Today, the 21st annual World AIDS day, comes at a time when AIDS has become an everyday fact of life. Conservative estimates have over 33 million people living with HIV world-wide with an adult prevalence of 0.8%. This is a common disease, but its distribution is unequal. Due in part to economic, cultural, political, and genetic differences, Sub-Saharan African has been hit particularly hard, although comparisons can be difficult. It is widely believed that some large countries, including China and Russia, significantly under-report HIV disease.
Coming to terms with HIV has been hard for the global community. Lack of resources drives some nations to deny the problem, while hate drives patients underground. In the US, the stigma of HIV disease has decreased (yes, it really has). In South Africa, where the former president was an HIV denialist, the new president has announced sweeping new HIV initiatives.
In Uganda, pending legislation will criminalize homosexuality and make homosexual contact among the HIV-infected a capital offense. They have not proposed similar legislation for heterosexuals who make up the majority of African HIV cases. (Of note, American evangelicals have tossed Ugandans under the bus on this one. They can interfere with foreign affairs for fetuses, but not for living people who might have “the gay”).
The scientific progress on HIV has been remarkable. A vaccine may or may not be in the future, but treatment has become very successful. Prevention has not been as good. Puritanical regimes both here in North American and overseas have blocked effective prevention programs. It’s hard to over-estimate potential American influence here. We provide an enormous amount of foreign aid to fight HIV. If we were to make real prevention a priority and free recipients from ridiculous abstinence-focused policies, this could have a real, tangible impact both at home and abroad.
Nearly thirty years ago, doctors began noticing clusters of an unusual pneumonia in gay men in Los Angeles. Since that time, HIV has rapidly become one of the world’s most important diseases both socially, medically, and scientifically. This is unlikely to change, but it can be mitigated with compassionate, science-based policies.