HIV/AIDS at 30: A Public Opinion Perspective
As the HIV/AIDS epidemic marks its thirtieth year, the Kaiser Family Foundation is releasing a major, new national survey—our eighth on the topic since 1995—to better understand the evolution of public opinion toward the disease and the national efforts to prevent and treat it. Overall, the survey paints a picture of a nation that sees many signs of progress on HIV/AIDS, one which is far less likely to view the disease as an urgent national threat now than when AIDS first emerged in 1981. Masked by the overall numbers, however, are deep pockets of concern among some of the communities most affected by the disease. This report examines broad national trends in public opinion over the past several decades, and also takes an in-depth look at the views and experiences of two groups in particular: black Americans, whose communities have been severely and disproportionately affected by the disease, as well as young adults under age 30 who have never known a world without HIV.1 Finally, it focuses in on trends in reported HIV testing rates and experiences.
Some of the key findings from the survey include:
Over the long term, a declining sense of national urgency, decrease in hearing about HIV/AIDS.
In 1987, two-thirds of Americans named HIV/AIDS as the most urgent health problem facing the country, a share that has declined steadily over the years, and sits at just 7 percent today. More recently, there has been a decline in the share who report having seen, heard, or read about the epidemic in the past year, from seven in ten in 2004 to four in ten today.
Personal concern about infection also down over long term, but ticks up this year for first time.
After nearly a decade of declining levels of personal concern about HIV, which may have reflected a growing complacency, the share who say they are “very concerned” about becoming infected ticked up for the first time in this year’s survey. The change was driven by young adults, among whom personal concern increased from 17 percent in 2009 to 24 percent in 2011.
Blacks overall, and young blacks in particular, express much higher levels of concern about HIV infection.
While the uptick in personal concern overall is important, these general population findings mask huge racial differences. Blacks are four times as likely as whites to say they are “very concerned” about becoming infected with HIV (40 percent vs. 11 percent). And young blacks are even more likely to be worried—half of black adults under age 30 say they are very concerned. Six in ten black parents express this level of concern about the possibility of their son or daughter contracting HIV, three times as many as among white parents.
In other ways, too, the impacts of HIV/AIDS are felt much more deeply in the black community.
Other survey findings also illuminate large racial disparities in reported experiences with HIV/AIDS. For example, black Americans are more than twice as likely as their white counterparts to say a close friend or family member is living with HIV or has died from AIDS (41 percent vs. 17 percent), and almost three times as likely to see HIV/AIDS as an increasingly urgent problem for their community (35 percent vs. 12 percent). Still, at a time when the HIV epidemic continues to place a disproportionate burden on the black community, many key measures of concern and visibility are not increasing for blacks, and are in fact flat or trending downward over time. For example, the share of blacks saying HIV/AIDS is a more urgent problem for their community than it was a few years ago fell from 49 percent in 2006 to 35 percent today.
Reported HIV testing rates flat since 1997, including among some key groups at higher risk, though reports of doctors suggesting HIV tests increased in last two years.
About one in five non-elderly adults say they have been tested for HIV in the past 12 months, a share that has remained about the same since 1997. Blacks, Latinos, and younger adults are more likely to say they’ve had a recent HIV test, but reported testing rates for these groups have also been flat over the past 14 years (currently 43 percent for non-elderly blacks, 24 percent for non-elderly Latinos, 26 percent for 18-29 year-olds overall, and 47 percent for 18-29 year-old blacks). While the share of non-elderly adults who say a health care provider has ever suggested they be tested for HIV ticked up from 19 percent in 2009 to 29 percent in 2011, so far this hasn’t translated into an increase in reports of actually getting an HIV test.
Continued support for government spending to combat HIV, despite economic recession.
Despite the severe economic crisis of the past several years, more than half of Americans continue to support increased funding for HIV/AIDS, and fewer than one in ten say the federal government spends too much in this area. Young adults express even higher levels of support for government spending on HIV, and are more optimistic than older adults that spending on prevention and treatment will lead to meaningful progress.
Media is by far the public’s top source of information about HIV, and many express desire for more information.
Six in ten Americans say most of what they know about HIV/AIDS comes from the media, putting it ahead of other sources like school, their doctors, friends and family, and the church. Media is the top information source on HIV across racial/ethnic groups and for younger and older adults alike. Substantial shares of the public—and much larger shares among blacks and Latinos—say they’d like to have more information on a variety of HIV-related topics, including how to prevent the spread of HIV, how to know whether to get tested and where to go to do so, and how to talk with children, partners, and doctors about the disease.
Many continue to hold potentially stigmatizing attitudes, but trend is toward a decline.
Thirty years into the HIV/AIDS epidemic, substantial shares of Americans continue to express discomfort at the idea of interacting with people living with HIV. For example, 45 percent say they’d be uncomfortable having their food prepared by someone who is HIV-positive, 36 percent with having an HIV-positive roommate, 29 percent having their child in a classroom with an HIV-positive teacher, and 18 percent working with someone with HIV. However, reported levels of discomfort have decreased over the past several years. For example, the share saying they’d be “very comfortable” working with someone who has HIV increased from about a third in 1997 to roughly half in 2011. There have also been striking declines since the early years of the epidemic in the share expressing the view that AIDS is a punishment (from 43 percent in 1987 to 16 percent today) or that it’s people’s own fault if they contract the disease (from 51 percent to 29 percent).
Looking for a leader?
The public is hard pressed to name an individual who stands out as a national leader in the fight against HIV/AIDS. Three-quarters of Americans couldn’t name anyone in this capacity, and no person who was mentioned made it into double digits. And most Americans say there has not been enough action on HIV from a variety of groups and institutions including Congress; their state and local governments; the media; corporate, religious, and community leaders; pharmaceutical companies; and the Obama administration.
