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National Survey of Americans on AIDS/HIV: News Release

Do Americans Think The AIDS Epidemic Is “Over”?

Many See Progress In Fight Against The Disease, Yet Support Still Strong For Spending On Prevention And Treatment

Though Still Number One, AIDS Now Tied with CancerAs Nation’s Most Urgent Health Problem

Embargoed For Release Until:10:00 am, ET, Thursday, December 4, 1997

Washington, DC — As new drugs have become available to help people with AIDS/HIV livelonger, advocates have worried that the public will perceive the epidemicas “over,” while others have questioned whether AIDS should receive specialstatus among the nation’s health concerns. Sixteen years since thebeginning of the epidemic, a new survey finds that while Americans seegrowing progress in the fight against the disease, they also continue toview AIDS as an urgent health problem for the nation and still stronglysupport spending on prevention, research, and treatment.

According to a Kaiser Family Foundation survey released today, the publicis far from thinking the AIDS epidemic is “over:” the vast majority — 88percent — give an emphatic no. But, a majority of Americans (52%) now dosee the country making progress in addressing the problems of AIDS. Only athird (32%) were as optimistic in 1995, when the Foundation surveyedAmericans on AIDS/HIV. And, in 1994, it was just a quarter (23%),according to a Times Mirror survey. Even so, the public continues to rankAIDS among the most serious health concerns facing the nation; although, itis now seen as more comparable with other diseases. Today, the samepercentages of Americans name AIDS (38%) as name cancer (38%) when askedwhat is the most urgent health problem facing the nation. Two years ago,AIDS was ranked first by 44 percent of the public, followed by cancer with27 percent. In 1990, 49 percent of the public said AIDS, and 31 percent,cancer, according to a Los Angeles Times poll.

“After more than a decade of fighting this deadly disease, Americans arelearning to live with AIDS. While the public continues to see AIDS as anurgent issue, it is no longer a viewed as an emergent one,” said SophiaChang, MD, MPH, Director of HIV Programs, Kaiser Family Foundation.

Support for government spending to help pay for drug therapies forlow-income people with AIDS is especially strong. Three quarters (73%) ofAmericans say the government should help pay for new AIDS treatmentsregardless of income-level; 20 percent say the responsibility should beleft to individuals and their families. Two thirds (64%) support spendingeven when told it would result in higher costs to the government; 29percent say the government cannot afford it.

Overall, a majority (51%) of the American people say the government spendstoo little money on AIDS (32% say “about the right amount;” 8% say “toomuch”). Forty percent (40%) say federal spending on AIDS is too low, ascompared to what is spent on other health problems such as cancer and heartdisease (35% say “about the right amount;” 11% say “too high”). This isdown from 1995, when 50 percent of Americans said not enough was spent onfighting the disease as compared to what is spent on other health concerns(31% said “about the right amount;” 12% said “too high”). Still, thereremain high levels of support today for spending in all areas of AIDSeducation, prevention, and treatment. When asked to choose a “toppriority” for HIV spending, the public favors devoting resources toresearch to find an AIDS vaccine (47%), followed by HIV/AIDS education andother prevention efforts (32%).

The survey also finds that most people — 89 percent — think that by nowall adults should know how to protect themselves from HIV infection, and 71percent think those who become infected today are more responsible fortheir circumstances than those infected earlier. While public sentimentleans toward greater personal responsibility, the public’s attitude towardpeople with AIDS is not punitive: a majority — 54 percent — do not thinkthat adults with AIDS/HIV should have to pay more of their medical billsthemselves than those infected years ago; 42 percent say should have topay more today.

Trends in AIDS/HIV.

For the first time this decade, in February of 1997,the Centers for Disease Control and Prevention (CDC) announced a decline inAIDS deaths in the United States. Deaths from AIDS among Americans, ages13 and older, declined 23 percent between 1995 and 1996. Declines werereported in all geographic areas, among men and women, among all racial andethnic groups, and in all risk and exposure categories. The number ofAmericans living with AIDS — almost a quarter of a million today –increased by 11 percent over the same time period. This increase in peopleliving with AIDS comes at a time when new drug therapies are available tohelp treat the disease and lengthen life. Protease inhibitors, a class ofdrug commonly used in combination therapies to treat people with HIV/AIDS,was approved by the Food and Drug Administration for use in this country inDecember 1995. The use of zidovudine (AZT) to prevent the transmission ofHIV from mother to child also appears to be having an impact. New AIDScases as a result of mother to child transmissions were recently reportedto have decreased by 43 percent between 1992 and 1996.

New Drug Therapies.

More people today (86%) than two years ago (75%) knowthat drug therapies are available to help people with AIDS live longer.The public is also more aware today that certain drugs can be taken bypregnant women with HIV to help prevent transmission to their babies: 49percent today, as compared to 30 percent in 1995.

Awareness about the availability of new drugs may be one reason the publicsees progress in the fight against AIDS: 44 percent of Americans today say”a lot” of progress has been made in keeping people with AIDS alive longer,up from 24 percent in 1995. However, most people believe that the newdrugs do not benefit everyone with AIDS/HIV: 79 percent say most peoplewho want the treatments are not getting them, and 58 percent say they arenot effective for most people who are taking them. The public also appearsto have a realistic understanding of the high cost of the new drugs: 42percent know the average monthly expense can be as high as $1000; 30percent think it is closer to $500 per month.

In spite of greater awareness about the drug therapies, the percentage ofAmericans who report having been tested for HIV has remained relativelyconstant over the last two years. Currently, two out of five people (38%)say they have ever been tested for HIV, including 16 percent in the lastyear; about the same percentages as reported being tested in 1995. Just 20percent of those surveyed say they have ever talked with a health careprovider about getting tested for HIV; two thirds (66%) of whom say theybrought the topic up themselves.

Needle Exchange.

Over the two years the Foundation has surveyed thepublic on needle exchange, Americans have remained supportive of these programs, which offer clean needles to IV drug users in exchange for usedneedles, as an AIDS prevention measure. As of the end of November, 64percent of the public favor needle exchange and 30 percent oppose. Earlierin the fall when the Foundation surveyed on needle exchange, 58 percentsupported and 38 percent opposed such programs. Two years earlier, 66percent supported needle exchange, and 30 percent opposed.

Public opinion on needle exchange, however, appears to be influenced byhow the issue is presented. When presented with the major arguments forand against needle exchange (including the criticism that needle exchangeprograms give tacit approval of illegal drug use) the differences levelout: in November, 48 percent support and 46 percent oppose. A few monthsearlier, 43 percent support and 53 percent oppose needle exchange whengiven these same arguments. Better knowledge of the scientific evidence onneedle exchange, on the other hand, appears to increase support. Afterhearing that organizations such as the National Academy of Sciences haveconcluded that needle exchange programs reduce HIV infection among IV drugusers without increasing their drug use, support for the programs in themost recent survey increases. Among the first group, those asked aboutneedle exchange without arguments, support increases from 64 percent to 73percent (20% still oppose); among those given both sides of the argument,support increases from 48 percent to 60 percent (32% still oppose). (Thisquestion was not asked in the earlier surveys.)

Today, a majority of Americans — 61 percent — think current law shouldbe changed to allow state and local governments to decide for themselveswhether federal funds should be used for needle exchange.

Other Prevention Efforts.

Americans support efforts to encourage condomuse to help stop the spread of HIV:

  • 62 percent say the TV networks should accept condom advertising (33%say should not);

  • 55 percent say when movies and TV shows deal with sexual relationshipsthere should be more references to condoms (32% say there are enoughreferences now); and
  • 44 percent say condoms should be made available in high schools, andanother 52 percent say only information about AIDS prevention should beprovided (1% oppose both).

Parents, Kids, and AIDS

The theme for this year’s World AIDS Day, held on Monday, December 1, was”Give Children Hope in a World with AIDS.” According to the Kaiser FamilyFoundation survey, parents remain a worried group about AIDS, especiallywhen it comes to their children: 52 percent of those with children 21 andyounger say they are “very concerned” about their son or daughter becominginfected with HIV, and an additional 21 percent say they are “somewhatconcerned.” Close to half — 46 percent say their concerns have heightenedfrom just a few years ago. Most parents — 57 percent — say they needmore information about what to discuss with their children about AIDS.

When it comes to other AIDS prevention efforts, parents are among the mostsupportive: 47 percent favor providing condoms in high schools; 64 percentsay more references to condoms should be included in movies and televisionshows that deal with sexual relationships; and 66 percent think condom adsshould be aired on network television. In total, 97 percent think someinformation about AIDS and how it is spread should be provided to teens inhigh school.


Methodology

The Kaiser Family Foundation’s 1997 National Survey of Americans onAIDS/HIV is a random-sample survey of 1205 adults, 18 years and older. Itwas designed by staff at the Foundation and conducted by telephone byPrinceton Survey Research Associates (PSRA) between September 17 andOctober 19, 1997. Additional questions were asked as part of a nationalomnibus telephone survey of 1,009 adults conducted November 20-23, 1997.The margin of sampling error for both national samples are plus or minus 3percent. The margin of sampling error may be higher for some of thesub-sets in this analysis.

The Kaiser Family Foundation, based in Menlo Park, California, is anindependent national health care philanthropy and not associated withKaiser Permanente or Kaiser Industries. The Foundation’s work is focusedon four main areas: health policy, reproductive health, and HIV in theUnited States, and health and development in South Africa.

Copies of the questionnaire and top line data for the findings reported inthis release available by calling the Kaiser Family Foundation’spublication request line at 1-800-656-4533 (Ask for #1346). Also availableis the top line data from the Kaiser Family Foundation’s 1995 NationalSurvey of Americans on AIDS/HIV (Ask for #1118).

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