America Living With AIDS

CHAPTER TWO
PREVENTION AND
EDUCATION
ntil a cure or a vaccine is found,
education and prevention are the only hope for altering the course of the HIV epidemic. This actually understates the importance of prevention, for prevention
strategies will continue to be a key component of HIV containment far beyond the
advent of successful drug treatments or vaccines. There are valuable lessons to be
learned from earlier experiences with sexually transmitted diseases. Effective and
inexpensive treatments for many of these diseases have long been available, yet drugs
alone have not stemmed the tide of infections, especially among young people and
those living in poverty. Those prior experiences are underscored by the rapid
reemergence of syphilis, and it can be said with certainty that medical science alone
will not be able to vanquish AIDS, even with a magic bullet.
There is an urgent need for implementation of carefully designed strategies to
prevent new HIV infections (primary prevention) and to prevent disease progression for HIV-infected individuals through early diagnosis, prompt treatment, and
continuing care and support (secondary and/or tertiary prevention). Educational
programs are also necessary to alter the public's perceptions that HIV disease is
someone else's problem. The discrimination that occurs against people with HIV
disease results largely from fear and ignorance, and the best weapon against these is
education.
Some of the most encouraging news thus far in the HIV epidemic comes from the
success of certain health education programs that have resulted in dramatic, sustained reduction in risk behavior. There is clear evidence that prevention is possible;
changes in attitudes and behavior can occur as a result of carefully tailored, targeted,
and credible prevention efforts. Such success is less dramatic to the public than a
laboratory breakthrough, but probably more important. This chapter considers an
array of education and prevention strategies, highlights some prevention success stories, and offers recommendations to focus prevention efforts for the second decade
of the epidemic. As we move into the second decade, the Commission believes poli
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