Op-Eds, Columns Weigh In on Two Decades of AIDS
Columnists and experts have responded to the 20th anniversary of AIDS by writing and expressing their thoughts in opinion pieces and interviews. The following is a summary of some pieces:
- "The Future of an Epidemic": "In the 20 years ahead, AIDS can be brought under much better control in the United States -- if we don't let down our guard -- but it will be devastating in some other parts of the world," AIDS researcher Michael Gottlieb, who co-wrote the first MMWR report, writes in a New York Times op-ed. In order to prevent further spread of HIV in the United States, "we need more culturally focused prevention programs, HIV education in the schools must be routine and we must treat drug addiction as a medical problem, so that drug users stop transmitting the disease through needle sharing and unprotected sex," he continues. But outside the United States, HIV is "spreading virtually unchecked" in Africa, Asia and the former Soviet Union, and there is "every indication that it will continue to do so for the next several years," he states. By 2020, AIDS-related deaths will number more than any other disease death toll in history and the "experience of suffering and death" in "AIDS-ravaged countries ... could lead to the downfall of governments and the breakdown of law and order," he predicts. However, Western governments and international humanitarian organizations "have an opportunity to mount a coordinated effort at damage control" by contributing money toward health care for the developing world and by forgiving foreign debtors, he states. "If we provide the money for effective action now, when the costs are still relatively low, we can minimize the setbacks that AIDS will cause at home and abroad. If we stand by or make token gestures, we will allow AIDS to spiral even further out of control," he concludes (Gottlieb, New York Times, 6/5).
- "A Black AIDS Epidemic": "The warning signs are wailing, but young black men who are gay don't seem to be listening. And so the march into self-destruction continues," Bob Herbert writes in his "In America" column of the New York Times. The recent CDC findings that HIV infections among young gay men are on the rise have been called "alarming," he notes, yet "there's been no tremendous outcry over these developments, from blacks or anyone else." Herbert states that he is "waiting for the so-called leaders of the black community ... to step forward and say, in thundering tones, that it's time to bring an end to the relentlessly self-destructive behavior that has wrecked so many African-American families" by causing so much suffering and death. "It is time to shatter taboos that have prevented blacks from speaking plainly and constructively about homosexuality, about HIV and AIDS and about drugs and other destructive practices," he continues. The "widespread belief among blacks that AIDS is a disease primarily of gay white men" is one of the "biggest obstacles" to disease prevention, he states, adding, "The denial runs so deep -- and the stigma surrounding homosexuality is still so strong among blacks -- that many black men who have sex with other men nevertheless think of themselves as heterosexual, not gay or bisexual," putting their female partners at risk. "A new and intense and creative effort -- led by black Americans -- will be required to reclaim the lives of thousands upon thousands of young blacks succumbing to the ravages of destructive sexual behavior, drug use and ... the emotional pain of self-loathing, depression and despair," he concludes (Herbert, New York Times, 6/4).
- "AIDS Deaths Top 23 Million -- Still No Cure": In a Portland Oregonian op-ed, Herbert states, "After 20 years, we're still not ready to commit to fight the epidemic that will soon have killed more people than the bubonic plague." After citing various AIDS statistics -- 23 million AIDS-related deaths, 12 million African AIDS orphans, 36 million HIV infections worldwide -- he predicts that "in some places, much, much worse is yet to come." AIDS-related deaths in the United States have been reduced "dramatically" by anti-AIDS medications, and a "dangerous sense of complacency seems to have settled in," he continues. "Twenty years later, the epidemic is still with us. There is no cure. There is no vaccine. And in a world as interconnected as ours has become, there is not cause for complacency," he concludes (Herbert, Portland Oregonian, 6/2).
- "AIDS Comes on Strong, So Must the Response": The recent news that HIV infections are again on the rise among some groups calls for a new plan of attack, Nancy Mahon, executive director of God's Love We Deliver, a not-for-profit agency that delivers food to AIDS patients in the metropolitan New York area, states in a New York Daily News op-ed. The first step is to "reexamine and reinvent HIV prevention methods for a new generation of gay men -- particularly black gay men -- as well as for heterosexuals," she states. Prevention strategies will only be successful if they are done "in partnership with the affected communities. That means directly addressing the stigma of homosexuality in minority communities and dealing with the difficulties black and Latina heterosexual women have in persuading their sexual partners to use condoms," she continues. "Equally important is reaffirming to everyone in these communities that their lives ... are worth saving," she states. "Without such a comprehensive effort, the 30th anniversary of the discovery of AIDS will bring more to grieve than to celebrate," she concludes (Mahon, New York Daily News, 6/4).
- "Plague Years: The Humbling of Humanity": Globe and Mail columnist Margaret Wente examines the AIDS epidemic as it has affected Canada. Now, AIDS "is increasingly a disease that hits the lowest and most vulnerable classes," and as such "[t]here will not be very many fashionable fundraisers for aboriginal drug addicts and junkie hookers," she writes. "The advent of AIDS has been a mighty humbling of humanity. Twenty years ago, we thought we had infectious diseases licked. We thought we were invincible," she continues. However, "[b]y the time the century ended, we had relearned some cosmic lessons about fate and destiny and the best cut down in their prime," she states. "It's tempting to forget. In Canada, AIDS is more or less at bay. But the virus is creeping back again among people who are young and never knew how bad it got," she continues. "AIDS was the great, chastening morality play at the end of the millenium. As the curtain rises on a new one, the way we choose to fight it on behalf of strangers, far away, will be our greatest moral test," she concludes (Wente, Globe and Mail, 6/5).
- "It Was 20 Years Ago Today, But This is No Time to Get Complacent About AIDS": Because of AIDS, "everything changed for everybody," Jay Croft, an openly gay Atlanta Journal Constitution columnist, writes. However, now "a lot of people -- particularly young, gay men -- want to pretend it didn't change so much for them," he continues. Croft states that it was "fear" that kept him "safe" from infection. "And a little fear is a good thing, especially for young men, who take stupid chances of all kinds," he adds. Although "AIDS hasn't infected my body. ... it's infected every day of my life," he states. The epidemic "ain't over yet" and people are dying "every day," despite the new drugs, he warns. He concludes that he hopes that information instills a "little fear" in everyone (Croft, Atlanta Journal-Constitution, 6/5).
- "AIDS is no Longer a Death Sentence": "The management of HIV infection and AIDS is one of the major medical success stories of our time," Dr. Kevin Carmichael, unit chief for the Arizona-based El Rio Special Immunology Associates, states in an Arizona Daily Star op-ed. In his practice there were 14 deaths per 100 AIDS patients in 1995, and that number was 3 per 100 patients in 2000, he notes. And although there has been a rise in the number of deaths for the first half of this year, those deaths are attributable to most of those patients not being on antiretroviral drugs and not to treatment failure, he states. "[T]oo many individuals with HIV infection do not perceive themselves at risk and therefore are not getting tested," he continues. "[N]othing can be done if one is ignorant of his or her [HIV] status," he adds. Substance abuse and mental illness also prevent people from accessing the care they need, he continues. "HIV is a very treatable condition, not a death sentence. The recent deaths we are seeing should not be a cause for pessimism or hysterics, but rather a reminder that HIV has not gone away and a call for continued efforts on all our parts," he concludes (Carmichael, Arizona Daily Star, 6/5).
- "The Examiner Q&A": The San Francisco Examiner "Q&A" spoke with Dr. Mitchell Katz, director of public health for the city of San Francisco and former director of the San Francisco AIDS Office. Katz says that "from a treatment point of view, things have never been better" for people with HIV. Drug therapies mean that people with the virus can live "however long God intended them to live," he says. But the success of the treatments has led to an unanticipated "failure of prevention." He also urges the HIV-positive community to "take greater responsibility not to infect people," saying that people have not always heeded safe-sex messages. He adds that "[i]f we want people to not become infected, then we have to increase self-esteem. We have to make people feel that they are part of the community ... What I know in talking with people who've seroconverted, is that it's that sense of not caring that much that results in the seroconversions," he concludes (Dodsworth, San Francisco Examiner, 6/4).
- "Blacks' Silence on AIDS Crisis Already Deadly": Atlanta Journal-Constitution columnist Cynthia Tucker writes about "an issue no one wants to touch," saying that "AIDS has replaced homicide as the leading cause of death among young black men." Despite the rising numbers of HIV/AIDS cases among African Americans, "the deadly virus provokes few alarms," Tucker writes. "Instead, the subject fills African Americans with shame and fear and embarrassment and apprehension, so we are silent. And silence and shame allow the virus to spread." Tucker notes that homophobia is "rampant" in the African-American community, "reinforced by conservative black churches and their narrowminded ministers." Further, the "stigma is so widespread that few prominent black activists will speak out on the subject of AIDS," Tucker writes, citing the example of Martin Luther King III, son of Martin Luther King, Jr. and president of the Southern Christian Leadership Conference, who will "not return phone calls" from Gay Men of African Descent, a gay advocacy group, according to GMAD program director Maurice Franklin. The stigma leads "many black gay or bisexual men" to live "dual lives ... dating women and engaging in heterosexual sex -- even marrying." Tucker concludes that AIDS "is a crisis that demands that the community look deep inside itself at its prejudices and fears and wrong-headed assumptions" (Tucker, Atlanta Journal-Constitution, 6/3).
- "'Acceptance' Isn't the Issue -- It's HIV": The San Francisco Chronicle's "Insight" section asked local journalist Bruce Mirken, who writes frequently about AIDS, and Michelangelo Signorile, New York author and Gay.com columnist, to address the question, "Has the AIDS epidemic helped or hurt the acceptance of gays in America?" Mirken responds that the question was "unanswerable," comparing it to asking Jacqueline Kennedy "as she stepped off Air Force One, still wearing a dress stained with her husband's blood ... '[D]o you think the trip to Dallas helped or hurt your husband's popularity?'" Signorile adds, "Of course it's unanswerable, and the idea of a 'debate' about it seems creepy. Should we debate whether slavery was good for blacks because, hey, it gave them something to fight against?" Mirken notes that AIDS "broke down some barriers, making it easier for corporations to fund gay-run groups -- after all, who can object to caring for the sick?" Mirken also speaks on "the people who believe that AIDS is over," criticizing writer Andrew Sullivan for "telling us that AIDS is no longer a crisis and dismiss[ing] reports of increasing high-risk behavior and rising rates of new HIV infections." Mirken also warns of the political consequences to the gay community of a resurgence of AIDS cases, saying, "When the second wave of AIDS [cases] becomes obvious, some on the right will rush to blame 'those promiscuous, irresponsible homosexuals.'" Signorile concludes, "I feel that many gay white men got their insurance, got their drugs and are back to their parties and sex joints. That's harsh and is too much of a generalization, but it's true that the AIDS epidemic in the black gay community is raging even more, and no one's doing anything" (San Francisco Chronicle, 6/3).
- "We Are All Living With AIDS": Ronald Valdiserri, deputy director of the CDC's National Center for HIV, STD and TB Protection, writes, "After 20 years experience with HIV ... it's reasonable to ask, 'Where are we?'" Valdiserri adds, "Unfortunately, our successes with AIDS are often overshadowed by the sheer breadth of this global disaster and by the realization that 20 years' effort has failed to produce a cure, or a vaccine, for this fatal illness." Valdiserri writes that "skepticism" over prevention efforts in light of increasing numbers of AIDS cases "is misplaced," adding, "By all means we should keep asking questions about what does and doesn't work when it comes to HIV/AIDS. But we need to make sure we're prepared to hear the answers. Not just the answers from the scientists and technical experts ... But also the answers from the people who are living with this disease and those who bear a substantial ongoing risk of its transmission within their communities" (Valdiserri, Pittsburgh Post-Gazette, 6/3).
- "Lack of Education Proves Most Significant Barrier to HIV Prevention": Dr. Jeffrey Nadler, an infectious disease specialist at the Brooklyn VA Medical Center, recalls how his first AIDS patients in 1981 "were not of much interest or were perceived as threatening to a great many physicians." He writes, "It was apparent to me that these patients were being discriminated against, even though they were in great need of specialty management." Twenty years later, Nadler notes, it has become apparent that the disease "afflicts people of all colors and sexual orientations, and is still spread to some by blood exposure (such as through shared needles) or perhaps as microscopic blood (from minor nasal trauma) on a rolled dollar bill through which coke is snorted. Many Americans don't realize this, still limiting their thinking, and thus often ignore their own potential exposure risk." Nadler concludes that "education remains a critical key to control of HIV" (Nadler, Tampa Tribune, 6/2).
- "The Asteroid of Global AIDS": "It is the People With AIDS and AIDS activists, seasoned campaigners all, who are forcing us to see the AIDS asteroid for what it really is: a complex viral disease," Jeff Getty, director of the activist group Survive AIDS, writes. "Progress made in the past 20 years against AIDS proves that with serious diseases, the strong demand for survival and compassion can and will outweigh the powers of greed, moralism and denial. Yet, we still have far to go." Getty concludes, "The trick will be to get decision-makers who are not yet affected or infected to care about people other than themselves and to commit to take action. Such compassion has been a long time in coming and may be the only true resource left to battle the epidemic" (Getty, San Francisco Chronicle, 6/3).
- "AIDS at 20: Power of the Quilt": "As an organizer, I saw the quilt primarily as a useful vehicle, tangible evidence of the suffering behind the statistics. Something with which to shame the politicians and capture the media's attention. I thought it was a good idea, but nothing could have prepared me for the artistry of the quilt, nor for its spiritual power," Cleve Jones, founder of the NAMES Project AIDS Memorial Quilt Project, writes in a San Francisco Chronicle commentary. Jones writes, "There was something about the process of creating the panels that was comforting ... I realized then the power of the quilt, not only as a memorial but as a call to action, a weapon against AIDS and the parallel epidemic of hysteria, bigotry and hate which it had unleashed." Although the project's offices have relocated to Atlanta, Jones says that the quilt "will always be remembered as a gift from the people of San Francisco. A gift offered freely to the world from a city and a community which, while devastated by incalculable loss, created out of hatred, fear and despair an enduring symbol of love, courage and hope" (Jones, San Francisco Chronicle, 6/1).