EXPERTS: PREVENTION KEY TO STOPPING HIV

At the end of the day, when Nickie Bell packs up her information
booth at a local health fair, she invariably has run out of pens and
pencils scooped up by visitors. The same cannot be said for her
basket of condoms.

"We're not usually the people that folks want to come over to visit,"
said Bell, a program manager with the AIDS Coalition of Coastal
Texas. "When people come by (the booth) they just act uncomfortable
or crack jokes about the condoms. They grab a (free) pencil and then
get away quickly."

For Bell, who attends many community events and speaks about HIV
prevention at schools around the county, that reaction to the AIDS
Coalition display is a nagging source of frustration.

"People will say, 'Oh, I don't need (condoms), I'm married,' or 'My
kids aren't having sex'," said Bell. "Well, guess what. Kids are
becoming more sexually active, around age 12-13, than ever before."

That reticence to discuss safe sex is in jarring juxtaposition to the
country's rising tide of HIV infections -- the virus that causes AIDS
-- and other common sexually transmitted diseases.

Medical experts and those who try to spread the word about abstinence
or safe sex among youths say the nation is under the heels of a pandemic.

Safe-sex Counseling

Despite the major medical breakthroughs that have made the incurable
disease much more manageable 25 years after AIDS was first
identified, abstinence and practicing safe sex are still the only
ways to prevent its spread.

At least 40,000 new HIV infections are reported in the United States each year.

In Galveston County, several agencies offer safe-sex counseling and
have educational programs to target at-risk groups.

For example, the Galveston County Health District -- which
administers HIV/AIDS programs in Galveston, Brazoria and Matagorda
counties -- uses two programs for intervention and prevention of HIV
or sexually transmitted diseases.

One program is dubbed RAPP -- Real AIDS Prevention Program -- aimed
at African-American women and also men who have sex with men.

Outreach workers take the program from street corners to pool halls
to community centers.

"The idea is to try to move people from one (opinion) to another,"
said health district spokesman Kurt Koopmann.

If a person says he never uses condoms, workers talk to him
one-on-one and try to get him to say he will use them sometimes,
Koopmann said. If someone says he uses condoms all the time, outreach
workers try to reinforce that.

Condoms In Schools

The heath district's other HIV risk-reduction and prevention program,
Turning Point, is aimed at intravenous drug users.

The sessions, offered in 2005 to 627 residents in the three counties,
typically are at drug treatment centers and include counseling to
encourage an HIV test and educational films.

"We're not allowed in the state to offer a needle-exchange program,"
said Koopmann, "But we can instruct them how to sterilize their needles."

Bell, with the AIDS Coalition, and other social agency workers
interviewed by The Daily News agree that more educational counseling
is paramount in school settings.

They understand the need to talk about abstinence but say to avoid
the topic of safe sex is a serious gamble.

School districts follow state guidelines on sex education. The Texas
Education Code specifies that school districts must "present
abstinence as the preferred choice of behavior for unmarried persons
of school age, and devote more attention to abstinence than to any
other behavior."

Teen Clinics

The Teen Health Center operates free clinics at several schools in
the county in association with the University of Texas Medical Branch.

The clinics, which offer free medical treatments and confidential HIV
testing to any school or college student up to age 22, are at Ball
High School and Central and Weis middle schools in Galveston, at La
Marque High School and at Blocker Middle School in Texas City.

Only one of these clinics -- at Ball High -- offers a service through
which a student, with a signed permission slip from a parent or
guardian, can obtain a condom.

"Somehow, some people's perception is that we're only a sex or STD
clinic, and we're telling (students) to go out and have sex or make
it easier for them," said Richard Rupp of UTMB, the teen centers'
medical director. "But clinic visits related to STDs or pregnancy
only represent about 2 percent of what we do. We promote healthy
lifestyles with the goal of having students not miss school."

Focus On Education

School districts are forbidden to distribute condoms in connection
with any instruction relating to human sexuality, which is another
source of frustration for Bell, especially when she makes a
presentation about HIV prevention in schools. Bell said she can hand
out pamphlets about HIV protection but is not allowed to demonstrate
the use of a condom.

"It's very important for us to do this (HIV prevention)," Bell said.
"You can't sugarcoat talking about sex.

"Younger kids are trying oral sex, and they don't consider it like
having 'real' sex. And it's more common than parents would like to
think. Parents need to be educated to educate the children."

A study in the June issue of Archives of Pediatrics & Adolescent
Medicine indicates that teenage girls face harsh realities when it
comes to practicing safe sex.

According to the study, about 40 percent of girls between 14 and 17
reported being threatened or pressured by their partners into having
sex, potentially increasing their risk of acquiring a sexually
transmitted disease.

The study involved 279 teenage girls in Indiana. Nearly 90 percent were black.

Among all participants, 37.6 percent said they had unwanted sex
because they feared their partner would get angry if denied sex.

Unwanted sex was also more often linked to situations when condoms
were not frequently used or if either partner used alcohol or marijuana.

With these kinds of social pressures evident in today's society --
and the fact that African-Americans now face the highest risk of
contracting HIV or other sexually transmitted diseases -- county
residents who are HIV-positive interviewed by The Daily News agree
that educators and parents must do a better job of hammering home the
message about abstinence and safe sex.

"What's worse -- to practice safe sex or face the possibility of
dying of AIDS, just from one mistake?" asked Galveston resident Kenny
Gray, who has been HIV positive since 1989. "We've got to preach that
practicing safe sex is the most sensible thing for people to do.
Their lives could be at stake."