U.S. Shifts Strategy to Curb Hiv’s Spread

In a controversial shift in AIDS strategy, the federal government Friday funded programs to prevent people with HIV from spreading the virus, instead of primarily targeting people at risk who are not infected.

In a controversial shift in AIDS strategy, the federal government Friday funded programs to prevent people with HIV from spreading the virus, instead of primarily targeting people at risk who are not infected. The Centers for Disease Control and Prevention announced $49 million in HIV prevention grants to 142 community organizations around the country. The money comes as the disease appears to be on the rise again. It is the first round of annual funding since the CDC launched an initiative last year aimed at keeping people with HIV from infecting others. The effort also tries to make testing more available — largely through a new rapid HIV test — so that the 200,000 or more people who have HIV but don’t know it become aware of their status and take steps to curb transmission. “Testing itself and learning that one is HIV positive is an important HIV intervention,” said Dr. Rob Janssen, director of the CDC’s Division of HIV/AIDS Prevention. With proper information, two-thirds of people who find out they have HIV are willing to reduce risky behaviors, Janssen said, but only a third of those who aren’t infected will alter their behavior. AIDS rates, which dropped dramatically in the 1990s, have stabilized. HIV, the virus that causes the disease, appears to be on the rise, especially among gay men, the CDC says. Public health officials say they must focus more on encouraging safe sex among those with HIV. In the new grants, $23 million is for “prevention for positives” as well as their partners and some people at highest risk for HIV; $14 million is for counseling and testing; and $12 million is for outreach and education. About 82 percent of the groups receiving funding target minorities, and 41 percent of the money is for programs for gay men. Two-thirds of the organizations previously funded by the CDC aren’t getting money. They’re being replaced by 75 newly funded groups. Some blame politics for the change. The Stop AIDS Project of San Francisco lost its funding after some Republicans in Congress complained last year about the group’s workshops on oral sex, anal sex and “safe and friendly relations with escorts.” In the “hypersexualized” world of gay San Francisco, frank discussions are necessary, the organization says. “I guess we are a politically high risk group,” said spokesman Jason Riggs. Terje Anderson, executive director of the National Association of People with AIDS, said that focusing on people with HIV can be counterproductive. “When you start shaking your finger and saying, ‘bad boy’ and ‘bad girl,’ it’s creating an environment that is stigmatizing,” he said. Janssen said the funding is based on the groups’ ability to meet CDC’s goals, not on politics, with money allocated according to AIDS rates. The South, where HIV has substantially increased, will get 43 percent of the funds. (Source: Cox Health News Group, May 2004)