“People want to deny that they’re vulnerable,” David Landers, visiting associate professor of psychology said. Landers recently asked one of his classes of second semester seniors why students aren’t doing what they know when it comes to HIV/AIDS prevention.
“Because it’s not going to happen to me,” one of his students said.
Landers then motioned around the room, pointing to the student’s classmates, asking, “if it’s not going to happen to you, who’s it going to happen to? Is it going to happen to him? Is it going to happen to her? Because we have the statistics saying it’s going to happen to someone.”
Cause for concern
HIV rates are up nationwide and in Vermont. According to the Center for Disease Control, the U.S. has an estimated 1.2 million people living with HIV or AIDS and in the past month, Vermont Cares has started working with four new patients.
“This is a really big increase because there are 480 known cases in the state,”said Peter Jacobsen, director of Vermont Cares. “A one percent increase in any given week is really significant.”
Vermont Cares attributes the rising rates of HIV to the reality that the most at risk groups have been hearing the same prevention messages for years, Jacobsen said.
“Those messages aren’t keeping pace with how people’s HIV risks are evolving,” he said. “I’m talking specifically about new substance use and new sexual risks.”
Jacobsen says that HIV organizations are struggling to make their message relevant and is currently trying to do more internet-based work, such as looking into HIV prevention messages on dating Web sites.
“It’s about knowing the culture you practice in,” said Mary Masson, the director of health services at St. Michael’s. “It’s maintaining knowledge of “what are people doing?” and making messages real for them.”
Masson also added that not only are at risk groups hearing the same prevention messages, but they’ve been hearing less of them over the past eight years because of national cuts in education funding.
“There’s a direct impact due to lack of education,” she said. “People think it’s gone, it’s happening in Africa, it’s happening in South America, it’s not going to happen to me. So people are again engaging in risky behaviors thinking there will be no consequences.”
Preventative by way of education
Sophomore Alexis Regan, member of the Student Global AIDS Campaign on campus, also says the problem lies in how HIV/AIDS awareness and education has been funded; pointing out that only 4 percent of government funding has gone to prevention, while the rest has gone to care.
Landers agrees that there is a link between lack of education and rise in HIV rates, saying that when delivering the message of prevention, it must be constantly tweaked to better resonate with incoming college students. He suggests perhaps incorporating HIV/AIDS awareness into college curriculums or bringing in people with backgrounds in marketing to effectively educate students.
“How do we market safe sex to students?” Landers asked.
According to the Vermont Department of Health, those who are at statistically higher risk are getting fewer HIV tests, whereas those at lower risk are getting tested more often. Jacobsen relates this back to the concept of prevention fatigue, where people who are most at risk are feeling harangued by the same “use a condom, use clean needles” message.
The overall numbers of tests up however, restoring some faith in the value of current prevention messages, Jacobsen said.
“The spike in tests overall speaks to the stigma coming off of HIV testing,” Jacobsen said. “People are more willing to think of it as a routine medical screening that everyone should do.”
The “Get to Know” campaign is Vermont Cares’ anti-stigma program. Its goal is to reduce the stigma around interacting with people who have HIV. The program also aims to reduce the stigma surrounding HIV testing itself.
“A lot of the attitudes around HIV haven’t changed in the last 25 years,” Jacobsen said. “There’s still a lot of fear, a lot of myths and misunderstandings.”
There’s no reason why Vermont Cares needs to have a program like this, except that HIV positive clients still get fired from jobs, kicked out of homes, and disowned by families, Jacobsen said.
The comforting walls of St. Michael’s are a harsh contrast to the reality faced by HIV positive Vermonters. Masson says that the health service office is one of the safe places on campus, where information is confidential. Masson says you never know what will motivate someone to seek information about HIV, but that the staff is always aware and willing to give students the time to access knowledge.
“The nice thing about how we practice here is we have time for students,” Masson said, “They can walk right in, they know they don’t need an appointment.”
Testing close to home
“If we can get prevention education to people at the ages of 17-25, that should take some edge off of new infections,” he said.
Colleges and universities in Vermont are doing a great job educating their students and providing resources for prevention, pointing out that some schools even host monthly testing clinics, Jacobsen said.
As long as HIV has been in Vermont, St. Michael’s health services have offered testing to its students. Though the testing is confidential, it is not anonymous because health services know your name. On the plus side, if medical records are ever requested to go elsewhere, the test results do not get sent out unless authorized by the student. Health services also refer out to other locations should students feel uncomfortable getting tested on campus.
Landers advocates going off campus if students want to get tested.
“Do not get confidential testing for HIV,” Landers said. “Period. If you get confidential testing, someone has that information and your name is connected to it. You don’t want that.”
Regardless of the multiple avenues for students to get tested on and off campus, the rates are still on the rise, especially among young adults. Jacobsen said the four new clients Vermont Cares took on in March were in their 20s.
“Globally, the impact of HIV/AIDS is enhanced by factors like poor water quality and lack of proper care,” said Alexis Regan, sophomore member of the Student Global AIDS Campaign. “In the United States the problem is just our blatant disregard to what we already know.”