5 Challenges in AIDS Fight

On World AIDS Day, a reminder of high stakes and a ticking clock

Today is Worlds AIDS Day. As the Wire previously noted, AIDS claimed 1000 times as many lives in 2007 as the war in Afghanistan. There is cause for optimism--the world has made improvements in recent years, especially in treatment. But AIDS remains a serious crisis. Here are five challenges that remain in confronting AIDS and HIV:

• AIDS in Washington, DC  The Huffington Post's Jose Antonio Vargas reminds us that AIDS is not restricted to the developing world. "At least 3 percent of [DC's] population is HIV-positive, and that's a conservative estimate, according to the city's HIV/AIDS Administration. Nearly 7 percent of all black men, who carry the burden of the epidemic in the city, are infected," he writes, noting that's higher than swathes of West Africa. "The leading cause of death for black women ages 25 to 34 is AIDS."

To me, there's always been two Washingtons--the federal city of monuments and museums, of the White House and the Capitol, the Washington of Georgetown, Bethesda and the inside-the-Beltway, I-read-Politico's-Playbook-because-I-have-to crowd.

Then there's this other Washington, the District of Columbia, a city within a city where health care access is a daily battle, where incarceration rate, drug addiction, poverty and illiteracy are high, a salad bowl of a city. [...] For almost a decade D.C. was the only city in the country barred by Congress to use its local tax dollars to fund needle exchange.

• Epidemic in South Africa  Global Post's Mercedes Sayagues reports on what living in "the global epicenter of AIDS" means for day-to-day life. "Here, sex, flirting and romance are never wholly free of the long shadow cast by AIDS. When do I bring up condoms? When do I suggest getting tested? With whom has he or she slept before? When do we stop using condoms? Who can I trust? One of the saddest things about the AIDS epidemic in Africa is that a generation of young people cannot discover and enjoy sex as freely as their parents," she writes. "AIDS is among us. AIDS is not a disease of the others."

• Problems with Mandatory Testing  Amnesty International blasts international programs for mandating AIDS testing. "Mandatory testing increases the potential for stigma and discrimination," the group declares. "In particular, women who test positive face a greater chance of violence at the hands of their partners. The measure would also criminalise 'attempted transmission' of HIV [as is done in the United States] and would provide for other criminal penalties for the failure of an HIV-positive person to 'observe instructions on prevention and treatment,' among other provisions. Laws like these are impractical, unnecessary and counterproductive--especially because they create incentives to avoid getting tested, receiving health information and obtaining necessary care."

• Better Care for Young Women  Former Assistant Surgeon General Susan Blumenthal warns that "HIV/AIDS is the leading cause of death worldwide among women of reproductive age." Blumenthal writes that "in a World Health Organization survey of 90 low- and middle-income countries, only 45 percent of HIV-positive pregnant women received antiretroviral therapy (ART) in 2008 to prevent mother-to-child transmission of HIV, up from 10 percent in 2004. And a significant percentage of those women did not receive the most effective ART therapy."

• Misconceptions Regarding Vaccine Trials  Open Left's Adam Bink explains that most people assume that HIV trial vaccines--tests in which healthy people are given HIV treatments and checked for side effects--can give the test subject HIV. But they can't. After getting a trial, Bink writes, "I was left wondering at the public approach to HIV/AIDS and other diseases. How are we ever going to get past prevention and onto eradication if we don't get past the perception that these vaccines just make themselves, and volunteering isn't critical? [...] But it simply doesn't make any sense to talk about prevention of diseases through pap smears and mammograms and HIV tests, and not ask people to volunteer to try and end these diseases permanently."