Following the Minnesota Department of Health’s annual report, health experts and organizations are scrambling to explain a startling increase in HIV cases.
The number of new HIV cases in Minnesota rose 13 percent in 2009.
In total, there were 368 new HIV infections in the state — the highest number of cases in 17 years. This was up from 326 HIV cases in 2008, with gay and bisexual men ages 15-24 accounting for much of the increase.
Some say it’s the times.
HIV looks much different than it did in the 1980s, when it was essentially a death sentence, said Peter Carr, manager of the MDH’s HIV and Sexually Transmitted Disease section.
“Young men aren’t seeing their friends dying on a regular basis like was the case in the mid-1980s,” he said. “There might be a sense that HIV isn’t a big deal.”
Despite the rise in HIV diagnoses, the number of new AIDS cases and deaths did not see a significant change — a result of successful advances in treatment.
Ever since anti-retroviral drugs became widely available around 1996, HIV has been more manageable — a change that has altered public perception of the disease, Dave Folkens, spokesperson for the Minnesota AIDS Project, said.
But complacency isn’t a good thing when it comes to HIV, he said. Without the necessary support systems, such as medication, it’s still a deadly disease.
A number of factors influence the spread of HIV, and attributing the rise to complacency may not lead to a productive conversation about them, said Keith Horvath, an assistant professor in the University of Minnesota School of Public Health.
“Saying that rising HIV rates is the result of complacency suggests that there isn’t much we can do about it,” he said. 
Several underlying reasons could be at the root of the rise, including underestimating one’s risk for HIV, peer norms that discourage condom use, alcohol and drug use and difficulty negotiating safe sex practices, Horvath said.
Others say the Internet has made finding sexual partners easier.
When speaking with patients who’ve recently been diagnosed with HIV, Paula Nelson, clinic manager of the Hennepin County Public Health Clinic, said many talk about meeting their partners online.
B. R. Simon Rosser, a professor in the School of Public Health, has gathered a team of public health and computer science researchers to develop an HIV-prevention computer program that will meet its audience on its own turf: the Internet.
“The most common explanation people say is that the Internet has led to a big change in how people find sexual partners,” he said, “but all our prevention effort is geared offline. We need to do more online.”
Although still in the early stages, Rosser’s program will likely be a highly interactive computer game tailored to individual users.
The University doesn’t see many HIV cases on campus, said Dave Golden, director of public health and communications for Boynton Health Service.
Every three years, Boynton conducts a survey of University students and often no one reports being HIV-positive. The last survey, released in 2007, found that 0.2 percent of students had been diagnosed with HIV at some point in their lives. Meanwhile, a 2009 survey of all postsecondary students in the state found that 0.5 percent of students had been diagnosed with HIV or AIDS in their lifetime.
The University sponsors educational campaigns to raise awareness, performs testing and distributes free condoms, Golden said.
Surveys also indicate that University students have far fewer sexual partners than the general public, with almost 80 percent reporting zero to one partner in the past 12 months, Golden said.
“Decrease the number of partners, decrease the risk of exposure to different bugs,” Golden said.
It’s important for those at risk of contracting HIV to get tested, as some people have been infected for up to eight years without knowing it, Carr said. The Centers for Disease Control and Prevention estimates one-fourth of the HIV-positive persons in the United States don’t know they’re infected.
Despite a recent rise in heroin use in the Twin Cities, the number of new HIV infections from injecting drugs has decreased since 2008 thanks to prevention efforts, Carr said. The Minnesota AIDS Project regularly exchanges used syringes for clean ones and several local pharmacies sell syringes without a prescription.
Although sex can be a difficult subject, it’s imperative to maintain an open dialogue about the risks and methods of protection against HIV, Folkens said.
“Sex is not always comfortable to talk about in our society — a lot of people won’t do it,” he said. “But until we can do so in an honest and appropriate way, HIV will continue to rise.”