1. Why Prevention is Critical Across Health Issues: Using HIV Prevention as a Model Cynthia A. Gomez, PhD Director, Health Equity Initiatives San Francisco State University CAPS 5 th Conference April 21, 2006

3. Our Declining Health Over the past 20 years there has been a dramatic increase in obesity in the U.S. with nearly 130 million adults being overweight or obese. There are 20.8 million children and adults in the United States, or 7% of the population, who have diabetes. While an estimated 14.6 million have been diagnosed with diabetes, 6.2 million people (or nearly one-third) are unaware that they have the disease. Heart disease is the leading cause of death in the U.S. and 1 in 3 adult men and women has some form of cardiovascular disease.

5. Unintended Pregnancies Unintended pregnancy is a major public health and social problem in the United States. Nearly half of the six million pregnancies that occur among American women each year are unintended. As a result, American women experience 1.4 million unplanned births and 1.3 million abortions annually. They also have one of the highest rates of unintended pregnancy in the industrialized world.

6. Is Prevention Working? Living with HIV/AIDS Living with HIV Living with AIDS New HIV Cases

7. HIV Prevention Model Is it time to expand?

8. Complexity of Determinants Genetics Child-rearing Opportunities Social Context Culture InterpersonalPhysiology Economics Environment Spiritual Gender dynamics

9. Stigma

10. Current Strategies/Services Prevention Outreach Pamphlets Counseling & Testing Individual/Group Programs Media Community Events Care & Treatment Early Identification Access to medication Adherence Tools Treatment Advocacy Support Groups

11. New Directions HIV services – do we integrate with other health-related services? Do we lead new prevention efforts across health issues? Can we become more holistic without loosing our mission?

12. Email: Drcgomez@sfsu.edu Tel: 415-405-4350