Whom HIV Infects Today


Happy AIDS Day! To mark the, er, occasion, Hugh Ryan argues that statistics about high risk groups can “conceal as much as they seem to reveal.” He wants a more granular approach:

What if we focused more on marginalization (and its real-world effects) and less on identities? What if we understood AIDS not as a disease affecting certain types of people, but rather, as a disease that affects those living at the intersection of a constellation of conditions, such as poverty, lack of access to education, inadequate health care, stigmatized sexual practices, drug and alcohol abuse (legal or illegal), and political disenfranchisement? This would not only reduce the stigmatization of identity groups with high rates of HIV infection, it would also allow us to tailor our health remedies to those who really are most at-risk. For example, in a further breakdown of that statistic regarding rates of infection among MSMs, the CDC notes that the numbers of new infections among white and black MSMs were almost identical—despite the fact that non-Latino whites represent 63 percent of the U.S. population and blacks only 12 percent. Additionally, the greatest number of infections was seen in the youngest age group. Again and again, it is those who sit at the intersection of marginalized identities—those with the least social capital and political agency—who are most at risk. We must discard generic categorical bromides in favor of health remedies targeted to their specific needs.

After reflecting on the plague years, Michael Specter makes related points:

[O]f the more than a million Americans who are infected with HIV (there are fifty thousand new cases a year), many have no decent health care, and nearly a third are not even aware they are infected. Racism, homophobia, and poverty continue to drive much of the epidemic. Minorities have the highest infection levels and are least likely to have access to satisfactory medical attention or drug treatments. Obamacare will help, but how fast or how well, nobody yet knows. This should be repulsive to us all; those people need education immediately, but there is little public funding available to teach young gay African-American men how to have sex with each other safely. That’s the society we seem to have become.

(Photo: Indian volunteers and members of the West Bengal Voluntary Health Association (WBVHA) light candles in the shape of a red ribbon during the closing ceremony of an AIDS awareness campaign on the occasion of World AIDS Day in Siliguri on December 2, 2013. World AIDS Day is celebrated every year on December 1 to raise awareness about HIV/AIDS and to demonstrate international solidarity in the face of the pandemic. By Diptendu Dutta/AFP/Getty Images.)