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When HIV and AIDS first came into the public eye in the 1980’s, it was a disease that carried a great deal of fear and stigma. In the United Sates, the disease, attributed primarily to promiscuous gay sex and intravenous drug use, was even considered a punishment for immoral behavior and possibly even the wrath of God. As the years went by, safe sex (later renamed safer sex) campaigns which promoted the use of condoms helped to reduce the spread of the disease in the United States. On a global scale, the crisis in Sub-Saharan Africa was beyond anything those of us in the U.S. could ever have imagined. As HIV infections increased and medical care could not meet the need (particularly in the years before antiretroviral treatment was available) there were vast number of deaths attributed to the disease. AIDS orphans were leading to a global orphan crisis. So where are we now?

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In the United States, many people probably don’t give much of a thought to HIV anymore. Fear of other sexually transmitted diseases certainly trump people’s fears. Colleges and some high schools can be found giving out free condoms, sex workers demand customers wear protection, and cities have even established clean needle programs. None of these initiatives came about without significant public debate over the impact of these programs on the moral state of our nation, including talk of collateral damage in order to motivate people into making safer choices.  Regardless of the debate, the effectiveness of condoms in preventing transmission and the impact of these campaigns certainly helped reduce infection rates as well as the stigma. According to the CDC, new infection rates hit a record high in the mid 1980’s at 130,000 new cases a year, and by the mid 1990’s had dropped to 50,000 new cases per year, where it has remained relatively stable since.

In the mid 1990’s I was a senior in college. Every senior graduating with a psychology degree was required to participate in a capstone course. I chose the HIV capstone class. Our course was focused on people’s perception of HIV/AIDS. We discussed the history of the disease, but by this point Magic Johnson had been living with HIV for years. Still considered a death sentence, people were still fearful, but less likely to feel that one’s HIV status was some sort of cosmic punishment. People were beginning to talk more empathetically, noting people like Ryan White and children born to mothers who were HIV positive. In college, our peer education program, like colleges across the nation, was discussing safer sex and HIV along with topics like alcohol and drug use. New drug cocktails were showing promise and the belief that people could continue to lead relatively normal lives was just starting to emerge. Within a decade, the fear of HIV was rapidly becoming a sidenote in people’s minds.

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Globally, the story was a little different.  While the HIV crisis was real in America, it was wreaking havoc on Africa. In Uganda the HIV infection rate of the early 90’s was 15%. In an attempt to combat the epidemic, they introduced the ABC initiative: Abstinence, Be Faithful, Condoms.  While it received some criticism, the results couldn’t be disputed. By 2001, the infection rate had dropped to 5%. (Public Library of Science, Murphy, et al) New medications that were available in wealthier nations were not easily accessible in Sub-Saharan Africa. In the early 2000’s, a strong push was made to make antiretroviral drugs available. As drugs became more available, the death rates began to decline. (The Economist) Today, the rates in several African nations are still high, but unilaterally they are improving.

 

While the news as it relates to HIV is good, it’s important to not believe the battle has been won.  More than 1.2 million Americans are living with HIV and 1 in 4 new cases are in youth ages 13-24. (AIDS.gov) Take that in comparison with Kenya, where 1.6 million people are living with HIV. (BBC citing UNAids/Unicef) Kenya has a population of 46 million versus the US with a population of 321 million. In Kenya alone, there are 200,000 children living with HIV and one million AIDS orphans. (BBC citing UNAids/Unicef)  Access to proper medications and education can reduce the risk of transmission from mother to child through birth and breastfeeding. Outside of the medical care, there is still great need to care for the financial, emotional, social, and educational needs of adults and children who are living with HIV or are suffering as a result of a caretaker’s sickness or death. It’s important to consider how far we have come and make sure we keep moving in the right direction.

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“The long-term future of children with HIV is uncertain. The current average life expectancy is about 10 years from the time of diagnosis, but new treatments mean things are improving all the time. With good care, HIV-infected children today have a good chance of living as long as anyone else who has the disease, and that can be several decades.” Chris Woolston, M.S. (Children and HIV, healthday.com)

Consider supporting an organization that works directly with children, like Kindle Orphan Outreach in Malawi. Their efforts include the community and provide a holistic approach to orphans, their caregivers, and the entire community.

Nyumbani, an organization working in Kenya, serves 4,000 survivors of HIV. They support children and families through medical and social assistance.  On my visit to Kenya in 2012, I had the privilege of visiting the Lea Toto community outreach facility outside Nairobi and was impressed by all I learned from the staff and volunteers there. Donations can help in saving the life of a child.

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Written by Barbara Seidle

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