By the early 2000s the U.S. public appeared less concerned about HIV/AIDS and its impact on health care than ever before. According to the Gallup Organization, in 2006 just 6% of Americans named AIDS as the most urgent health problem facing the country, compared to 68% of Americans in 1987 who identified it as the most pressing health problem. In 1992, 41% identified AIDS as the most pressing problem, and another 30% named health-care costs. In 1997, 29% of poll respondents cited AIDS as the most urgent health problem, 15% named cancer, and 13% cited access to health care.

The 2000 Gallup poll marked the first time since 1987 that AIDS did not top the list of Americans' health-care concerns. AIDS (18%) was third, trailing behind health-care costs (25%) and cancer (20%). In 2005 just 6% of Americans considered AIDS the most urgent health problem.

Interestingly, even though Americans may no longer view HIV/AIDS as the most pressing health problem facing the United States, when asked whether the virus was a serious problem throughout the world, 89% of survey respondents in December 2006 and 82% in June 2007 said HIV or AIDS was a very serious problem. Furthermore, the virus was seen as a very serious threat to global health by more Americans (82% in 2007) than cancer (79%), tuberculosis (24%), malaria (24%), or poor nutrition (75%).

During the more than two decades since HIV/AIDS was first identified, aggressive community health education and awareness programs have sought to increase the public's knowledge about the prevention, transmission, and treatment of HIV/AIDS. Based on the findings of the Henry J. Kaiser Family Foundation, in Survey of Americans on HIV/AIDS (May 8, 2006), even though public understanding and awareness have improved in many areas, misconceptions about HIV/AIDS persist.

There is, however, an understanding that the U.S. HIV epidemic has had a profound effect on U.S. culture and society as well as on personal behaviors. Historically, the Kaiser Foundation surveys and other polling organizations have found that about half of Americans feel that there has been considerable discrimination against people with AIDS. In fact, the percentage of people expressing this belief as remained virtually unchanged, varying by just a few percentage points from 1986 through 2006. In contrast, Americans' feelings about an individual's personal responsibility in contracting HIV have changed over time. The Kaiser Foundation reports in ''Attitudes about Stigma and Discrimination Related to HIV/AIDS'' (August 2006) that in 1987, 51% of those surveyed agreed with the statement, ''In general, it's people's own fault if they get AIDS.'' By 2002 just 40% of respondents said they agreed with this sentiment.

The Kaiser Foundation finds in Survey of Americans on HIV/AIDS that most Americans (58%) said the epidemic has prompted people to practice safe sex and almost half (47%) felt it has made it easier for people to engage in open discussions about sexual matters and practices. However, half of those surveyed felt the epidemic has also had a chilling effect on tolerance--50% of respondents said they felt the epidemic has made people more likely to discriminate against people who identify as gay or lesbian.

Another measure of increasing tolerance is the finding by the Kaiser Foundation that 71% of survey respondents said they would feel very comfortable or somewhat comfortable working with a person infected with HIV or someone with AIDS. Twenty-nine percent of parents said they would be very comfortable if their children had a teacher who was HIV positive, and 25% of adults said they would be very comfortable with a roommate who was HIV positive.

Despite vigorous efforts to improve Americans' knowledge about how HIV is spread, the Kaiser Foundation reports that in 2006 over 40% of adults held one or more misconceptions about the transmission of the virus. More than one-third (37%, down from 64% in 1987) believed HIV may be transmitted through kissing, 22% (down from 44% in 1987) said the virus may be spread by sharing a drinking glass, and 16% (down from 31% in 1987) thought it could be spread by touching a toilet seat. In ''The Public's Knowledge and Perceptions about HIV/AIDS'' (August 2006), the Kaiser Foundation finds that even though misperceptions declined with educational attainment, nearly one-third (32%) of college graduates held mistaken beliefs about HIV transmission.

Not surprisingly, the Kaiser Foundation reconfirms the finding that misinformation and misconceptions about HIV transmission contribute to stigma and discrimination. In general, people who believed that HIV could be transmitted via shared drinking glasses or touching a toilet seat were less likely to describe themselves as comfortable working with someone with HIV or AIDS.

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