Advancements in HIV/AIDS Treatments May Hamper Public Health Messages, Columnist Says
The increase in "gay men's confidence in the ability" of combination antiretroviral therapy to "enable HIV-positive people to lead normal and longer lives" has made it more difficult for public health officials to promote HIV prevention messages, syndicated columnist George Will writes in a Washington Post opinion piece. Will describes the challenges faced by Dr. Mitchell Katz, director of the San Francisco Department of Public Health, who must promote a message of safe sex at a time when the "fear of HIV" among gay men has decreased. Fear of the virus served as a "powerful motivator" for safe sex among gay men in the 1980s and early 1990s -- when "to have unsafe sex was to die" -- but Will writes that increased "confidence" in new treatments has made it more difficult to "protect the uninfected." In addition, he points out that the "behavioral changes of the late 1980s" that led to a decrease in the number of new HIV infections "are not being sustained" as the "decline of fear produces fatalism about the inevitability of unsafe sex." Although the spread of HIV in the United States can "largely be contained" by "avoidance of risky behavior" among gay men and intravenous drug users, Will writes that new treatments have allowed many of those individuals to become "complacent" about their participation in unsafe practices. According to Will, the trend has forced public health officials to ask individuals with HIV to share needles or have unsafe sex only with others who have HIV. However, Will writes that the messages have only "very limited utility," concluding that "with AIDS, progress has its perils" (Will, Washington Post, 6/9).This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.