Finding One: Off The Radar

Finding One:
HIV/AIDS In The United States Is Off The Radar For Most People

Experts say, and survey research indicates, that concern over HIV in America has lost salience with the public. Our groups showed this to be true, though African-Americans and New Yorkers were more aware of the issue.

Experts viewed the AIDS epidemic in the United States as an urgent problem. They believe, and rightly so, that the American public has become increasingly less concerned with HIV/AIDS. Having dedicated many years of their lives to studying and fighting the AIDS epidemic, they consider HIV/AIDS in the United States to be as urgent a problem as ever.

Many experts lamented the lack of a single coordinated national effort geared toward educating the public and preventing the spread of the virus. A director from a national public health organization said, “I think that we have a communication problem in public health around prevention. We talk to ourselves, we listen to ourselves and we answer ourselves. We have not engaged the American people effectively in this prevention message. And this is not just for HIV/AIDS, it’s for every disease.”

This was echoed by a program officer for a women’s organization who stated, “There are many people who’ve been saying, ‘Gosh, we’ve been thinking about this since the early 1980s, and there has never been a strategic, collective effort around [combating HIV/AIDS]….’ The public perception is that AIDS is still a problem, but that there are things that have been fixed, so that everything is okay. There’s still not a cure, but things are okay.”

For many experts, there has never been a serious effort to combat the disease, and they believe that the problem is only exacerbated by the public’s complacency with the epidemic in the United States. As observed by an activist who works primarily with African-American churches, “One of the biggest challenges [in HIV/AIDS] is the lack of reality that AIDS is a major problem in America. I think Americans of all races, creeds and color have no idea that this epidemic is so bad here in the U.S.”

One public health official we spoke with put it more bluntly: “HIV is not a major problem just for Africa; it’s a major problem in the United States. That’s what I would like for people to understand. When you talk about HIV, people are always looking to Africa or someplace else, not the U.S. They think the problem is over, essentially, in the U.S.”And another health official, the director of a national public health organization, concurred: “There are folks that think we’ve cured it, that say, ‘We’ve handled that problem, it’s not an issue anymore. But it’s an issue overseas.’ We have people who think it’s an overseas problem and not a U.S. problem anymore.”

Research with the public shows that while a vast majority of Americans consider HIV/AIDS in Africa to be a very serious problem,¹ less than half of the public has heard even ”some” about HIV/AIDS in America today, and just 14 percent say that they have heard “a lot” about it.² Our focus groups clearly corroborated that finding. While at least two people in each focus group identified HIV/AIDS as the biggest health problem facing the world today, only in Los Angeles did anyone cite HIV/AIDS as the biggest health problem facing the nation.

Additionally, the majority of participants noted that since they had not heard much about HIV in the United States for years, they assumed it was no longer a serious issue. Many participants mentioned Earvin "Magic" Johnson, the high-profile professional basketball player who announced he was HIV-positive on November 7, 1991, about 17 years ago, as the last time they really heard about HIV/AIDS.

Surveys show that African-Americans have a higher awareness of the disease,³ and our research suggests this as well; people are also aware that the disease strikes more frequently in minority populations. We heard from an African-American in Birmingham: “Most reports I’ve been listening [to] on the radio recently [are] saying it’s African-Americans.” In Los Angeles, an African-American said, “In certain communities, the rate is much higher, such as in the African-American community, much higher,” and an African-American woman in Westchester correctly knew that “minorities, Spanish and African—they probably have a greater risk...”

To one African-American male in New York, the issue hit close to home: “It’s just a problem that I see increasing more and more. I know more people, I meet people every day that they either lost somebody close to them or somebody they know died from AIDS.”

We also found that HIV/AIDS messages clearly had reached the young adults in New York, including awareness of where to be tested. One male was very specific, saying, “You could get [testing for] free. They have parties now in Brooklyn [where you get] free food and get tested.” Another man in New York spoke more generally: “I’m aware that they have like the health clinics that you go to, like to go get tested... [If] it’s HIV, there’s people there who are willing to help you... It’s free.”

Focus group respondents from other regions showed less awareness of the problem. Residents in Los Angeles spoke of the disease as practically absent from social consciousness, with one male saying, “To be quite honest with you, I haven’t done any research or really talked about it with anybody in years. It’s a non-subject,” and one woman confessed that “it’s like an underground disease. I just think that people think it’s somehow gone away or it’s not important.”

This lack of recognition was replicated in other regions as people noted there is little or no continuing dialogue concerning AIDS, leaving some to conclude that the rates of infection are less of a problem. In Westchester County, a suburb of New York City - a city that has one of the highest HIV rates in the country - a woman said, “I don’t even hear anything talked about it. You don’t see anything in the papers; up here, you’re not seeing it in the papers. I don’t see anything about it out there anymore.”

This was echoed hundreds of miles away by a woman in Des Moines, Iowa, who said, “You don’t hear about [HIV/AIDS] as much anymore, so maybe the [rate of infection] is staying the same.”

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