An Epidemic Change


This Friday, World AIDS Day, activists, health care providers, caregivers, and people living with HIV or AIDS will gather to memorialize millions worldwide who’ve died of AIDS, celebrate survivors, and tout the gospel of HIV prevention to a generation that needs to be reminded that AIDS is still a killer.

Last March, the Joint United Nations Programme on HIV/AIDS (UNAIDS) (which includes the World Health Organization, UNESCO, and five other groups) launched the World AIDS Campaign—its third since 1997—which culminates each year on World AIDS Day, December 1.

The program’s goal is to convince men that they have the power—and a responsibility—to change the course of the AIDS epidemic.

The theme for this year’s campaign, and the 13th annual World AIDS Day, is “AIDS: Men Make a Difference.” In a news release issued at the launch of the campaign, Peter Piot, executive director of UNAIDS, noted that “working with men to change some of their attitudes and behaviours has enormous potential to slow down the epidemic.”

It makes sense to target prevention efforts at men, according to a UNAIDS report, because they are more likely than women to have multiple partners, which increases their risk (and their partners’). Likewise, men often migrate for work or live away from their families in all-male environments, such as the military, where the likelihood of sexual risk-taking increases or leads to sex for pay and the use of substances, including alcohol, that reduce inhibitions.

The program’s goal is to convince men that they have the power—and a responsibility—”to change the course of the AIDS epidemic. Too often men think that it’s unmanly to worry about avoiding drug-related risks or to bother with condoms,” says Piot. “These attitudes seriously undermine AIDS prevention efforts.”

UNAIDS reports that HIV infections and AIDS deaths in men outnumber those in women on every continent except sub-Saharan Africa. Young men are more at risk than older ones; about one in four people living with HIV is a young man under the age of 25. Boys who are brought up to believe that “real” men don’t get sick may not view themselves as at risk or vulnerable to illness.

Efforts to change men’s risk-taking behavior are under way with long-distance truck drivers in parts of Africa, Central America, and Asia, who have been encouraged to reduce the number of sexual partners, and to practice safer sex more often.

In Thailand, successful programs have targeted army recruits for prevention. Studies from many countries show that many college students are delaying the onset of sexual activity and using condoms more frequently.

On World AIDS Day, UNAIDS will hold a town hall meeting at the UN at 10 a.m. on the role of men in preventing the spread of AIDS. Speakers will include United Nations and UNAID representatives and youth from South Africa’s loveLife HIV prevention program, which produces radio and television programs and sponsors a full-size mobile youth health clinic. For information, call 212-584-5036.

Housing Works, which recently won a victory over the Giuliani administration that gives all homeless persons living with AIDS the right to same-day emergency housing placement, is sponsoring an “epic commemoration” of World AIDS Day on December 1, to “Tell the Mayor: People With AIDS Are Dying.”

The vigil begins at midnight with the reciting of the names of those who have died from the disease, reflecting “the overwhelming devastation of our communities.”

At 2 p.m., a march will commence at Broadway and Houston Street, and end with a 3 p.m. rally and press conference on the steps of City Hall. For more information, call 212-966-0466, ext. 296.

Sandy Piper, 42, an HIV educator and support group facilitator, has been HIV-positive since age 26. But, at a forum held earlier this month on HIV, women, and clinical trials, her beaming smile and joie de vivre belied this fact. She proudly told of her participation in seven or eight clinical trials over the years. Piper believes that other HIV-positive women can benefit from participating in HIV drug studies.

The HIV Law Project, which provides legal assistance to low-income HIV-positive individuals, sponsored the seminar to explain a change to the U.S. Food and Drug Administration’s regulations, which says the agency can put a “clinical hold” on applications for investigating new drugs (intended to treat a life-threatening disease or condition) if women or men of reproductive age are excluded. A hold is not ordered, however, if “the other gender” is part of a concurrent study, or one to be conducted “within a reasonable time.”

Dr. Gina Brown, gynecological and medical director of the Women’s and Children’s Care Center at Columbia Presbyterian Hospital, said that although pharmaceutical companies have traditionally excluded women, lack of knowledge about the purpose of trials and fear of side effects of new drugs also prevent women from participating.