Take blame out of prevention efforts and messages to people with HIV, activist advises.(Clinical Rounds)

MIAMI -- If HIV prevention messages are to be effective, a shift in strategy--away from assigning blame--is needed, said Terje Anderson, executive director, National Association of People With AIDS, Washington.

"We've built up this whole culture of assigning blame. So much of the approach toward [HIV-] positive people in the United States is the vector approach--delivering the single message to positive people and society at large that they are the vectors of disease.

"I don't think in the long run that will be effective in preventing new cases," said Mr. Anderson, who offered an HIV-positive person's perspective on prevention during a conference sponsored by the American Foundation for AIDS Research.

Prevention programs should begin by asking HIV-positive people what they want in their lives and assessing what drives their behavior, Mr. Anderson suggested.

In such discussions with HIV-positive people, several themes have emerged. They want:

* Good, nonjudgmental information from health care providers.

* Acceptance and a sense of belonging in their community. They experience an amazing degree of social isolation because of their HIV status, Mr. Anderson said.