AEGiS-WSJ: OPINION: Learning From Our Mistakes

Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.

OPINION: Learning From Our Mistakes

Wall Street Journal - June 9, 2006

It's been 25 years since the first cases of what we now call AIDS were diagnosed, and in that time more than half a million people have died from the disease in the U.S. According to the Centers for Disease Control, more than a million others in America now either have AIDS or the HIV virus that causes it.

Yet, thanks to new drug regimes, the condition is no longer a certain death sentence. And thanks to prevention efforts, the rate of new HIV infections in the U.S. has dropped from 150,000 a year in the mid-1980s to about 40,000 now.

Lest we are tempted to rest easy, the CDC warns that the global HIV/AIDS pandemic -- it estimates that 25 million people have died world-wide -- rages on. Even so, after the terrifying assertions and predictions from earlier days about how far and fast the virus would spread here, it is impossible not to see the progress we have made as a success.

What or whom should we credit with that success? When all is said and done, the spread of HIV can only be prevented by individuals, specifically those who protect themselves and others, by abstaining from risky behaviors. The declining rate of new infection in the U.S. is proof that many people have accepted this responsibility.

But perhaps the biggest turning point of all -- and one that made safe behavior both possible and more likely -- came when AIDS began to be viewed as a public-health issue.

This wasn't always the case. Early efforts to combat the problem quickly became ensnared in politics. Because AIDS hit first and hardest in the gay community, those dealing with it worried that the rest of society would ignore the problem. From such concerns, however, grew some bad decisions.

To name only a few examples: San Francisco's bath houses, which were known as environments where HIV was spread, weren't closed until 1986 out of concern that such governmental interference would violate the civil rights of homosexuals.

Beginning in the mid-1980s, medical educators tried to convince the public that HIV/AIDS was about to explode among the heterosexual population. The notion that it could strike anyone, any time, certainly shifted some of the stigma away from gays as a group and made the general public more receptive to the idea of AIDS education and increased funding to combat the disease. However, when it became clear that, absent certain specific risky behaviors, relatively few heterosexuals were getting sick, the alarms began to fall on deaf ears. The CDC estimates that perhaps a quarter of the people with HIV today don't know they have it. Surely some of them will never get tested because they assume, wrongly, that some misleading information in the past from public-health officials means that all their warnings can be safely ignored.

A few dubious claims about AIDS will live on forever, including the allegation that Ronald Reagan was indifferent and stingy in the crucial early days of the epidemic. True, the estimated $5.7 billion allocated for AIDS during his administration sounds small compared with some $20 billion the government spends each year now on fighting it at home and abroad. But no one, including scientists, knew a fraction then of what they know now.

Still, in the U.S. at least, 25 years of HIV/AIDS have brought the battle into perspective. Patients have more treatment options than they once did. And the rest of us have more information now, and thus the means, if only we will use them, of prevention.

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