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Analysis of First Impressions:
AIDS in Essex County, New Jersey
The social stigma surrounding AIDS resulted in spotty media coverage and education until years into the epidemic. The “gay disease” was avoided by the media, government, and society.1 Almost 3 decades later, and with HIV infection spread throughout many populations, media coverage and government help are still not making effective progress in curbing the spread of HIV.
The Newark Star Ledger and The New York Times coverage of the AIDS epidemic in New Jersey started in the mid-1980s. Because of limited coverage of databases, it is difficult to find records of HIV/AIDS coverage before the late-1980s. In those articles which are still accessible, records show increased media attention in patches in 1983 and 1985. An article written in Chicago and published in The New York Times reported the results of a study done in Newark, NJ in which the researchers concluded that some children with AIDS had contracted the disease through “routine close contact” with their families.2 The article was published in The New York Times on the 6th of May 1983. The night before, ABC and NBC television networks had run short, vague news clips on the findings of the study. The clips left the nation terrified and uneasy about sending children to school with AIDS-afflicted peers. The findings of this study were eventually disproven, but for years the nation was wary and clung to the old impression that HIV could be spread easily in the classroom and home. Thus, early newspaper articles were alarmist and drew attention to the concerns of parents whose children were to attend school with AIDS-afflicted youngsters. Before 1985, only one article appeared in which New Jersey’s AIDS problem was addressed. Beginning with the 1985-1986 school year, articles were featured with some frequency in the fall, averaging about one article per week. The main focus of these articles was to update the public on findings regarding classroom transmission.3
Since those days early in the epidemic over two decades ago, AIDS has become a grave problem in New Jersey, which ranks 5th among the states for cumulative AIDS cases. The epidemic is especially prevalent in Essex County, the county with the most cumulative cases. Essex is home to 11 municipalities with more than 50 cases, in which the cumulative rate is 1214 cases per 100,000 people; the rate across the country is only 339 per 100,000 (Table 1). Essex County also has extremely high numbers of women and children infected with HIV. Clearly, Essex County’s AIDS epidemic needs both proactive medical and legislative attention.
In the fight against transmission of the HIV virus, New Jersey has fallen far behind other states. New Jersey, where 44% of AIDS cases are attributed to transmission through intravenous drug use, was the last state to approve Needle Exchange Programs (NEPs) to prevent the spread of blood-borne disease. The state legislature was involved in a tumultuous legislative battle until December 19, 2006, an “historic day for public health”, when the NJ legislature passed a bill that allows for six communities to start NEPs (3).
Though it is a slow start, the dawn of lower Intravenous Drug Use (IDU) transmission rates is approaching. Until December, New Jersey was the only state in the union to have neither syringe sales nor a Needle Exchange Program (4). In Essex County, IDU transmission accounts for 42% of HIV contraction; 44% of HIV/AIDS infected males and 40% of females originally contracted the virus intravenously (Table 2). The national average for IDU transmission overall is 13%, or 21% for males and 36% for females. Currently, the nationwide statistics show that overall heterosexual contact is the leading cause of HIV transmission at 13%. In Essex County, heterosexual contact sits second, at 33% to IDU transmission, which accounts for 42% of transmission.
