Latinas and Deadly Sex: The Politics of HIV/AIDS Reporting

Abstract

HIV and AIDSThe general public first acknowledgement of AIDS in the United States occurred in the early 1980s when Rock Hudson became infected and subsequently died. In the 1990s, largely due to categorization of the virus as Gay Related Immune Deficiency (GRID), and subsequent neglect by the nation's political system, the virus quickly spread to previously uninfected populations (Shilts, 1986). Human Immunodeficiency Virus (HIV) is caused by exposure to infected blood, semen, vaginal fluids, and breast milk. When an individual's CD-4 or T cell count falls below 200 and/or the individual begins to experience serious complications, the Acquired Immune Deficiency Syndrome (AIDS) is diagnosed as a disease. [http://hopkinsaids. edu/publications/ pocketguide/pocketgd0105.pdf]. As the science of treatment improved and public health surveillance and treatment systems were established, HIV infected individuals with knowledge of the risks of infection and access to health care progressed much more slowly to AIDS. New AIDS cases experienced a dramatically curbed escalation in 1996 with the introduction of Highly Active Antiretroviral Therapy (HAART). [http://www.cdc.gov/hiv/stats/2003SurveillanceReport.pdf]. Although cases of AIDS decreased markedly due to improvements in treatment, overall HIV infections did not.Although modes of infection have been clear for some time, reporting mechanisms within the country have been obscured by many issues including the requirement of the Centers for Disease Control and Prevention (CDC) to report all HIV infections using a confidential, albeit not anonymous, system of name-based reporting, to which some states, like California, have objected. Due to the extensive window period that can average 10 to 15 years wherein HIV infected individuals experience no symptoms, comprehensive data collection and reporting on HIV infection becomes imperative if the US is to accurately target HIV prevention and management efforts, particularly among underserved populations.The Reporting System: HIV versus AIDSPublic health in the US begins at the local level and involves both private and public health providers. Early work with other sexually transmitted diseases such as Gonorrhea and Syphilis at the local level initiated and improved the reporting process from the local level to the state. [http://www.cdc.gov/std/Syphilis2003/SyphSurvSupp2003.pdf]. Nationally, the Atlantabased CDC initiated the collection of AIDS case data from the states.As an understanding of HIV's progression to AIDS matured, terms such as ARC, (AIDS Related Complex), were eliminated and the staging became reduced to HIV and AIDS as measured by T cell or CD-4 cell counts and more recently viral load. [http://hopkinsaids. edu/publications/ pocketguide/pocketgd0105.pdf]. Although AIDS cases are reported by each state to the CDC, many states have been slower in their progression to HIV reporting. A major issue among and between the states and the CDC arose as to the classification system to be used for reporting of HIV and AIDS cases, one that has still not been fully resolved for 19 states and the District of Columbia. Exposure categories for adults are further broken down into the two categories of HIV and AIDS. This paper analyzes the categories of exposure for adults, with emphasis placed on the emergence of HIV and AIDS in the Latino population, particularly among women.Due to HIV underreporting or reporting practices that do not meet the CDC requirements of name-based case identification, the most recent edition of the CDC's HIV/AIDS Surveillance Report includes HIV data from only 31 states. [http://www.cdc.gov/hiv/stats/2004SurveillanceReport.pdf]. The underreporting of HIV to the CDC is problematic for a number of reasons, as it fails to provide the nation with the information needed for an effective HIV/AIDS prevention and management strategy. This is particularly true among underserved populations such as Latinos, who are often uninsured or underinsured and may lack access to culturally and linguistically appropriate health care and HIV prevention information. …