HIV Prevention in Youth

Introduction

As the U.S. concludes its third decade of fighting to control and contain the spread of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS), governments at all levels, health agencies, nonprofit organizations, and special interest groups have come to recognize the importance of communication to their efforts. Given that the acquisition of HIV/AIDS is a multifaceted problem, requiring a multifaceted approach to effectively prevent it from spreading within high-risk populations as well as throughout communities in general, the role of communication in all forms—interpersonal, mediated, and mass—has played and will continue to play a central role in increasing knowledge, altering attitudes, and impacting risky drug- and sex-related behaviors associated with HIV/AIDS.

As researchers have learned to target audiences, develop specific messages for those audiences (or adapt them), and deliver these with sufficient frequency via mass media and other appropriate channels, intervention results have been encouraging. Clearly, one message is typically not effective for multiple target populations; as the target audience changes demographically, psychographically, and culturally, the intervention-prevention message regarding HIV/AIDS must be altered. For example, merely translating an effective intervention message from English to Spanish, without taking into account the cultural differences between those populations, does not facilitate the shared meaning essential to a successful communication effort. Nearly 30 years of research, across multiple target audiences, with a variety of educational and/ or behavioral objectives related to HIV/AIDS acquisition prevention, has shown this to be so.

In the years ahead, as the average cost of treating an HIV/AIDS patient over 20 or more years continues to rise from its current estimate of more than $600,000, and disproportionately affected states such as New York, Florida, California, and Texas struggle to absorb a significant portion of these costs, effective prevention messages and other interventions will become even more critical. With millions of dollars at stake, and a significant number of lives hanging in the balance, the fight to prevent individuals from acquiring HIV and controlling the spread of the infection within various target populations will continue. (Singer, 931)

Historical Perspective of HIV in Youth

Researchers such as Merrill Singer have asserted that HIV in youth is not an “equal opportunity” disease; acquiring HIV is not a random event. As metropolitan areas develop, concentric circles of poverty are generated from the inside out, with the most economically depressed area typically at a given city's geographic center. Life circumstances within that center (crime, illicit drug use, unemployment, lack of adequate housing, improper nutrition, lack of health care, and so on), coupled with sociopsy-chographic variables (sexual practices, religious beliefs, attitudes toward family and government, level of sensation seeking, and others), combine to increase the likelihood of acquiring HIV. In short, place and the life circumstances associated with this place make HIV more likely within this population. For these reasons, Singer labeled HIV a syndemic (involving the co-occurrence of multiple health-related problems) rather than an epidemic and argued that prevention efforts must focus, to some degree, on altering these life circumstances if the HIV/AIDS fight is ...