HIV AIDS May 2009

Introduction

Current statistics reveal that HIV/AIDS remains a major public health problem in America. In 2005, AIDS was the sixth-leading cause of death among people aged 25-44, and AIDS was the third-leading cause of death for African-American women aged 25-44. In addition, growing numbers of people disabled by the disease increasingly burden some communities.

There are more than 56,300 new HIV infections every year and a total of 1.1 million people living with HIV/AIDS. Of those infected with HIV, 21 percent don’t know their status.¹ And while treatment advances have substantially reduced AIDS-related morbidity and mortality, not all who need treatment have access to it, and treatment is not a cure². Half of those living with HIV are not receiving care and treatment

But as the AIDS epidemic in America has matured, there has been growing public perception that the issue is under control. In 1995, just under half of the public (44 percent) named HIV/AIDS as the most urgent health problem facing the nation - since then, that figure has dropped to 6 percent³. This may be fueled in part by policymakers having, in the past decade, shifted their attention to the epidemic overseas. The expansion of global initiatives, such as the President’s Emergency Plan for AIDS Relief (PEPFAR), underscores this reallocation of resources, and attention, toward crises in the developing world.⁴

A recent national survey conducted by the Kaiser Family Foundation shows decreased HIV/AIDS awareness among Americans as compared with a similar survey five years ago. In 2004, 34 percent of adult Americans surveyed stated they had heard “a lot” about the problem of AIDS. In 2009, that percentage dropped to 14 percent. The findings also uncovered decreased awareness among African-Americans: 62 percent knew “a lot” about AIDS in 2004 compared with 33 percent in 2009.⁵

Policymakers are now re-engaging on the issue of HIV/AIDS in the United States. The Obama administration recently pledged $45 million for a five-year communications campaign, Act Against AIDS, to “put the HIV crisis back on the national radar screen.” It is targeted both to populations most affected by the virus and to organizations and media outlets striving to raise awareness.⁶

Funding efforts such as this often need public support in order to gain momentum. Some questions that officials should be asking include the following:

• Does the public think HIV/AIDS in the United States is a serious issue?
• Do they have an understanding not only of how HIV is transmitted, but also of the obstacles and barriers that infected people face?
• How do the public’s views on strategies to curb HIV transmission differ from solutions that experts and policymakers are considering?
• What proposed solutions are people ready to support now, and what proposals do they need more background on?
• What beliefs and values do the public consider when they voice their support or their opposition?

The disease cannot be sidelined in policy and discussion, and it is not a problem that can be addressed without engaging the public. Policymakers not only need public support for their initiatives, they also need to raise awareness. This is particularly important within communities most at risk for HIV, in order to reduce the rate of new infections. Unless leaders can build public support for their ideas, they probably won't realize their goals.

About the Research

With the counsel of the National AIDS Strategy Coordinating Committee and support from the M•A•C AIDS Fund, Public Agenda—a nonprofit, nonpartisan research and citizen engagement organization that studies public issues—conducted five focus groups around the country, talking with a wide range of demographically distinct individuals in New York, New York; Westchester County, New York; Los Angeles, California; Des Moines, Iowa; and Birmingham, Alabama, to explore whether people are aware of the incidence of HIV/AIDS domestically, as well as the composition of those living with HIV/AIDS and the challenges they face.

We also wanted to uncover the values underlying people’s perceptions of the disease to see how those views affect their attitudes toward their policy priorities and initiatives. In addition, 13 telephone interviews were conducted with people who work on various HIV/AIDS issues—including scientists, advocates and policymakers—to get a deeper sense of how their knowledge about HIV/AIDS informs their thinking.

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