AIDS at 25

While Lindsay give the quote of the night to Bill Gates and much of the coverage in the press this morning focuses on his talk of microbicides, his wife Melinda spent much of her time discussing the stigma that comes with being diagnosed with HIV. She discussed how political figures won't accompany her when she goes out to discuss the virus with sex workers, and how many women in AIDS hospices have been abandoned even by their own families.

Stigma makes it easier for political leaders to stand in the way of saving lives....This is a serious obstacle to ending AIDS. In the fight against AIDS, condoms save lives. If you oppose the distribution of condoms, something is more important to you than saving lives.

Some people believe that condoms encourage sexual activity, so they want to make them less available. But withholding condoms does not mean fewer people have sex; it means fewer people have safe sex, and more people die.

She emphasized that sex workers play a key role in the epidemiology of the disease, and that they should be our allies. But standing side by side with a sex worker certainly isn't the image many politicians want to project. Gates suggests:

If politicians need a more sympathetic image to make the point, they should think about saving the life of a faithful mother of four children whose husband visits a sex worker. If the sex worker insists that her clients use condoms, that sex worker is going to help to save the life of the mother of those four children. If you're turning your back on sex workers, you're turning your back on the faithful mother of four.

So let's not turn out back on anyone. Let's agree that every life has equal worth, and saving lives is the highest ethical act. If we accept this, then science and evidence, untainted by stigma, can guide us in saving the greatest number of lives.

Many strides have been taken to reduce the stigma since the discovery of HIV, but stigma is still a huge obstacle in dealing with the spread of the virus. Shelley even notes that women in South Africa are purposely gaining weight as a sign that they're not HIV-positive. As this trend, and Gates' words, reminds us (and as will be discussed in later conference sessions), we still have a long, long way to go.