The Judgment of Future Historians

Jim Burroway

June 23rd, 2006

Stall, Ronald D.; Mills, Thomas C. Editorial: “A Quarter Century of AIDS.” American Journal of Public Health 96, no. 6 (June 2006): 959-961.

This month’s edition of the American Journal of Public Health is dedicated to the twenty-fifth anniversary of the CDC’s first report of AIDS. In one of the lead editorials, Drs. Ronald Stall and Thomas Mills provide a brisk overview of the public response to the epidemic, and emphasize the special difficulties that come with combating a heavily stigmatized disease.

“A Disease of Denial”

Noting that AIDS struck first and the hardest at the most marginalized groups in society — gay men, drug users, foreigners, racial minorities and others of lower socioeconomic status — AIDS has been a disease of denial at the individual, group and national level. When the disease is seen as affecting “those people” it’s easier to deny some of the realities of what it actually takes to combat the epidemic:

Because so many controversial issues directly shape the AIDS epidemic, governments will continue to be tempted to respond by funding unproven programs that convey the impression of restoring traditional cultural values rather than fielding scientifically proven prevention approaches that directly target issues of sexual safety or drug use.

Citing six major meta-analysis studies, the authors contend that we have definitive proof that AIDS prevention programs which directly target safe sexual practices and drug use yield significantly positive results. The difficulty is in finding ways to put these programs into practice given the cultural and political climate today.

“How Will History Judge Our Actions?”

The twenty-fifth anniversary of the first report of AIDS offers an important moment to reflect on our response to this epidemic. Drs. Stall and Mills contend that because future historians will know that we weren’t ignorant of the dangers of the disease or how it is transmitted, “we cannot escape responsibility for our failure to use effective, scientifically proven strategies to control the AIDS epidemic.”

They will probably be impressed with the rapid progress made in scientific understandings of the pathogenesis and treatment of AIDS, yet appalled by the instances when the ancient curses of racism and homophobia prevented us from fully responding to AIDS epidemics unfolding in our midst, as is the case now with African American MSM [men who have sex with men].

…They will also likely regard as tragic those instances when we allowed scarce resources to be used to support ideologically driven “prevention” that only served a particular political agenda.

My Thoughts

We can avoid the harsh judgment of future historians, but that’s probably poor motivation for implementing the programs that we know will be effective in preventing the spread of AIDS. Instead, we should be motivated because we see those who are vulnerable as our neighbors, not as “those people.” Until we recognize the humanity of all those who are vulnerable and at risk, prevention measures will continue to be driven by ideology and not science — or compassion.

You can further explore the role that anti-gay prejudice has played in the AIDS epidemic in our special report Opportunistic Infections.

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