In an age chronicled by Facebook posts and six-second Vine videos, the persistent threat of HIV/AIDS barely registers. Even in LGBT media, the disease is most often addressed by the smiling faces of athletic men in drug ads. The lurking danger of the Eighties and early Nineties has somehow emerged benign. It’s not easy to fight a monster that many have forgotten exists.

But it’s the job of the Q Austin to remember. The Q (www.qboyz.org) is an Mpowerment Project of AIDS Services of Austin, part of a nationwide evidence-based initiative to curb unprotected anal intercourse among young gay and bisexual men. In Austin, the project is addressing a problem that has long vexed prevention programs: the AIDS plateau.

With the availability of antiretroviral therapy, new cases of AIDS have dropped dramatically since the peak in the mid-Nineties. At that time, widespread public information campaigns helped sharply drive down HIV contraction rates. Although incidences are stable in the United States, the rate of new infections remains troublingly high. In recent studies, the Centers for Disease Control and Prevention have reported approximately 50,000 new HIV infections per year.

“There is a lack of awareness,” says AIDS Services of Austin Prevention Promotions Specialist Marcus Sanchez, “I think there’s been a lot of indifference from what we’ve heard and seen doing outreach within the community. We hear [the disease is] not an issue unless it’s a visible thing. More guys are concerned with contracting herpes or syphilis as opposed to a disease they’ve accepted as something that can be lived with. As important as the medical advances have been, it’s also giving younger guys an excuse for not thinking about their behavior.”

Sanchez’s worries are confirmed by the latest Texas HIV Surveillance Report, a snapshot of the epidemic released annually by the Texas Department of State Health Services (DSHS). At first glance, the numbers seem low. In 2012, 252 new HIV infection diagnoses were reported in Travis County. Only 112 new AIDS cases were diagnosed in the same year.

A closer look at the numbers reveals some distressing trends. The DSHS report showed a 23% increase in new HIV infections in Travis County during 2012. In Dallas and Harris Counties, the percentage is even higher. And those numbers only show a part of the picture. The surveillance data does not include those tested anonymously (as opposed to confidentially) or those who have avoided testing altogether. Stigma is still a prominent deterrent – especially in communities of color.

“In POC [people of color] communities,” Sanchez says, “stigma still plays a big role in that. In my [Hispanic] culture, it’s something we don’t talk about. I’ve had relatives who have passed away from AIDS complications. Families either lie about the cause of death or don’t talk about it. People aren’t getting treatment or getting tested because they don’t want to be identified as being a drug user or gay.”

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