SubscribeThe Minnesota Department of Health released initial 2009 HIV epidemiology data last week — something that they normally wait until April to do. MDH saw an urgent need to release the information due to the dramatic rise in incidence over the past year, particularly the 83% increase in young men who have sex with men (YMSM).
In response to this spike in incidence, the Department of Health, Department of Human Services (Ryan White Part B Grantee), and Hennepin County (Ryan White Part A Grantee) brought together a group to start raising awareness around this issue and start thinking about new solutions. This group, which I am a part of, has been meeting since November in preparation for a series of events happening at the end of February (not coincidentally the end of Part A’s fiscal year). This includes YMSM focus groups, a provider summit (open to all youth workers), and a youth PSA contest.
Obviously, this increase has been all over the blogs and newspapers in the past weeks. The response from many providers has been: youth like risky behavior, the interwebs gives you AIDS, and USE CONDOMS DAMMIT. Maybe I’m being a little overdramatic.
My point is that I don’t think this is a productive conversation. Adolescents are risky, but not necessarily intentionally so. I doubt any 17 year old is thinking, “if I have sex tonight, I might get HIV … that’s so risky.” No, they’re thinking, “Gee golly, that’s a really hot person that I’d like to touch inappropriately.” The internet doesn’t promote unsafe sex, it provides a medium for people to pursue something they’re pursuing anyway. This goes both ways — there are dating-oriented websites that connect people who may not have otherwise met.
And then there’s condoms. Yes, they’re effective, but they’re only effective if they’re being consistently used. The problem is that it’s really hard to tell a teenager that they need to use condoms for the rest of their life. We can put millions of dollars into education and advertising, but it doesn’t make it any easier to carry out.
I don’t have the solution, but I know we have a problem. We can’t blame the internet for this increase, we can’t blame the youth, and we can’t expect condoms to continue to be the solution. We, as a society, need to figure out a reasonable, life-long prevention plan for not just gay/bi men, but for everyone. I really wish I had a magical answer for this one…
The only magic bullet would be a vaccine or cure for common strains of HIV; retroviruses in general are much harder to deal with in that respect since we don’t have good methods or templates for producing vaccines for them. Even so, all of that is guaranteed to be decades away, well beyond the average post-infection lifetime of most HIV patients. HIV positive teens are pretty much screwed.
I’m not sure that a vaccine for HIV would be a magic bullet. We have vaccines for the flu, and people continue to die from it. I’m sure it would drastically decrease the mortality and morbidity of HIV, but I don’t think it would solve our problems.
Figuring out a way to promote responsible sexual practices would ultimately benefit everyone, and not just from an HIV standpoint. Unfortunately, that’s not very simple either … and would require our society to move past our “moral” hangups.