Early predictions of a "rampant spread" of AIDS are proving to be inaccurate, but the latest Irish figures reveal no room for complacency, according to the Minister for Health, Mr Cowen.
Up to the end of September Ireland had 608 AIDS cases, of whom 311 have died. Up to the end of August, 1,799 people have been found to be HIV positive, 45 per cent of whom were intravenous drug uses.
Speaking at a conference in Dublin to mark World AIDS Day yesterday, Mr Cowen said it was often difficult to remind people that AIDS remained a problem. "The spread has not occurred in the way heralded by some, but our latest Irish figures reveal no room for complacency."
With estimates of 29 million HIV cases and eight million with AIDS globally, the figures were startling. "The figures must concern us all, given increased travel and a shrinking of the global village.".
He introduced his Department's new campaign commercial on safer sex, a frank message to be screened to cinema audiences over 18 years. It focuses on letting the brain, rather than the body, dictate sexual practice. Health messages on sexually transmitted diseases and AIDS/HIV will only be effective if they relate to the current sexual practices of young people, a psychologist, Ms Doortje Braeken of the Rutgers Foundation, told the conference.
Having evaluated trends in 53 countries and analysed the generation of 1997, she felt health educators, albeit professionals, were at variance with young people. "Most discussions of health educators on AIDS/HIV prevention are far from being sexy, interesting and stimulating. They tend to go for things that are absolutely boring for people on the street."
This contrasted with other media fanatically interested in making everything sexual. Any effective strategy had to understand how sexuality fits into the lives of the young; how they talk about sex, express sexuality, relate love and sex and their concerns. "To control the AIDS epidemic we can never close our eyes from the sexual behaviour of young people," Ms Braeken said.
The foundation's Generation 97 survey indicated that young people wanted to know about safe sex, clarification on contraception, and honest and clear information about how they could improve their relationships and enjoy sex. Health messages, she added, rarely say what you can do. Equally, "no one gives you information on how to be abstinent."
Dr Mary Horgan of Cork University Hospital, an infectious disease specialist, said that despite advances in AIDS treatment, vaccines, drugs and education would be required in combination to control/prevent infection. "Vaccine development is ongoing, with no promising candidates to date.".
Post-exposure prophylaxis - treatment after exposure to infection risk - was not a morning-after pill, but a combined more prolonged treatment that could have some success. But there was a risk that it could lead to complacency.
Sexual health services and sex/ sexuality education were crucial to effective AIDS/HIV education, said Ms Ailbhe Smyth, director of UCD Women's Education Research and Resource Centre. Sex/sexuality education continued to be contested issues in Ireland and was seriously under-developed.
"It's hard to see how young people, especially heterosexual girls and young women and young gay people, can achieve real understanding of safer sex, and the confidence and skills necessary to practice safe sex where openness about sex/sexuality remains so difficult."
