Beth Clifford

AIDS paper 3

Yoshino

THE SOLUTION: AIDS IN UTAH

Utah has a certain stigma attached to it that there are few to no HIV/AIDS cases because of the ultra-conservative culture that is affiliated with the Church of Latter Day Saints (LDS), more commonly known as Mormonism. Although it tends to be more conservative, Utah is a very large contributor to the tourist industry; after the 2002 Olympics, tourism profits increased 21 percent and are continually rising[1]. Also, with the Salt Lake International Airport being the 25^th busiest in the world, serving around 21.5 million travelers in 2006, one can assume that large diverse groups of people come into Utah every year. [2]

My original perceptions of the disease in the Salt Lake Valley were very wrong. I had originally thought that the HIV/AIDS number would be much higher. I had thought it was much more of an explosive epidemic, in fact I thought it was 10 times as prevalent in the Salt Lake County than it really is at about 2200 cumulative cases of HIV/AIDS[3]. This is a common mistake due to misinterpretation of information: one either guesses extremely high or extremely low, unless one is very familiar with the disease and its whereabouts. It was pointed out in the first paper that a lot of the exposure to the disease came from the media. It is obvious that the media can be a valuable tool in the promotion of HIV/AIDS prevention if used correctly.

The numbers that were correlated show that HIV/AIDS in Salt Lake is most prevalent in men who have sex with men, in particular, white men who have sex with men[4]. The next highest risk group is the injected drug users (IDU). At rates like 10.5 infected among 100,000 white men, and about 90.4 infected for every 100,000 black men, you would think that the problem was in black men, not white men. The interesting thing about Utah is that there isn’t much diversity. 84.7 percent of the population of Salt Lake County is white, 15.8 percent of the population is Hispanic, and only 1.3 percent of the population is Black/African American[5]. This shows that the county is predominantly white. Even though the rate per 100,000 is low the actual number of AIDS cases is pretty high when all things are considered. It’s common knowledge that most of the HIV/AIDS cases would be in the most populated places. The most populated place in Salt Lake County is the Wasatch Front with around 2.3 million living there and also holding 88 percent of the County’s HIV/AIDS cases[6]. Other correlations found through research were poverty and male householders with male partners. This data shows that the highest risk group was the lower middle class white gay man, which was already known.

            The ski resorts bring enormous amounts of people to Utah. Utah has 13 world class resorts, and 9 are within an hour drive of the airport[7]. This easy access to the slopes has made Utah’s winter tourist industry explode, brining in around $1 billion dollars each year[8]. The most popular resorts include Snowbird, Alta, Deer Valley, Park City, Brighton, and Solitude[9]. These all have a good range of high end hotels to the more inexpensive hotels closer to the bottom of the canyon, therefore including most social classes. There is a very flexible price range from around $500 - $49 per night[10]. Similar to the situation with the International Airport, the spread of HIV/AIDS starts with non-native Utahn’s. Many vacationers will come into Utah, being attracted to the great outdoors located there and usually they are looking to relax, to unwind from the hectic lifestyle they practice. It is the perfect place to meet a stranger and have sexual relations with them. This is another factor to be thought about in the spread of HIV/AIDS in Utah

The field of medical geography and studying disease patterns can help us to truly identify the factors that are associated with the spreading of HIV/AIDS. Some studies have made attempts to analyze the migration and spread of HIV/AIDS. Migration here is used broadly refer to any form of population mobility. We know that germs and epidemics travel only as fast as people do. That makes it important to not only look at the pattern associated with Salt Lake, but also look at the effects of the pattern in accordance with the world. People travel for many different reasons: business, vacation, looking for a better life, seeking adventure, etc. HIV thrives in mobile communities, not just because it has human carriers but also because mobile populations are often in situations that make them more venerable to the infectious disease; meaning a riskier lifestyle such as going out more often, going to clubs and bars, using addictive substances i.e. injected drugs, and having unprotected sex. It is important to remember how people usually travel long distances: mostly by plane. If the population that is infected with HIV/AIDS is mobile and happens to travel to another mobile place, the disease is spreading fast. Communicable diseases like HIV spread faster and better due to the improvement of transportation technology. It is very easy to follow the spread of a disease by looking at the major highways, international airports, and also sea ports.           

Utah has 2 out of 3. Salt Lake international Airport is the Delta hub of the West coast, and is expanding every year to accommodate more flights to more places. It’s a big airport and is unusually close to the city, it averages about 2.5 million passengers per month[11]. One can assume that when someone travels, just like the original cause of the spread of HIV, they have unprotected with a variety of people. In “The Band Plays On”, Shilts researches and explains the spread of HIV and how it all began with a couple of gay flight attendants. That is the source of the spread of HIV/AIDS in America, and it is the source of the spread of HIV/AIDS in Utah. The spread of the disease is probably happening in the airport or in the neighboring clubs, bars, or hotels. I think that information pamphlets should be available all over the airport, the bars/clubs, and hotels. The pamphlets will have various facts about HIV/AIDS and what Utah is doing to try and prevent the spread of the disease. It will also include the resources that are available to anyone seeking protection, counsel, or information.

            Utah’s second feature that makes it vulnerable to the spread of the disease is that I-15 runs right down the middle of the state. Salt Lake City is about the same distance away from San Francisco, Seattle, Los Angeles, and Denver, making it one of the best roads to travel for product distribution with the trucking industry. Also it makes it one of the easiest ways for HIV to spread amongst truck drivers and then among their partners at various locations.

            I am proposing that there needs to be a condom distribution program within not only the International Airport, but also at the Ski resorts and at all the rest stops along I-15. The question is then raised, what will the parents say about condom dispensers all over the state? I don’t think every family will be happy with this proposal, but the dispensers can be concealed well enough for a young child not to be able to tell what it is. An ultra-conservative parent should also take into consideration that the only thing that will protect their child is knowledge -- knowledge about the disease and also about the spread and prevention of the disease. This plan could possibly be put in place in about 6 months time. The cost of 100,000 condoms is about $3,200 making this a great, inexpensive solution to the spread of an epidemic[12]. The dispensers will be very inexpensive, maybe at around 5 cents per condom. I think also that the money that is kicked back from those 100,000 condoms ($5,000) should be put to not only building the Condom Distribution Program, but also to the future of condom distribution. After the program has become semi-established a majority of the proceeds should be looking at free distribution in the more targeted risk areas of the state. This should be funded publicly, but it is not likely to pass in such a conservative environment. Private funding would not be hard and volunteers should be easy to find if you notice that the Gay Pride Parade is the second largest parade in the state[13]. Many people who are passionate about the Gay Pride events would also be passionate about the HIV/AIDS prevention events.

            The Condom Distribution Program should also be instilled within the Gay Bars and Clubs located in Salt Lake City. In an email to the Manager of The Trapp Door, one of the hottest gay clubs in Utah, I asked if he had any sort of condom distribution within the club, and if not would he be interested in instilling that if it was funded; he replied that there was not any condom distribution in the club and he would support it if it was available, but unfortunately he was not in charge of those types of decisions. The clubs don’t promote unprotected sex; in fact, they encourage the use of a condom[14]. There just isn’t a plan that provides condoms. If these clubs gave out condoms at the door or in the bathrooms would probably increase business. During the 2002 Winter Olympics free condoms were provided to contestants, workers, and audience members to promote safe sex and reduce the transmission of HIV/AIDS. Although this program brought up many protests, it obviously did what it was intended to do; prevent a huge outbreak of HIV/AIDS right after the Olympic Games. Over 120,000 condoms were distributed. 12,000 of those would be available at free clinics around 10 competition sites. This program shows that condom distribution is effective and just needs to be put in place until we don’t have a problem with STD/HIV/AIDS.[15]

            Another interesting possibility for reducing HIV/AIDS in the Salt Lake County is something called sereosorting. Sereosorting means that HIV positive men who know their sereostatus only have sex with other HIV positive men therefore lessening the amount of infected by eliminating the infectors. This is something that has been done in San Francisco over the last couple of years and has proved to change the increasing rate of HIV infections to more of a flat line, and hopefully in the future it will proceed to start declining. It is something that cannot be forced upon individuals because that is quite invasive and against the rights of men, but it can be presented as an option to HIV positive men to contribute in the global fight against HIV/AIDS. The men of San Francisco did this on their own accord and it was noticed.[16]

Increasing the frequency of HIV/AIDS prevention counseling and also providing more Rapid HIV testing sites are effective solutions to preventing the spread of HIV/AIDS in Utah. These two programs go hand in hand; while someone who may be HIV positive is being tested by the Rapid results test, which takes about 20-30 minutes, and the whole time they will be talking to a counselor and possibly working out a risk reduction plan or even a family counsel type of thing[17]. This will be funded publicly: the majority of the funding will come from the Utah AIDS Foundation and also the State Government. There shouldn’t be that much trouble receiving the money from the government because the Utah AIDS Foundation should have just as much pull or leverage as the Breast Cancer Foundation for instance. These solutions I believe are what Utah needs to be successful in the quest to actually prevent the spread of HIV/AIDS.