Addressing the HIV / AIDS Epidemic in Michigan & Beyond: The Importance of Needs Assessment & Context

Abstract

For approximately the last twenty years, HIV/AIDS has been impacting individuals, their families, and the communities in which we all live and work. The people coping with this disease are our mothers and fathers, daughters and sons, aunts and uncles, wives and husbands, chosen family, and others that we love. Yet, this disease does not equally affect all people: Adolescents, women, gay and bisexual men, and minorities are disproportionately affected by this disease. Therefore, education remains a primary tool for how we address HIV/AIDS (Centers for Disease Control and Prevention, 2002; AIDS Epidemic Update, 2001). It is imperative that Health Care Reform contextualize HIV/AIDS education so that the diverse information needed by individuals and their families as well as policy makers is heard and acted upon in order to slow this global epidemic.An International & National OverviewAn estimated 40 million people are infected with HIV/AIDS worldwide. From the beginning of the epidemic around 1980 to the end of 2001, more than 60 million people have been infected globally. HIV/AIDS is at pandemic levels in sub-Sahara Africa, where it is the leading cause of death (AIDS Epidemic Update, December 2001).In the United States, approximately half a million people have died of HIV/AIDS during the past two decades; however, the number of people infected every year has remained at about 40,000 for the past several years. By the end of 2000, the number of people who died each year in the United States from HIV/AIDS declined to approximately 15,500. This decline in the death rate is thought to be due to new treatments that prolong life for those with HIV/AIDS. Due to this intervention, over 850,000 people are currently living with HIV infection in the United States (Centers for Disease Control and Prevention, Morbidity and Mortality Report, 1999; Centers for Disease Control and Prevention, 2001).HIV/AIDS in MichiganMore people are living with HIV/AIDS in Michigan each year. Between the years 1990 to 1996, approximately 1,200 people were newly infected annually with HIV/AIDS in Michigan. The infection rate declined slightly to approximately 825 people in 2000. Today, it is estimated that 15,500 residents of Michigan are living with HIV infection (Michigan Department of Community Health, 2002). Statistics have remained fairly constant from 1996 to 2000 regarding the different ethnic and sex groups who may contract HIV in Michigan, as well as the varied modes of transmission (Michigan Department of Community Health, 2002).Men outnumber women with HIV or AIDS in Michigan, with 8,090 men and 2,388 women reporting living with HIV or AIDS as of January 2002. This number represents approximately a four to one infection rate of men versus women in the state. For men, the modes of transmission listed from greatest to least are as follows:* Male-male sex (57%)* Injecting drug use (14%)* Male-male sex with injecting drug use (7%)* Heterosexual (5%)* Blood recipient (1%)* Perinatal [in womb] (1%)* Undetermined (15%)For women overall, the modes of transmission listed from greatest to least are as follows:* Heterosexual (39%)* Injecting drug use (31 %)* Perinatal [in womb] (3%)* Blood recipient (1%)* Undetermined (26%).Estimates of the number of Michigan residents living with HIV or AIDS as of January 2002 by ethnic background indicate the following distribution (Michigan Department of Community Health, 2002; Centers for Disease Control and Prevention, 2002):* Black, non-Hispanic= 8,990* White, non-Hispanic= 5,580* Hispanic = 470* Asian = 130* American Indian = 130.The number of people in Michigan who have died of HIV-related causes declined by approximately two-thirds between 1995 and 2000 (Michigan Department of Community Health, 2002). The period of sharpest decline was from 1996 to 1997, because of the availability of new treatment regimens, followed by a slight decline in the death rate from 1998 to 2000 (Michigan Department of Community Health, 2002; Centers for Disease Control and Prevention, 2001). …