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30 Years of HIV/AIDS: Progress, but No Answer

In the early days, infected people were showing up with clusters of symptoms that didn’t conform to anything clinicians had ever seen. Infections normally suppressed by the body were running riot in previously healthy young men. Skin cancers almost always observed in elderly Mediterranean men were erupting on the limbs of young people without a drop of Mediterranean blood.

The illnesses were landing so heavily on homosexual men that doctors first proposed gay-related immune deficiency, or GRID, as a name for this new set of illnesses. Long before the HIV virus was isolated, doctors grew wary of GRID as a name, and concluded Acquired Immunodeficiency Syndrome, AIDS, more accurately reflected what was going on.

A kind of panic set in as an American public trying to understand the new disease concluded one was better safe than sorry: HIV positive people were harassed, shunned, discriminated against. Once “bodily fluids” from infected people were identified as a culprit, sweat, tears, and saliva were obsessed over before being ruled out as a vector.

Actor Rock Hudson died inch-by-inch, ravaged by the disease and in public denial until a few months before his death. Diagnosed in mid-1984, Hudson traveled to clinics domestically and abroad seeking treatment for AIDS, while telling the public he suffered from liver cancer. In retrospect, amid fear, suspicion, and even hatred of AIDS sufferers, Hudson’s going public before his death was an act of courage for a gay man who had so remained so carefully private for decades.

There’s so much to say about the evolution of this epidemic. The stubborn and deadly march of the disease has continued along with my career in the news business. From interviewing gaunt young men fighting thrush infections and wearing makeup to cover skin lesions in the early 1980s, to holding HIV-positive infants born to infected mothers later that decade, to chronicling the lives of AIDS orphans and the wildfire of HIV-tuberculosis co-infection in Africa in the 21st century, and now watching anti-retroviral therapy make AIDS a chronic condition rather than a death sentence.

It’s sad to mark the 30th anniversary of the first case, but encouraging to see the progress amid disaster.

My most recent assignment on AIDS brought me to Vatican City with the NewsHour’s global health team to look at issues surrounding prevention of HIV.

Since the early days, talk of HIV prevention has always involved confronting taboo topics of sexual behavior. And as we saw in Rome last week, the debate over one of the only proven prevention methods for HIV transmission, the condom, continues among groups heavily involved in providing treatment to the parts of the world now hardest hit by the epidemic.

Since Pope Paul VI’s encyclical, Humanae Vitae, On Human Life, was released in 1968, the Catholic Church has been on record forbidding condom use to married couples who wanted to avoid conceiving a child. All married and unmarried people on earth were implicated in the teaching, since in the Catholic view, no one else but married people should be having sex in the first place.

With the arrival of AIDS in the 1980s, Catholic medical and social service agencies rolled up their sleeves and got to work, caring for the sick and the dying throughout the world, preaching love and acceptance for the infected when fear made pariahs of the HIV positive. At the same time, the same Church never wavered in its condemnation of behaviors that fueled the spread of the disease, such as homosexual intercourse and promiscuity.

It’s that policy that estranges those who are shoulder-to-shoulder with the Catholic Church in the battle against AIDS.

Secular AIDS advocates are right when they say an infected individual who wears a condom in a sexual encounter is unlikely to give a sex partner HIV. And Catholic clerics and medical care workers are right when they say people with multiple sex partners have contributed to the spread of AIDS to millions, and that more condoms have not stopped the spread of HIV.

Church authorities we spoke with would not engage with the idea that in any one sexual encounter involving two people, a properly used condom would block the transmission of the HIV virus from an infected partner to an uninfected one. They would instead return to the view that in entire populations the availability of condoms had not stopped the spread of the disease.

A witness standing on the sidelines watching the argument can see the right in both perspectives. However, from what I saw in reporting before my trip and during the Vatican conference, the two sides regard each other’s motives with suspicion.

That suspicion is almost paradoxical given the intimacy with which these parties work with each other in some of the unhappiest places on earth. Both sides are united in wanting more people treated with life-saving medications, fewer new infections, and fewer deaths from AIDS.

Michel Sidibe of UNAIDS recently told me only 6 million of the more than 15 million people needing antri-retroviral (ARV) medication in the developing world can get it. This news came amid clinical studies that show the drugs can suppress the virus in a way that makes infected people less contagious and could stop the spread of the disease in an important way.

The success of ARV therapy is tempered by the reality that seven thousand people are newly infected with HIV every day. Seven thousand every day. As we go forward, marking this somber anniversary, one thing we do know is we can’t simply medicate our way out of this pandemic.

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