 1 in 20 HIV infection rate. It is not above Rwanda's rate. There are all those politics that go into what disease is paid attention to and funded. The media's short term memory does not equal people's awareness. It is a disease of mostly the poor and minorities. When HIV was in its Rock Hudson phase it was more in the national consciousness.

A few points I would like to add. Den Beste: by some means of counting AIDS is already the number one infectious disease killer in the world. It is the new Black Death, if not percentage-wise, numberwise. And the major outbreaks of plague come and peak fast and disappear. AIDS will be with us for a long time.
Second, AIDS in the US was grossly underfunded and underreported in the first few years, which is when you need to attack to slow an epidemic.
Third, the chart by ChasFile is misleading. Here you have a disease that is preventable, so money going to prevent it makes sense, compared to a disease on the chart like pancreatic cancer where there is no prevention (and virtually no cure). If there is a breakthrough means of getting a handle on pancreatic cancer I'm certain its funding will increase to pursue that lead. As it is, it is a disease we've recognized for a hundred years without a good way to attack it.
AIDS/HIV infection is disease that attacks the young, removing many more life years than many of the other diseases on that chart. For that reason it deserves more funding (comparatively).
Fifth, AIDS is a combination of many diseases that attack those with weakened immune systems, including cancers, opportunistic infections, and severe infections by the same organisms that attack non-immune compromised people. Researching AIDS is researching dozens of diseases.
I'm sure I can come up with others. It's a peeve of mine when people believe that HIV is overfunded and use simplistic numbers to make their case.
posted by dances_with_sneetches at 11:00 AM on June 22, 2006

by some means of counting AIDS is already the number one infectious disease killer in the world

Some of those "means of counting" are blatantly fraudulent. And in any case, we're talking about the US incidence rate, not the world rate.
posted by Steven C. Den Beste at 11:06 AM on June 22, 2006

Best answer: The Whitman-Walker Clinic in DC reports these statistics as of 12/31/02 on their web site (PDF): 8201 living with AIDS. 12682 HIV-infected not including those with AIDS. That would be 20883 total. Whitman-Walker also uses the 1-in-20 statistic elsewhere on their web site.

The Census Bureau estimates the DC population in 2005 at 550,521.

Although the numbers do not appear to add up, Whitman-Walker explains:
It's estimated that one in every 20 adults in the District of Columbia is infected with HIV. Up to one-third of them do not know they are HIV-positive.
I don't know how they estimate undiagnosed HIV cases -- perhaps it's based on extrapolation from testing when people seek other medical attention? -- but WWC is a very reputable source. I had my own first HIV test there in 1987.
posted by Robert Angelo at 11:52 AM on June 22, 2006

De Beste: When I referred to "by some means of counting" I wasn't referring to obscure or particularly controversial means. You can claim TB is the number one killer in the world, but one reason for TBs prominence is the increased number of TB deaths due to AIDS.
AIDS, as in HIV, doesn't kill. It makes you susceptible to other diseases that kill. That's how hairs are split around whether AIDS (HIV) is the number one infectious killer or not.

I read the question as to whether people in the US cared about AIDS, not whether people cared about AIDS (HIV) infection in US citizens, but I can see it being interpreted either way.

Angelo's numbers would have it at about 1 in 27 DC residents. DC always had that situation of being counted somewhat as a state, somewhat as a city. Highest rate for a US state (if it were one), but not a US city. As to how they estimate infection rates, several means are used. One is when you have screenings of groups. One is based on what percent of HIV infected people have defining symptoms (or AIDS) most of whom are counted and then back-extrapolating from there.
posted by dances_with_sneetches at 12:15 PM on June 22, 2006

Newsweek recently dedicated almost an entire issue to AIDS.

I don't think it's really realistic to expect it to keep up the level of pervasiveness it had in the 80s and 90s, because that was an uncommon phenomenon. We still hear about it quite a bit compared to many other diseases and afflictions.
posted by lampoil at 12:20 PM on June 22, 2006

Because it is, despite the hype, statistically simply not a significant risk for staight, middle-class people, and they are the majority target demographic for the major media. And because Americans, in general, don't care what happens in Africa or India or China as long as it doesn't affect them. Which makes them no better or worse than most people in the world.
posted by fourcheesemac at 3:20 PM on June 22, 2006

Bingo-bango, fourcheesemac. I've know of precisely one person who had it over a decade ago and he was gay. I've lived in multiple states and known and worked with a lot of people and haven't heard a peep about it outside of the media.

I just don't encounter it so it isn't on my radar. Hey, don't hate me 'cause of my lifestyle. :)
posted by codswallop at 6:14 PM on June 22, 2006

Because most Americans are more concerned with/afraid of/at risk of cancer, heart disease, diabetes, automobile accidents, and any other number of things that can kill them -- and those things are NOT as preventable as HIV.
posted by davidmsc at 6:24 PM on June 22, 2006

And much more likely to kill them as well. The AIDS hype was a classic chicken little scenario in the US. And now it's mostly a marketing strategy for trendy brands and AIDSwalk (tm) events.

I am not minimizing the horrors of this disease. But the hysteria it engendered in the US (among straight and middle-class people, certainly) has been followed by a predictable backlash of unconcern. Neither is the correct attitude. The risk is still there, the disease will kill you (though I'm surprised no one has mentioned the revolution in HIV treatment as a reason many people care less than they used to), and it makes sense to take precautions. But the OMFGSTDS attitude of many people adds to a culture of shame that is nothing but counterproductive. Terrifying people over things that are not statistically terrifying is bad public health policy.

It's the same reason the government's anti-marijuana policy is such a freaking joke.

On the other hand, people freak out about all kinds of risks, most recently terrorism, that are statistically insignificant. There was a story about a year ago about a family that fled NYC for Colorado after 9/11 to get away from "terra," only to die when a bridge beam fell on their minivan on a lovely Colorado highway. Life sucks, and then you die. Of something. Hope it's quick and painless. But live a little before it happens. Eat good food, have sex, whatever. You're not going to be happy if you live to 90 but never do anything pleasurable along the way, and yet you still die.
posted by fourcheesemac at 10:58 AM on June 23, 2006

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