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Gays Shrug Off Fear of AIDS

San Francisco survey shows little concern about HIV

THURSDAY, Nov. 1, 2001 (HealthDayNews) -- A new study suggests that homosexual men in San Francisco are doing their best to forget that AIDS poses a threat to their lives. In focus groups, gays say they rarely talk about the disease, even with those who are infected.

"People told us loud and clear that HIV is off the radar," says study co-author Steve Morin, professor of medicine at the University of California at San Francisco.

While the men said they hear more about the risks of smoking than of unsafe sex, they said better education would help. Many suggested that advertising campaigns focus on reasons to avoid AIDS, not just messages about using condoms.

University researchers interviewed 55 gay men over the summer in a project commissioned by the San Francisco Department of Public Health. Officials wanted to gauge the attitudes of gay men amid projections that suggest the number of newly infected HIV cases will rise significantly in the city this year, Morin says.

An estimated one in three gay men in San Francisco is HIV-positive. Although numbers for this year aren't available, projections say 2.2 percent of the gay men in the city will get infected in 2001. That's double the rate of 1997.

The university released the results of the study at two medical conferences this month. Researchers expect they will be published later in a medical journal.

In the survey, men who were HIV-negative said their perceptions of AIDS have changed over the last four years. They now see AIDS as a "manageable" disease, something more of an "inconvenience" than a killer, Morin says.

Medical officials have been warning for some time that changing attitudes about AIDS may threaten public health. The diagnosis of AIDS, which develops some time after HIV infection, used to be a near-certain death sentence. But now, medications can keep people alive for years.

"You don't see as many people who are sick and dying, the obituaries, the Kaposi's sarcoma lesions, the people unable to walk, the funerals," Morin says. "Those things kept HIV in the mind. With the decline in those, it's less visible."

The men surveyed also said they rarely talk to their friends about the disease, a finding that surprised researchers. "We were not expecting to find this deterioration of friends talking to each other," Morin says.

Even those infected with HIV aren't warning their friends to be careful. Those men used to talk to their friends and urge caution, saying "Look what happened to me," Morin says. "But as they feel better and healthier, they don't have the same types of discussions."

But just as their attitudes about AIDS have changed, the men also have new perspectives about the best ways to reach people like themselves. They weren't interested in messages about wearing a condom or the importance of being honest about one's HIV status. "There was considerable concern that people lie," Morin says.

The men supported campaigns based on slogans like "Friends Are Good Medicine," which encouraged gay men to help each other stay healthy. They liked campaigns that challenged gay men to challenge their assumptions about safe sex, and they supported more publicity about rising AIDS infection rates.

Health officials should consider the findings when they design new HIV prevention campaigns, Morin says.

The results are not surprising, considering that public health officials always are fighting battles to keep people from falling off the wagon once they quit something like smoking or unsafe sex, says Michael Allerton, HIV operations policy leader for Kaiser Permanente Health Plan doctors in Northern California.

"You have to constantly and continually move and change strategies as times change. It's not a one-shot, everybody's-done deal," he says.

What To Do

HIV hasn't gone away by a long shot. Although a new generation of drugs may fend off full-blown AIDS, taking them involves a difficult, uncomfortable and expensive regimen.

To get the latest information about how AIDS is transmitted and how to avoid infection, check the Centers for Disease Control and Prevention.

For more information on AIDS around the world, see the World Health Organization.

SOURCES: Interviews with Steve Morin, Ph.D., associate professor of medicine, University of California, San Francisco, and Michael Allerton, M.S., HIV operations policy leader, Kaiser Permanente Medical Group, Oakland, Calif.; San Francisco Department of Public Health
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