It was 25 years ago today...

To what extent do you worry about AIDS, either with respect to yourself, your children, or the world at large?...

In this business, you tend to accumulate a lot of paper, and eventually you learn to cull it, ruthlessly-ish.
But there are always some things you keep, to remind you... one item in my stack is the 16 Dec 1982 issue of New Scientist, on page 713 is a 3 page news article on the mystery of the 500 cases of a new syndrome of "acquired immunodeficiency", including 11 cases in Europe. 175 of these had died.
The article discusses extensively the possibility that this is caused by nitrite or nitrite/hydrocortisone interaction, but at the end suggests the disease pattern is indicative of an infectious agent...

I was a teenager, about to head off to university. I remember reading the article, I remember the subsequent articles on the discovery of the HIV virus and the spread of the disease into the general population.

When I arrived at university, AIDS was a complete non-issue.
I doubt more than 1% of the students were aware of it although that changed rapidly over the next three years.
The disco era was, thankfully, over, the biggest concern about STDs was genital herpes, and safe sex was a complete non-issue.
Student life was moderately promiscuous, not wildly so, and there was the full spread of students from those who abstained (some by choice), those in stable monogamous relationships (a small percentage of which survived college), the general pattern of few medium term relationships interspersed with some casual sex, to a few who were excessively promiscuous, even by the standards of that era. (I knew about half-dozen women who were highly promiscuous, statistics on the male promiscuity spread are unreliable - worryingly, of those half-dozen, the three women who became good friends of mine, friends enough to confide in me, and who were highly promiscuous (tens of partners per year, or more, up to one or more per day) - all had been abused as pre-teens or early teens, and two had severe self-esteem issues).

The year I graduated, the first AIDS case on campus occured - I knew of the guy, he was politically active, mainly in LGB groups, but also in broader student groups I interacted with, but I didn't know him personally. As I recall he died within a year; and by then there were multiple cases on campus and in the town gay scene.
I also recall a totally surreal conversation among some friends, over beer, over whether this AIDS thing meant people should avoid having sex with Americans. The Americans objected.

I then moved to California. A friend of mine from San Francisco was seriously concerned about AIDS, and got quite irate when the rest of "us" took it lightly. Visits back to the Europe suggested a much higher awareness of AIDS among my contemporaries than before, and a very successful safe sex campaign.
At that point I was in a long term monogamous relationship, and still am, so personally my worry about AIDS was more or less over. By the time I got married AIDS testing was required, and seemed to be a sensible no-big-deal to me (some not-very-much-older relatives were very indignant when they heard about that requirement, which puzzled me).
One fistfight I was involved in at a party lead to blood drawn, and I was mildly surprised when the first question was whether the other guy was known to be be HIV-negative. Similarly sports where blood was occasionally spilled (ie "soccer") became a little bit more tentative. Main residual worry is possible blood transfusions, which I have not needed - main worry there now is prions I think, screening looks to be highly efficient.

Do I worry about the munchkins - yes - but only in the abstract at this point. Too far in the future and too much likely to change. Strangely, my main actual worry right now is that our culture will become too conservative and that young people in the future will miss out on some valuable experiences, I have no desire to see the return of Victorian Values, even if in name only.

I do worry about the world: avert.org has statistics on AIDS: in Africa - ~ 25 million cases, 2 million die per year, ~ 3 million get infected.
Steady state is not yet there, much less decline, and the full impact has not yet been felt. The demographic impact of AIDS could be quite horrendous, particularly if the cases continue to rise there and in Asia and South America - in North America and western Europe the incidence seems to have stabilised, for now at least, with low level endemic incidence at less than 1% of the population.
Some regions of the world could see 10+% of young adults and children die prematurely in my lifetime - a slow plague comparable to the worst of the Middle Ages.
- oh, a friend of mine does an interesting in-class exercise (in statistics) - get the probability of whether someone in a (large introductory stats class) has HIV infection but does not know it...
For a reasonable sized class at a US university the expectation value is over 1. Good shock therapy for the numerate.

Future prognosis: I think we understand HIV well enough now that worry about a jump to a more casual transmission mode is low. Progress on a cure is disappointingly slow, although I am optimistic that eventually it will be solved. Somehow. Cures may be too expensive for most of those who need it though. Treatments continue to improve, although that, as always, is a Red Queen Race.
Virii evolve. Get used to it.
Fatalism or denial may lead to new surges in incidence.

Then the Next Plague will come. Eventually.

PS: in my more paranoid moments I ponder what could happen if an emergent epidemic hits a dense immunocompromised population filled with secondary infections - eg if avian 'flu or SARS gets loose in sub-Saharan Africa. Simplistic, but of some potential concern.

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