Three decades into the HIV epidemic, health advocates say apathy, denial and misinformation about the disease persist, particularly in minority communities.
Blacks represent 14 percent of New Jersey's population but 53 percent of those with HIV, according to the state Department of Health. Hispanics, meanwhile, represent 18 percent of population and 23 percent of HIV cases.
"Specifically in the black community, there hasn't been a huge conversation or a dialogue regarding sex and HIV," said Travis Love, a health educator at Atlantic City's Oasis drop-in center.
Denial and fear mean that many who engage in risky behavior don't know or believe that they're at risk; or that HIV can be fatal if untreated.
"The price of silence is that we have a greater value for shame than for life," Love said.
While many still associate HIV with drug users, homosexuals and sex workers, the autoimmune disorder has spread far beyond those initial stereotypes.
When Jean Haspel first came to AtlantiCare Regional Medical Center in 1986, the disease was being found predominantly in the young, white gay men who frequented the city's gay bars. But in the 1990s, the adult nurse practitioner and HIV specialist started seeing more injectable drug users and their partners being diagnosed.
"There's a lot of denial," she said. "A lot of heterosexual African-American females had no idea their partner was an injection drug user and some say they knew ... but they were just happy to be in a relationship with him."
And the impact of one HIV-positive drug user can have wide-reaching effects, Haspel said. That one person may have had five or 10 partners and shared needles with 10 or 20 more people.
Many programs have worked to curb this chain of infection. Oasis, for instance, distributed 43,000 clean syringes in the third quarter of 2011 alone. It also hands out about 2,500 condoms each month.
Haspel said there should be no new HIV infections, but getting good information out into the community is difficult.
"Unfortunately, I think sex is still the major factor for this town," she said. "There's a lot of sex going on, and not enough people are taking precautions."
Love, 31, grew up in Atlantic City and met many people who were infected before coming to Oasis four years ago. Many of the clients he talks to today have misconceptions about the disease and their risks.
"People say, 'I'm only going to have sex with people who live in Egg Harbor and not Mays Landing'," he said. "A lot of people think that way."
Others engage in risky behavior, under the false belief that they're safe because they engage in sex only with college students or the wealthy, Love said.
Another at-risk group which Love often deals with is men who have sex with men, but don't consider themselves bisexual or homosexual. They don't identify themselves as gay because they feel they won't be accepted by family and friends.
But the same mindset the leads them into risky behavior is found in a lot of at-risk groups, he said.
"People who feel isolated or don't have someone to talk to or turn to are the ones who are putting themselves at risk," he said.
Love will lead a workshop today at Atlantic Cape Community College as part of National Black HIV/AIDS Awareness Day to increase awareness of the issue.
"What we hope to communicate is the need for awareness of sexual health and healthy lifestyles," said Lisa Givens, a program specialist for student activities.
Givens said the event was started by a student group two years ago and has been continued by the school to encourage healthy choices for all students.
Haspel said medical advances in the treatment of HIV -- as well as public success stories, like that of Magic Johnson -- have provided a false sense of security.
While coping with the disease is easier than it was in the 1990s, when patients had to take a cocktail of 18 to 20 pills a day, the disease can still be fatal if the patient doesn't follow their treatment.
"People who come in at 20 should live well into their 70s as long as they do what they need to do," she said. "If patients don't, their life expectancy will be much shorter and they'll be more likely to spread the virus."
At a event in Trenton on Tuesday to promote the national awareness day, state Health Commissioner Mary E. O'Dowd encouraged more people to get tested.
"Although we've made great strides over the years in reducing the transmission of HIV, every day more people become infected," she said. "Currently, more than 36,000 New Jersey residents are living with HIV or AIDS and statistics tell us that too many of them are African American."
Nationwide, blacks comprise 14 percent of the population and 44 percent of new infections, according to the Centers for Disease Control and Prevention. Hispanics account for 20 percent of infections and 16 percent of the population.
Love said there's still a very real stigma attached to HIV.
"People fear walking through our doors, although we have a lot of other programs and not just for people who are positive," he said.
Others are hesitant to seek treatment for economic reasons, said Jillian Nehr, who oversees operations at Oasis.
"Those who are already positive think if they don't have medical insurance, they can't get care," she said.
Under the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, which was passed in 1990, people with no other resources can receive free treatment for HIV/AIDS.
Those from the lower end of the socioeconomic spectrum tend to face challenges beyond accessing treatment -- from addictions, limited transportation and other untreated illnesses. But Nehr said the resources are there if they seek them out.
"I think some people would rather choose to ignore it than face the facts and do the hard work," she said. "Living healthy means proper diet, exercise, seeing a doctor regularly and taking meds as they're prescribed. A lot of people are afraid to dive into that world."
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