“After a quarter century, the devastating outbreak of the human immunodeficiency virus that causes acquired immunodeficiency syndrome is still surging, a savage wonderment of microbiology.” So writes Loretta McLaughlin in The Boston Globe.
Today, as when it was officially first recognized on June 5, 1981, this vicious infectious agent remains unique even within its own classification of retroviruses. More is now known about it than any other microbe. Nonetheless, this anniversary in no way marks the end of the Age of AIDS, though it may mark the end of the beginning.
There is little certainty about what this phenomenal virus may do next. For it has an immeasurable capacity to change its outer appearance — millions of times over the course of the illness in each cell it infects in each person — and thereby to elude conquest. Despite brilliant approaches to a vaccine, none is in sight, nor is any expected in the foreseeable future, HIV/AIDS researchers agree.
For scientists — and a few lay journalists such as myself — who have pursued in our respective ways the labyrinthine course of the international AIDS pandemic, these years have been an extraordinarily humbling journey. From a time when we wondered if we would ever see a hundred, a thousand, a million people infected with HIV/AIDS, we now are near the 70 million mark of officially infected people, worldwide. More than 25 million of them have died, and 14 million others have been orphaned.
George Will also offers an insightful analysis of the anniversary, and he points without hesitation to the bahavioral roots of the disease: The 14th-century Black Death killed one-third of Europe’s population, but it was in the air, food and water, so breathing, eating and drinking were risky behaviors. AIDS is much more difficult to acquire. Like other large components of America’s health care costs (e.g., violence, vehicular accidents, coronary artery disease, lung cancer), AIDS is mostly the result of behavior that is by now widely known to be risky.
The U.S. epidemic, which so far has killed 530,000, could have been greatly contained by intense campaigns to modify sexual and drug-use behavior in 25 to 30 neighborhoods from New York and Miami to San Francisco. But early in the American epidemic, political values impeded public health requirements. Unhelpful messages were sent by slogans designed to democratize the disease — “AIDS does not discriminate” and “AIDS is an equal opportunity disease.”
By 1987, when President Reagan gave his first speech on the subject, 20,798 Americans had died, and his speech, not surprisingly, did not mention any connection to the gay community. No president considers it part of his job description to tell the country that the human rectum, with its delicate and absorptive lining, makes anal-receptive sexual intercourse dangerous when HIV is prevalent.
Twenty years ago a San Francisco public health official explained death’s teaching power: Watching a friend die, like seeing a wreck along a highway, is sobering. But after driving more slowly for a few miles, we again speed up. AIDS has a more lasting deterrent effect.
There has, however, been an increase in unsafe sex because pharmacological progress has complicated the campaign against this behavior-driven epidemic. Life-extending cocktails of antiviral drugs now lead some at-risk people to regard HIV infection as a manageable chronic disease, and hence to engage in risky behavior. Furthermore, the decline of AIDS mortality means that more persons are surviving with HIV infection — persons who can spread the virus. And drugs like Viagra mean that more older men are sexually active.
George Will is absolutely right — AIDS is an epidemic that could be stopped in its tracks by a behavioral change. But, in this confused world where political corrrectness dresses up as morality, it is forbidden to say what we all know — and what could really make a difference.
One of the changes over the past 25 years is the fact that most of us now know someone who has contracted the disease. AIDS is not an abstract problem, but an all-too-real epidemic. Christian compassion is the much-needed response, but so is Christian honesty. Love of neighbor requires that we combine compassion and truth telling.
R. Albert Mohler Jr.
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