State of Denial

PBS Premiere: Sept. 16, 2003Check the broadcast schedule »

Is There a "State of Denial" in the U.S.?

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Dr. Harold Jaffe

While different nations face different challenges as they confront HIV/AIDS, denial and avoidance are problems wherever HIV/AIDS is found. In the United States in 2003, more than 20 years since the epidemic began, denial about HIV remains a leading reason why this still-lethal virus continues to spread. America's AIDS denial rests on the false perception that this plague is no longer a major problem because we have it 'under control.'

"However new data show that -- far from being over -- HIV and AIDS in America could be poised for a resurgence. While the overall rate of HIV infection has remained stable for the past decade, trends among certain populations are troubling. The number of new HIV diagnoses among gay and bisexual men in 25 states increased by 7 percent from 2001 to 2002, and by nearly 18 percent since 1999. For the first time in nearly a decade, AIDS cases in the United States rose in 2002, by 2.2 percent -- meaning more people with HIV progressed to the stage where they are ill. It is too soon to tell what these data mean, but public health officials are on alert for a resurgence in HIV -- among gay and bisexual men, and among other populations at risk, including people of color, and youth.

"While the reasons behind these HIV and AIDS trends are many and complex, denial and complacency toward the disease are undoubtedly major factors. One of the most troubling issues stemming from such complacency is that a quarter of the roughly 900,000 Americans with HIV do not know they are infected *. Unaware of their HIV status, these individuals are not benefiting from life-prolonging treatments, and many are unknowingly passing the virus on to others. We must do a better job of reaching those at risk and ensuring that they learn their HIV status.

"People nationwide must understand that AIDS here at home is not over. Until such denial is diminished, HIV will continue to spread -- with each new infection adding to the already immense human and economic toll."

*The CDC estimates that there are 850,000 to 950,000 people currently living with HIV in the U.S.

Dr. Harold Jaffe serves as Director of the National Center for HIV, STD, and TB Prevention at the Centers for Disease Control and Prevention.

Gene Copello

There is definitely still a problem in the U.S. with denial about AIDS. In some of the emerging communities dealing with HIV and AIDS, there needs to be more education about how the virus is transmitted and what the implications of infection are. Also, we do know that even in our own country, still, there are many cases of HIV discrimination that go on in the workplace, with insurance carriers, and even with health care workers. Because of that discrimination, and the stigma that it carries, people may be less apt to be tested for HIV or they may choose to ignore the results of their tests.

"Over the past few years, we've seen the public, and even the communities most impacted by HIV/AIDS, become more complacent about the disease. It seems that AIDS has not been as much in the public's eye through media coverage as in the past. The very positive development of newer drugs to treat HIV, drugs that have prolonged life and increased the quality of life, has added to complacency. The fact is, we don't have a cure for HIV. It is a devastating disease. People are living longer and in a better quality of life. However, this is still a disease for which there is no cure and from which people die all the time. So there is a myth that we are further along in the treatment of HIV than we actually are.

"Stigma and complacency are more profound in some Southern communities, especially in the rural South. Prevention education has not been as pervasive as it has been in other parts of the country. This is partly because of funding issues and partly due to the culture in the South, to some extent. It's more difficult to talk about issues regarding sexuality and drug use."

Dr. Gene Copello is Executive Director of the AIDS Institute and Co-Chair of the Southern AIDS Coalition.

Phil Wilson

It's extremely appropriate that we are airing 'State of Denial' here. Quite frankly, there's still denial and stigma connected with HIV and AIDS in this country. The issues are not the same as they are in South Africa, but they are similar, particularly on the question of race. In the U.S. we still have a raging epidemic, particularly among poor people, particularly among women, and particularly among people who are black and brown. Over 50% of new AIDS cases are in the black community, over 64% of women with AIDS are black and over two-thirds of children with AIDS are black. As a country, we've not yet figured out how to appropriately address the AIDS epidemic in black communities.

"One of the biggest barriers in black communities is that we're still suffering from the way that HIV/AIDS was introduced in this country -- as a white, gay disease. It's a horrific disease, no one wants to take ownership of it. People still want to believe that it's not their problem, that it's uniquely about white, gay men. We also still don't have an infrastructure to appropriately respond to this epidemic -- black and brown AIDS agencies don't have the same kind of resources that white AIDS agencies have.

"The attention span of Americans is very, very short. Many Americans believe that AIDS has had its day. 'We dealt with that in the last decade. It's over.' When the epidemic is now focused primarily in poorer communities of color, the mainstream of America is not paying the same amount of attention. And that's why it's important for black America and brown America to realize that this epidemic is about our communities and we have to respond to it, whether or not anyone else does."

Phill Wilson is the Director and Founder of The Black AIDS Institute.

Matt James

While great strides have been and are being made in building awareness about HIV/AIDS, the epidemic is on track to be the worst in our history, if more is not done. In the United States, almost one million people are estimated to be living with HIV/AIDS and there are 40,000 new infections each year. Certain populations are at particular risk.

"Mass media are a critical partner in efforts to build awareness and reach those at risk with life-saving information. This is why we've partnered with Viacom, Inc. to launch KNOW HIV/AIDS, a multi-year, targeted HIV/AIDS awareness campaign. The KNOW HIV/AIDS campaign is designed to reach those most at-risk for HIV, including young people, people of color, women, and men who have sex with men. It is a multi-media campaign that has reached millions of people through public service announcements running across the full range of Viacom's TV, radio, and outdoor properties, AIDS-related themes woven into Viacom-produced entertainment series, a free educational guide and other resources.

"Given the enormity of the epidemic's impact, both here and throughout the world, it is essential that individuals and all organizations, both public and private, work to combat HIV/AIDS -- each possess unique strengths to make a difference."

Matt James is Senior Vice President, Media and Public Education and Executive Director, at The Henry J. Kaiser Family Foundation.