Menlo Park, CA Americans view HIV/AIDS as the number one global health issue and still see it as one of the most urgent health problems facing the nation, according to a survey released today by the Kaiser Family Foundation. The nationally representative survey the third conducted by the Foundation since 1995 captures Americans views about the HIV/AIDS epidemic 20 years after the first cases were documented in June 1981.
The survey findings describe a public concerned about their own and their families risk for HIV infection and supportive of a range of government and private approaches to the epidemic in the U.S. and abroad, including some controversial measures. Those bearing the brunt of HIV/AIDS in the U.S. minority Americans and youth are most concerned. The survey also found that the proportion of Americans ranking AIDS as the number one U.S. health problem declined in recent years.
An AIDS timeline marking scientific, policy, cultural, and community milestones over the past 20 years was also released by the Foundation today.
AIDS Still Seen as Major Health Problem
When asked to name the most urgent health problem facing the U.S., more than one in four Americans (26%) names AIDS, second only to cancer (35%). Nearly half of Americans (49%) think HIV/AIDS is a more pressing problem for the nation today than it was a few years ago. And more than one third (37%) name HIV/AIDS as the most urgent international health problem, ranking it number one among all global health issues.
More than four in ten Americans (43%) say they know someone who is either living with HIV/AIDS or has died of AIDS, and more than one in three (37%) say they are personally concerned about becoming infected. Forty percent say AIDS is a serious problem for people they know. And 71% of parents are worried about their children becoming infected.
The fact that after 20 years so many Americans continue to view AIDS as one of the most important health problems facing our country today is a testament to the unflagging efforts of the HIV/AIDS community, said Drew Altman, Ph.D., President of the Kaiser Family Foundation. Our survey found remarkably few signs of ‘AIDS fatigue, but those signs point to the need for sustained efforts, especially to reach those hardest hit by the epidemic.
The proportion of Americans citing AIDS as the nation's top health problem declined from 44% in 1995 to 26% in 2000. The largest shift occurred among whites (42% to 23%), but minority Americans, while still ranking AIDS number one, also showed some declines: for African Americans, from 56% to 41%; for Latinos, from 51% to 40%. African Americans were the only racial/ethnic group to show a decline in personal concern about becoming infected with HIV (from 71% in 1995 to 56% in 2000), despite disproportionately high rates of infection in the African American population.
Desire for More Public and Private Action and Support for Broad Range of Policies
Two-thirds (66%) of Americans believe that the federal government is not doing enough to fight the epidemic in the U.S., and more than half believe state and local governments (59%) and schools (51%) are not doing enough. Majorities also say that corporate America (56%) and parents (66%) should be doing more.
Americans express strong support for federal spending on AIDS. More than half (55%) say the federal government should be spending more on AIDS in the U.S., another 25% say spending is about right, and 5% say spending is too high. Most believe that prevention and education (86%), finding a vaccine (83%), and treatment and care (75%) should all be federal policy priorities.
Support for some more controversial policies is also notable. Nearly all Americans (97%) want high school sex education to address HIV transmission and prevention, and 90% would include information about condoms. A majority of Americans (58%) also favor needle exchange programs, while 35% oppose them.
Americans also support U.S. assistance to Africa, which is home to the majority of adults and children living with HIV/AIDS worldwide. Two thirds (66%) of Americans support U.S. spending on AIDS in sub-Saharan Africa, while 29% oppose it. Americans support spending U.S. dollars on a number of specific strategies in sub-Saharan Africa, including prevention (77%), treatment and care (75%), and debt reduction (65%). Most (81%) also think that drug companies should be willing to cut AIDS drug prices in developing countries.
While the public supports federal spending on HIV/AIDS, AIDS policies will have to compete with other priorities for a seat at the budget table, said Altman. Polls consistently show that other issues such as education, health care and Medicare, social security, and a tax cut top the public s priority list for federal dollars.
African Americans, Latinos, and Young People Especially Concerned
The demographics of the epidemic in the U.S. are reflected in the heightened concerns expressed by those hardest hit. African Americans represent 12% of the U.S. population and Latinos 13%, but they represent 47% of and 19% of reported AIDS cases respectively. Young people are also disproportionately affected: Americans under age 25 account for about half of all new HIV infections.
- African Americans (70%) and Latinos (64%) are much more likely than whites (44%) to say that AIDS has become a more urgent problem for the country over the past few years.
- More than half of African Americans (56%) and Latinos (53%) are personally concerned about becoming infected with HIV, compared to one third (33%) of whites.
- A majority (57%) of African Americans report knowing someone with HIV/AIDS, compared to 38% of Latinos and 42% of whites.
- Among all age groups, 18- to 24-year-olds are the most likely to say that AIDS is a more urgent problem for the country now than it was a few years ago, with 61% of young adults saying it is more urgent as compared to 46% of those 25 and older.
- Majorities of young adults say that they are personally concerned about becoming infected with HIV (52%) and that AIDS is a serious problem for people they know (53%).
Information, Misinformation, and Discrimination
The survey findings show that after 20 years, most Americans know the basics about AIDS. Nearly all Americans are now aware that HIV can be transmitted through unprotected intercourse (99%), sharing intravenous needles (99%), and unprotected oral sex (91%). Eighty-six percent know there are drugs that can extend the lives of those living with HIV/AIDS, and 89% know that no cure has yet been found. However, some significant misconceptions and gaps in knowledge persist:
- One in five (22%) Americans believes that sharing a drinking glass can transmit HIV or is unsure about the risk of this activity.
- Sixteen percent believe that touching a toilet seat can or might transmit HIV.
- More than half (58%) do not know that having another sexually transmitted disease, such as herpes, increases their risk of HIV infection. Less than half (43%) are aware of available treatments to prevent mother-to-child transmission.
- Many want more information on specific AIDS-related topics. The two things Americans most want to know more about are how to talk with children about HIV/AIDS (44%) and information about HIV testing (26%).
A large majority of Americans (84%) believe that people with HIV and AIDS still face some or a lot of prejudice and discrimination in the U.S. today, although fewer than one in five (17%) thinks discrimination has increased in recent years. One third (33%) of Americans are concerned that others would think less of them if it were known that they had been tested for HIV. Forty-three percent of Americans say they have been tested for HIV, representing a slight increase since 1995, when 37% said they had been tested.
More than one in four Americans (28%) say they would be uncomfortable working with someone who has HIV/AIDS. Those who think HIV can or might be transmitted through toilet seats, drinking glasses, or kissing are much more likely to express such discomfort.
