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Are We Getting Bored With AIDS?

Harold Pollack is a professor at the University of Chicago School of Social Service Administration and Special Correspondent for The Treatment.

Almost six thousand people died of AIDS yesterday. An even greater number became HIV-infected, though most of these men and women won't know this for months or even years. As far as we know, yesterday wasn't any better or worse than any other day in this regard. That it happened to be World AIDS Day was almost incidental.

AIDS was certainly incidental to much of the mainstream media. Scanning the nation's three leading national newspapers, HIV and AIDS were virtually absent from the front pages. The health sections included some good stuff, including one story about South Africa's decision to treat all children living with HIV; that was pretty much it in the area of AIDS. There was apparently no room for further AIDS stories, though there was ample space for stories about how loneliness may spread from person to person, how venting at the office is good for your heart, and more. I saw some good reporting on health reform. Not one of these stories examined how the 2009 reforms might address HIV/AIDS. I'm not sure I have seen any such story this entire year. The rest of the paper included other stories. Some concerned Afghanistan. Many involved a golf club wielded by Mrs. Tiger Woods.

I can understand why AIDS has become boring. We've lived with it for thirty years now. Once a mysterious new and fatal disease, HIV infection is now a treatable, chronic illness, in the wealthy nations at least. Ceremonies that first marked the horrors of a great war gradually become occasions for barbecue and TV football. It's nobody's fault. That's nature's way.

Still, it's foolish and disrespectful to the dead to let the day pass unnoticed.

Five hundred and sixty thousand Americans have died of AIDS. That's ten times the number of American combat deaths in the Vietnam era. Despite treatment advances, five times as many Americans will die this year of AIDS as were killed on 9/11. An estimated 56,000 Americans will become HIV-infected this year. The rate of new infections is rising, especially among young gay men—the main risk group that is continually replenished with susceptible people. This epidemic is not over by a long shot, even here. Around the world, more than 30 million people are living with HIV/AIDS. Most of these men, women, and children lack access to relatively cheap and cost-effective treatment. Millions will die of AIDS. Millions of these deaths could be avoided.  

In addition to supporting larger and smarter investments in global health, we need to have some serious national conversations about our rather stalled HIV prevention efforts here at home. Last year, I lamented the sorry state of our public health infrastructure, and the insufficient investments in HIV prevention at every level of government. The Obama administration, more sympathetic and skilled than its predecessor, has promised to address these difficulties. On the ground, however, the same operational challenges remain daunting. On a day in which the President commits $30 billion to a difficult but worthy Afghan fight, we struggle to find a few hundred million dollars to fund basic investments in substance abuse treatment, syringe exchange, and reproductive health.

We also have to have some serious conversation about the high prevalence of risk-behaviors among men and women who are most at risk for this disease. Millions of Americans are having unprotected sex. Tens of thousands of young gay men live with HIV, yet do not know it. Too many therefore expose others to significant infection risks.

I hate to be a scold, especially when I'm as curious as the next guy about Tiger Woods' alleged girlfriend. Still, when we're done with all the gawking, can we take a moment for something more important?