Bay Area Reporter - November 30, 2000

This year's focus on men is something we're glad to see as it reinforces something we've always known: men who have unprotected sex with men still represent the largest risk category for infection with HIV. Also, HIV infections and AIDS deaths in men worldwide outnumber those in women on every continent except sub-Saharan Africa.

While the San Francisco Department of Public Health badly mishandled its announcement earlier this year that HIV cases are dramatically increasing in San Francisco, we don't dispute the bottom line that HIV cases are going up in the city that long ago created the so-called "model" for AIDS care and treatment in the country and the world. It's obvious to us that the model needs to be updated -- perhaps drastically -- so that more attention and money can be devoted to HIV prevention campaigns in an effort to decrease the HIV infection rate. Prevention has always lagged behind treatment when it comes to funding -- in HIV as well as other diseases. It's apparent to us that preventing a disease means that fewer people will get the disease.

Public health officials and HIV prevention workers must pay particular attention to young men, who are especially at risk for contracting HIV. About one in four people with HIV are young men under the age of 25. They have grown up in the era of HIV/AIDS, and since the disease isn't the death sentence it once was for many, a lot of young people are in denial about becoming infected and living with HIV once they are. Living with HIV/AIDS is no picnic, it requires life-altering changes for many, and right now at least, a dependence on toxic medications to keep the virus at undetectable levels. As anyone living with HIV/AIDS will tell you, it's no fun. Yet the drug companies, in their zeal to market different combinations of medications, continually portray PWAs as being able to do almost anything. Smiling faces in ads grace the pages of virtually all gay publications -- including this one -- and reinforce the notion that HIV/AIDS is a chronic, manageable condition. Tell that to the PWA who can't leave his house because of diarrhea, or whose body has become disfigured because of the HIV drugs that are helping him survive. It's not pretty, it's not easy, and living with HIV/AIDS is not enjoyable.

As for those living with HIV/AIDS, more effective treatments are desperately needed. As Jeff Getty notes in this week's Survive AIDS column, since 1996, when protease inhibitors hit the market, there has been little or no advancement in the drug arsenal. People like Getty, who are resistant to the drugs, require stronger and more toxic remedies month after month, and there aren't many choices left for them.

Leadership in fighting HIV/AIDS starts at the top, and that means with the U.S. president. We are extremely distressed at the increasing reality of a Bush administration, because among other things, Governor George W. Bush has barely mentioned the word "AIDS" in public, and didn't do so until he became a presidential candidate. We remember the Reagan years, when the president stood by as thousands were dying, unable and unwilling to talk publicly about the disease that was wiping out communities. We dread the possibility of sliding backwards when it comes to HIV/AIDS treatment, education, and prevention, because it took 20 years to get where we are.

In the meantime, public health leaders and politicians in both parties must continue to push for research, treatment, and prevention programs so that we don't have to "celebrate" World AIDS Day forever; it's one day we could do without.

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Always watch for outdated information. This article first appeared in 2000. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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