AIDS programs shift focus, target at-risk populations

Josh Linehan

Most college students remember sex education classes from high school. Teachers might have preached abstinence, condom use or a combination of both, but one thing remained constant.

The simple message was addressed to most teens: Preventing HIV infection is best accomplished by keeping those without the disease from contracting it.

Today, with HIV infection rates holding steady nationally and in Minnesota for the population in general, most AIDS education and prevention programs have taken a new tack: targeting groups whose infection numbers are high or rising and trying to prevent those who already have the disease from passing it on.

Lorraine Teel of the Minnesota AIDS Project calls it “prevention for positive” and said it is part of a nationwide trend in AIDS prevention.

“The old idea was more of a shotgun approach. This is like a rifle. We want to laser in on communities where infection and risk are high and on those who are already positive,” she said.

In Minnesota, Teel said, immigrants from sub-Saharan and eastern Africa as well as young men who have sex with men are particularly high-risk groups.

The inherent challenges of dealing with immigrant groups – such as language barriers and a lack of community agencies – as well as stigmas associated with infection make prevention efforts difficult, Teel said.

According to the Minnesota Department of Health, 100 of the state’s 283 new infections in 2001, the newest data available, occurred among the black population, which includes African immigrants. Of those 100, 47 were women. In comparison, 145 whites reported new infections in 2001, 15 of them were women.

Teel said the United States does not allow HIV-positive people to immigrate here, but many can be infected after they are screened or if they return home to visit.

At the University, a coalition group funded by the state and the University aims its “prevention for positive” efforts at young men who have sex with men.

Founded in 1989, the University of Minnesota Youth and AIDS Projects actively pursues men and boys age 13-21 for testing, peer counseling and care for those already infected.

Director Gary Remafedi said although a combination of primary and secondary prevention remains necessary, his organization primarily focuses on at-risk groups.

“While most populations are remaining steady – and that’s a good thing – some populations remain problematic,” he said.

More than half of Minnesota’s new cases in 2001 reported infection from male-to-male sexual contact.

Though the education is slowly catching up with pockets of infection, reaching even smaller, targeted groups remains difficult.

Of every four people approached to participate in the Youth and AIDS program, one eventually participates.

Results from the increasing number of programs targeting those at high risk or already infected will be available soon. Minnesota plans to release new infection statistics from 2002 around April 15, Teel said.

Josh Linehan welcomes comments at [email protected]