New HIV/AIDS Cases Increase in Minnesota

The Minnesota Department of Health just released their HIV/AIDS Surveillance Report for 2008. The report documents 326 new cases of HIV infection reported last year – one new case every 27 hours. I’ve been following these reports since 1986 – the year my first friend tested positive for HIV.
The early years of the AIDS epidemic were horrific for my friends who were diagnosed in the 1980s. Some lost their jobs and their homes and filed for bankruptcy. Most became estranged from family members. For others, their religious leaders abandoned – and sometimes condemned – them. Many did not live to see the introduction of life-sustaining anti-retroviral medications.
But the 326 Minnesotans who were diagnosed with HIV/AIDS last year have to confront something that my friends, who are now long dead, never had to deal with. These individuals became positive decades after we learned what behaviors cause the transmission of HIV and how to prevent becoming infected. With the general public today there seems to be little sympathy – and perhaps no empathy – for those who have recently become infected with HIV. After all, new rates of HIV infection could be dramatically reduced if everyone followed the ABC model of AIDS prevention: Abstain, Be faithful, and use Condoms. Like all diseases that have a behavioral component, however, it just isn’t that black and white.
As my 88-year-old mother says, you only need look at all the unplanned children in the world to see that abstinence alone doesn’t work – not as a form of birth control and not as an effective method of reducing the spread of sexually transmitted diseases. Monogamy is effective – but only if both partners practice it. Condoms work. They prevent the spread of HIV/AIDS. Still, some men resist using them and the cost and availability of female condoms have made this option less accessible for women.
There are factors, unrelated to education and outreach efforts, which contribute to the spread of HIV/AIDS. The use of alcohol and drugs can cloud ones judgment and result in high risk behaviors. Young people often view themselves as immune from bad things ever happening to them and consequently take chances. Others think that the medical advances in the treatment of HIV/AIDS make this a manageable disease. They are under the false impression that if you contract the disease you just take a pill and go on with your life as normal.
But there is another underlying issue that some people who have been newly diagnosed with HIV/AIDS have talked with me about, and it has to do with self-esteem. Time and again, women and men of varying age, race and sexual orientation, have told me that a negative self-image – feelings of worthlessness, isolation, and deep loneliness – translated into them engaging in sexual behavior that resulted in them contracting HIV. Immediate human contact, sometimes with the possibility (or fantasy) of a relationship, made engaging in unprotected sex a risk worth taking for some.
Now, I’m not so naive as to believe that if every person was self-actualized that we would see the elimination of HIV/AIDS. I am suggesting, however, that as long as there are people – who intentionally or unintentionally – tell individuals or groups of people that they matter less than others, or that they don’t matter at all; we shouldn’t be surprised if next year’s surveillance report shows yet another increase in new HIV/AIDS cases in Minnesota.