Research Team Finds Gaps in Local HIV Prevention Efforts

A research project commissioned by the federal government and the Chicago Department of Public Health recently found that HIV prevention efforts in Chicago are insufficient: HIV prevention services across the City range from comprehensive to non-existent and are particularly inadequate at night- a time when much high-risk activity occurs. Even where prevention services exist, the team's report says, people at high-risk for HIV often have an incomplete understanding of such services. The report, known as the "RARE Report," is helping local service planners and public officials gain a better understanding of Chicago's HIV prevention needs.

The team used methods known as RARE-Rapid Assessment, Response, and Evaluation-to study the disproportionate impact of HIV/AIDS on communities of color in the City of Chicago. Other at-risk populations, such as youth and sexually active heterosexuals, were not the focus of the team's efforts. Research teams using RARE methods have assisted communities worldwide in responding to emerging health crises.

The Chicago team selected four geographic areas for its assessment: Altgeld Gardens, East Humboldt Park, Cicero Avenue between Roosevelt Road and North Avenue, and a private north side location frequented by men who have sex with men (hereinafter referred to as an "MSM venue"). Below are some of the team's key findings and recommendations as reported in the RARE Report.

Findings:

• The largest proportion of all new AIDS cases in Chicago are attributable to injection drug use: either directly through use of a syringe contaminated with HIV or indirectly through sex with an HIV-positive drug injector. (RARE Rep. at 6).
• The greater access injection drug users have to sterile syringes, the less they will share needles. Virtually every injection drug user interviewed reported sharing needles when a clean one was not available. (RARE Rep. at 23.)
• At the Altgeld Gardens study site, injection drug users who were interviewed reported that there were no needle exchange services available, and several subjects did not know what a needle exchange program was. (RARE Rep. at 24.)
• Some police officers cite condom possession as evidence of prostitution. Therefore, some commercial sex workers do not carry condoms for fear of being charged with a felony. (RARE Rep. at 7.)
• Among the men interviewed at an MSM venue, most admitted recently not using a condom during anal sex. (RARE Rep. at 31.)
• Most people interviewed stated that they had been tested for HIV but were not being tested every six months despite the fact that they were engaging in behaviors that placed them at risk for HIV. In addition, many reported receiving an HIV test but not returning for the test results. (RARE Rep. at 7, 33.)

Recommendations:

• Increase the availability of sterile syringes. In all areas of the city, access to sterile syringes could be increased at no cost if pharmacies were allowed to sell syringes without prescription. (RARE Rep. at 38.)
• Conduct street outreach at night. Police should not discourage anyone, including commercial sex workers, from carrying condoms. (RARE Rep. at 7, 37.)
• Considerable HIV prevention programming, including onsite outreach, regular HIV testing, and increased availability of condoms, is needed for MSM venues. (RARE Rep. at 7, 37-38.)
• HIV testing at an MSM venue should be performed by a single agency. Any agency providing HIV testing at MSM venues should explore innovative means for providing test results that would increase the likelihood that test results are obtained by clients. (RARE Rep. at 38.)

For more information, contact the Chicago Department of Public Health, Division of STD/HIV/AIDS Public Policy and Programs, at (312) 747-9865.

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Research Team Finds Gaps in Local HIV Prevention Efforts

Research Team Report (PDF)

Chicago HIV/AIDS Statistics (PDF)

The Value of HIV Prevention (PDF)

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