After years of disappointing trial and error, a vaccine shows success in a clinical trial in preventing the transmission of HIV/AIDS. Granted, the trial shows a less than one-third success rate. Compared to the 85 percent success rate of the new H1N1 swine flu vaccine, that’s quite low. Yet it clearly is the most promising success to date , and we can only hope that it soon leads to a workable vaccine that that immunizes against the HIV/AIDS virus. But what until then? Each year, in the United States alone there are 1.1 million people living with HIV and it is estimated that someone in the U.S. is infected every 9 and a half minutes. Even under the best conditions, the optimistic view is that it will take at least three years before a HIV vaccine is available in the United States. What can be done to help those who have the disease now? Is the American public ready to act?
Actually, a lot–though it seems most Americans remain unaware of this. As a researcher for Public Agenda, a non-profit non-partisan research and public engagement organization in New York City, I have had the opportunity to study both what could be done today to reduce the effects of HIV/AIDS transmission and increase treatment and to see what the public thinks of these ideas. The gap between the solutions that HIV/AIDS experts push for and what the public understands about how to address the AIDS epidemic is wide indeed.
When we spoke with experts about what can be done to address AIDS in America, we heard many different solutions. Some experts focused on prevention (targeted education messages to at-risk populations for example). Others talked of ways to increase access to HIV testing (such as providing it for all patients admitted into an ER, for example) and ways to increase access to treatment. Some talked about solutions focusing on what some experts saw as the underlying social reasons why certain populations, including African-Americans, Hispanic/Latinos and gay men of all ethnicities, are disproportionately affected by the disease, including addressing disparities in the health care system and providing social networks to combat the stigma and isolation that many who are HIV positive may face. Are these solutions viable? Will the public support funding for them? Unfortunately, we just don’t know. According to a Kaiser Family Foundation poll conducted in April of this year, half of Americans support increased funding to address HIV/AIDS in the United States. That sounds promising, but 45 percent say they had ”seen, herard or read” “little” or “nothing at all” about HIV/AIDS in the United Statesin the past year. In focus groups Public Agenda conducted on HIV/AIDS in the United States, the lack of awareness of the issue was pervasive7. Many participants said they were not sure how serious a problem this was any more in the United States. Outside of New York City and Los Angeles, the two cities in the study that had a high incidence of HIV/AIDS cases, few others had any conception of how much this disease has ravaged areas of the country and minority communities. But, in discussion, participants became more engaged and began to question why more was not being done, even as they were unaware of the different proposals that experts recommended. A self-described fiscal conservative in Birmingham summed up his feeling about supporting more funding by saying, “…you can pay now or pay later. I’d rather pay for it on the front end of it and have people tested and make sure that would somehow be defraying higher costs down the road.” There are many good ideas out there that may indeed curb the spread of HIV. Until a vaccine becomes available, there will also be many more infections in the ensuing years. The public is ready to discuss measures that may only be needed in the short-term, but every day they are not addressed is another day more people become infected. With our health care system at the center of public debate, now is the time to have a national conversation about what can be done right now to address the issue and see where the public really stands on this issue.
Jonathan Rochkind is the Vice President and Director of Research at Public Agenda, a nonprofit research organization.