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Perceptions of an Epidemic

My Experience Growing up in Palo Alto, California

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Growing up in Palo Alto, home to Stanford University, in an affluent and educated community just 30 miles south of San Francisco, I have always been aware of the perils of AIDS but not of its presence in my community. The AIDS epidemic first spread in the bathhouses just north of my town. As long as I can remember, I have been constantly bombarded with information about the dangers of the disease and the devastation it causes in far-off places such as Africa. Despite these facts, I still underestimated the number of cumulative AIDS cases I believed occurred in Palo Alto.  I guessed that 75 cumulative AIDS cases in my town, when, in fact, there have been 117. I believe my underestimation is a result of the stigma that surrounds the disease in our society today. Throughout my experience as a student in Palo Alto schools I have been taught of the horrors of the disease, the risks of contracting it, and the importance of its prevention. Having had little personal interaction with AIDS patients, I have failed to grasp its presence in society. Despite my underestimation of the numbers, Palo Alto’s AIDS rate per 100,000 people, at 205, is below Santa Clara County’s rate of 236, and well below the national average of 339 (see Data Tables page).

            My perception of AIDS, Acquired Immune Deficiency Syndrome, and HIV, Human Immunodeficiency Virus, in Palo Alto has been influenced by the education I received in school, and in particular Palo Alto High School’s Living Skills program. Additionally, my high school newspaper conducted sex surveys that emphasized the necessity of protection and education.  My community’s proximity to San Francisco has influenced its willingness to discuss the disease. The fact that Stanford researchers conduct prominent AIDS drugs research and Stanford doctors treat AIDS patients in my town draws attention to the medical aspect rather than the social perspectives about the disease. Aside from medical discussion, most of the talk about AIDS in my community centers on devastation abroad. Palo Alto residents often sponsor fundraisers to send money to foreign AIDS victims and orphans. Looking at the AIDS data, I was surprised to see the high percentage of males that contract the disease, high transmission rates from male-to-male sexual contact, and the higher AIDS rates in other towns in my county.

San Francisco

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Stanford University

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Initial Perceptions and Education:                        

Throughout my childhood in Palo Alto, I witnessed many AIDS awareness campaigns both in and out of school. At my private all-girls middle school we had an extensive unit on sex education in science class. Much of the unit focused on sexually transmitted diseases and prevention. We were assigned an out-of-class project in which each girl researched a different sexually transmitted disease and form of protection and then presented the material to the class. Later in that class we did an experiment where we, determined what blood type we each had by pricking our fingers and testing our blood. When doing this, I remember discussing that the teacher was not allowed to help us and that we were not able to share needles or blood due to the risk of contracting AIDS. That year our school held an assembly that featured a panel of AIDS/HIV patients and experts. Seeing an AIDS patients sit on the stage in our auditorium, I remember being shocked to see someone who actually had the disease and who soon would die.

            I attended a co-educational public high school called Palo Alto High School. In order to graduate from Paly, each student is required to take one semester-long class called Living Skills. Focusing on basic life skills, students learn about racism, drugs, eating disorders, and especially sex. The Living Skills program was created in 1993 after the Paly newspaper, The Campanile, conducted a sex survey that revealed that students were not being safe when having sex. According to Paly’s Verde magazine, the Living Skills class is considered an “abstinence plus” program that teaches about the risks of sex and methods of prevention of STDs and pregnancy in addition to abstinence.

The Paly Living Skills program is known as an abstinence-plus, or comprehensive health program, designed by the California Department of Health Education. Students are taught about condoms and contraceptives, but abstinence is also stressed as the only way to stay completely safe. In a four-week unit, students learn about anatomy, values, decision-making, STD prevention, abortion, safe sex choices, abstinence, and many other aspects of sexuality. Burton tries to encompass all she can in the unit, including guests from Planned Parenthood and Save-It, an abstinence program designed by the Community Pregnancy Centers of Santa Clara County.[i]

            Last year, as a writer and section editor for Paly’s The Campanile, I was involved in the 2005 sex survey the newspaper conducted to see how well the Living Skills program had been working. While the survey did not explicitly mention AIDS, it served to emphasize the risks of sexual activity and highlighted the need for protection. The results of the survey showed that fewer students were having sex, but there was still a prominent portion of the student body that did not use protection. Only 57 percent of the students who had sexual intercourse always used a condom.[ii]  The survey’s most shocking results centered on the lack of protection used during oral sex, which suggests that students’ biggest concern is about preventing pregnancy and that they are either unconcerned with or unaware of the possibility of contracting life-threatening STDs, such as AIDS, from engaging in oral sex. According to Nancy Brown, a Palo Alto Medical Foundation (PAMF) research and coordinator of the PAMF teen health website, “Since there’s no risk of pregnancy, teens don’t take protection as seriously. This risk has been so ingrained as the biggest risk of sexual activity, but really it’s sexually transmitted diseases…it’s a lack of communication between teens and parents and health experts.”[iii]

            After seeing that only 3 percent of the students always use protection during oral sex, the Paly students addressed the school and the administration through the newspaper asking for more education about oral sex in Living Skills. According to an editorial in The Campanile, “most students are aware of the dangers of intercourse but underestimate the dangers of oral sex. In light of these alarming statistics, The Campanile believes the Living Skills program now needs to shift its focus and concentrate even more on the risks of oral sex.”[iv]

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The Palo Alto High School Newspaper

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Misperception:

Learning about all the risks of sexually transmitted diseases and methods of protection in school has influenced my perspective on AIDS. Having had this knowledge throughout my childhood has led me to believe that AIDS is easy to prevent and has given me a bias that one would have to be stupid or highly promiscuous to contract it. Having had so much education about the prevention of AIDS led me to guess low the number of cumulative AIDS cases in my town.

The media in the San Francisco Bay Area has altered my perception of AIDS by focusing more on AIDS on a broader scale and less on the presence of AIDS in my town. With prominent research being conducted in San Francisco and at Stanford University, I have often heard about new advances in drugs for AIDS patients and other aspects of the disease related to the medical world.  Recent headlines in the San Francisco Chronicle have featured stories on a possible vaccine, the advantages of medicinal marijuana, problems with government budgets that provide limited AIDS funding, the shortcomings of abstinence only sex education, gay men, and the risks of treating AIDS erratically. More frequently, I hear about AIDS in relation to the devastating role it plays in Africa. Many philanthropists in Palo Alto organize benefits, fundraisers, and programs sending supplies to AIDS victims and orphans in Africa.

Palo Alto, home to Stanford University, has been at the forefront of AIDS research since the epidemic began almost three decades ago. The fact that Stanford treats AIDS patients and conducts research could be one factor that increases the number of cumulative AIDS cases in Palo Alto. In 1996, Stanford treated over 200 AIDS patients and ran 12 drug studies.[v] The Stanford Blood Bank, the place where I frequently donate blood, was the first blood bank of any to screen the blood for AIDS. According to Randy Shilts in And The Band Played On, “by the end of May 1983, Stanford University Hospital became the only major medical center in the United States to decide to start testing blood for evidence of AIDS infection.”[vi]  Although the blood bank required me to answer questions about having sex with gay men and I am aware that they screen the blood, never before did I realize there were actually so many AIDS cases in my town. I thought it was all merely precautionary.

Underestimation:

            Another factor that could have contributed to my underestimation of the number of cumulative AIDS cases in my town is the fact that the disease first spread in the Bay Area. Since 90 percent of the cases in Santa Clara County have occurred in males, 75 percent of males acquired it from male-to-male sexual contact, and 56 percent of the male cases resulted in death, one can assume that many of the cases occurred at the beginning of the epidemic (see Data Tables page).

            While Palo Alto’s AIDS rate per 100,000 is 205, its neighboring town, Mountain View, has a higher AIDS rate of 236. Although Mountain View is a slightly less wealthy town than Palo Alto, both cities are located in the heart of Silicon Valley where the presence of poverty is negligible. The most probable reason for Mountain View’s higher AIDS rate is the presence of more diagnosis clinics. Whereas both towns have hospitals within their boundaries, only Mountain View is home to a Planned Parenthood.

Although I underestimated Palo Alto’s number of cumulative AIDS by guessing 70 when, in fact, there have been 117, my town does not have a large problem with AIDS. Palo Alto’s cumulative AIDS rate, at 205 cases per 100,000, is below Santa Clara County’s 236, and well below the national average of 339 (see Data Tables page). Throughout my childhood I have been taught of the horrors of AIDS and the necessity of its prevention. As a result, I developed a bias in which I thought AIDS only strikes stupid people who do not use protection, leading me to believe that my town has fewer cases than it does. Because of the high incidence of AIDS in men and the transmission from male-to-male sexual contact rather than by drugs or blood, many of the reported cases in my town were most likely reported towards the beginning of the epidemic when education about protection was not an option. It is likely that fewer people are contracting AIDS in my town now and in recent years. Despite my underestimation, my town does not have a huge problem with AIDS and its residents remain aware and active during the AIDS epidemic.

[i] Radicati, Let’s not talk about sex. (Verde Magazine, 2005).

[ii] Lehmann, Paly survey shows less teenage sex: Results show unsafe oral sex, highlight misconceptions of peers’ sexual behavior. (The Campanile, 2005).

[iii] Lehmann, Paly survey shows less teenage sex: Results show unsafe oral sex, highlight misconceptions of peers’ sexual behavior. (The Campanile, 2005).

[iv] The Campanile Editorial board, Editorial: Living Skills should put emphasis on safe oral sex. (The Campanile, 2005).

[v] Kazak, HEALTH CARE: New AIDS treatments create hope. (The Palo Alto Weekly, 1996). 

[vi] Shilts, And the Band Played On: Politics, People, and the AIDS Epidemic. (New YorkL St. Martin’s Press, 1987), 307-309.