AIDSWEEKLY Plus; Monday, August 10 & 17, 1998
Daniel J. DeNoon, Senior Editor
HIV infects 16,000 people every day. Most of these people soon will die from treatable diseases such as tuberculosis. A relative few, fortunate enough both to have access to state-of-the-art treatments and to withstand their side effects, will survive for extended periods.
Despite the "Bridging the Gap" theme of the 12th World AIDS Conference, held June 28-July 3, 1998, in Geneva, Switzerland, a yawning gulf separates those who survive and those who quickly succumb to HIV disease. But this is not the gap it is most urgent to span.
A greater gap lies between what can be done - now - and what is done. One simple truth lies hidden behind all the hoopla of this most recent but far from last World AIDS Conference: AIDS is completely preventable.
Media coverage of every single international AIDS conference has focussed on the quest for a drug to cure AIDS. No drug ever will do that. It is now fashionable to say that only a vaccine can stop the AIDS epidemic. But while we wait for a cheap and effective vaccine - which is likely to be at least two decades away from deployment - the pandemic is spinning wildly out of control.
The behaviors that spread AIDS - unprotected sex and intravenous drug use - are widely considered impossible to change. But abundant research shows that this is not necessarily so.
The truth is that behaviors can be changed, if only governments and public health officials have the stomach for it.
It is possible to eroticize safe sex, to educate young people and sex workers about the urgency of self protection, and to identify and support peer leaders who can help disseminate prevention messages.
It is possible to demand human rights, particularly the right of women to make their own sexual decisions.
It is possible to develop and distribute acceptable vaginal microbicides that reduce HIV transmission (several candidates already are ready for clinical trials).
It is possible to treat the sexually transmitted diseases (STDs) that facilitate HIV spread.
It is possible to treat injection drug use as a medical rather than a criminal problem, and it is possible to make clean needles readily available.
It is possible to work with rather than against sex workers and other marginalized populations.
It is possible to stop blaming the victims and to begin treating them as human beings.
Is this a pipe dream? Once it was thought that pharmaceutical companies would never commit major resources to the development of AIDS drugs, that governments would never fund AIDS research, that a marginalized population - gay men - could never muster political support. Sustained activism by patients, health-care providers, and non-government organizations brought all these things about.
Currently there are no signs of the political will needed to stop AIDS. This is because we suffer from a lack of imagination and from a lack of courage, not from a lack of possibilities.
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