Family’s Role Stressed in HIV Fight

U.S. Surgeon General David Satcher has a prescription for communities to begin fighting AIDS: Encourage education in homes, schools and churches; create a safe, comfortable treatment and testing environment; and promote healthy daily routines.

“If we could really look at lifestyle and behavior, we could make a lot of progress,” said Satcher, who was keynote speaker at an HIV prevention conference in Los Angeles on Wednesday. “The country needs to look at a model of community-based health care.”

Policymakers, researchers, residents and health-care providers attending the conference met at Charles R. Drew Magnet High School in Los Angeles to focus on the role of family support, education and guidance in HIV prevention efforts. The three-day event was sponsored by the UCLA AIDS Institute, the National Institute of Mental Health and Charles R. Drew University of Medicine and Science.

“If we don’t build bridges to the communities, the danger is we will develop interventions that don’t have any relevance to real people,” said Dr. Steven Hyman, director for the National Institute of Mental Health. “In medicine, almost all of our interventions have been targeted toward the individual. When it comes to issues like prevention [of AIDS], focus on the individual is not enough.”

Satcher said families must encourage their children to practice safe sex or abstinence, while discouraging drug use and other risky behavior. They can also help get treatment for infected family members who would not seek it on their own, and they can encourage patients to get medical attention. For many living with the disease, family support is crucial to help them cope and lead healthier lives, he said.

Many of the nearly 300 people who attended the conference participated in discussion groups on topics including barriers to health care in families affected by HIV, disenfranchisement of parents and disparities in HIV prevention programs for families.

“The family has been at the center of this struggle for a long time,” Satcher said. “The family has survived immigration, slavery, poverty . . . a lot of challenges. And today, when it comes to HIV, the family is facing a triple challenge.”

One-third of people infected with the virus have been diagnosed, yet do not seek treatment because they are embarrassed or afraid, do not know where to go or do not have medical insurance, Satcher said. Another one-third of people who are infected do not even know they have the virus.

“Families are dealing with all these types of infected people,” he said. “In all those areas families need a lot of support.”

With 65% of youth sexually active before they finish high school, sex education should be incorporated into curricula, Satcher said.

“When we talk about sex education, we’re not just talking about sex,” Satcher said. “We’re talking about human sexuality, what it means to be a sexual being, what it means to appreciate yourself.”

If children are taught early to respect themselves, they may not give in to peer pressure or make dangerous decisions, he said.

Dr. Irvin Chen, director of the AIDS Research Institute at UCLA, said education is the only method available today to prevent the spread of the disease.

“What we’re trying to do is develop drugs and vaccines,” he said. “But with 16,000 people infected every day, and 40 million people infected worldwide, those drugs and vaccines are going to come too late.”

More than 22 million people in the world have died from AIDS, Satcher said.

In the U.S., 760,000 cases have been reported to the U.S. Centers for Disease Control and Prevention since 1981. And nearly a half a million deaths have been reported in the United States in the last 20 years.

Satcher said that AIDS is the “worst infectious disease out there right now,” and that the U.S. cannot afford to ignore the importance of socially based prevention.