AIDS as a metaphor for inequality

Photo: UN

Sources: Los Angeles Times, Bloomberg, The New York Times

“One stubborn fact was hard to ignore” at the International AIDS Society's annual meeting in Rome last month: the syndrome “remains a metaphor for inequality,” wrote Michel Sidibé, Executive Director of the Joint UN Programme on HIV/AIDS (UNAIDS) and Under-Secretary-General of the United Nations. His words are backed up by new studies on HIV that reveal the persistent gaps between poor and rich countries and between wealthier and marginalized communities in the United States.

“In the world's wealthier nations, where access to medicine is widespread, AIDS is becoming a chronic disease rather than a death sentence. But in the developing world, 1.8 million people die of AIDS each year,” said Sibidé in an op-ed column he wrote for US newspaper, Los Angeles Times. In the Northern Hemisphere, we are seeing a new generation born HIV-free, while each year in the southern half of the world, 370,000 babies start life infected with HIV. In the southern region, 9 million people living with HIV are still waiting for treatment to survive,” he added.

“It is hard not to conclude from all this that life is not valued equally across the world. This is morally wrong and unacceptable,” Sibidé regretted.

A new study, funded by the World Bank, UNAIDS and the World Health Organization, revealed this week that HIV epidemics are emerging in the Middle East, Central Asia and North Africa, where infections more than doubled from 36,000 a year in 2001 to 75,000 in 2009. More than a quarter of new infections are attributed to sex between men, according to the report.

Those transmissions are ascribed to certain occupational groups —such as truck drivers in Morocco and Pakistan— but also to marginalized sectors of the population such as street children, sex workers and prisoners, the researchers said.

“The survey is the first to describe the state of HIV among gay and bisexual men in a region where same-sex intercourse is often criminal and the stigma associated with it can hinder efforts to prevent transmissions,” reported Bloomberg news agency.

Laith Abu-Raddad, an Associate Professor of Public Health at the Weill Cornell Medical College in Qatar who led the study, hopes the findings will spur governments to curb the epidemics. “Only a few countries” such as Morocco, Pakistan and Lebanon “have started in the right direction,” Abu-Raddad said, but “the majority of countries still haven’t really acted.”

On the other hand, the number of new infections with the virus that causes it has remained stubbornly around 50,000 a year in the United States for a decade, according to new figures released on Wednesday, wrote Donald G. McNeil Jr, a journalist in charge of covering health issues at The New York Times.

In this case, “the epidemic is still concentrated primarily in gay men, and is growing rapidly worse among young black gay men,” McNeil added.

Researchers explained to The New York Times that “black teenage boys who realize they are attracted to men are often too poor to move to gay-friendly cities like San Francisco or New York, […] and often must keep their homosexuality hidden from relatives and friends, making it more likely they will have furtive, risky sex.”

“They often lack health insurance, meaning they do not get checkups where a doctor might suggest testing. And while new surveys find that they use condoms at about the same rates as young gay white and Hispanic men, sex tends to stay within racial groups and more older black gay and bisexual men are infected. Also, untreated syphilis, whose sores open a path for H.I.V., is more common among blacks,” they said to McNeill.

“That realization is causing a rift in the AIDS community. Activists say the persistent H.I.V. infection rate proves that the government prevention policy is a flop. Federal officials are on the defensive even as they concede that the epidemic will grow if prevention does not get better, which they know is unlikely while their budgets are being cut,” added the journalist.