HIV/AIDS: A New First Impression

If only HIV/AIDS had made a different first impression.

I wonder where we'd be right now if those first few cases of AIDS had been found in straight white guys. If the disease hadn't been initially referred to as "gay cancer" or GRID (gay-related immunodeficiency disease). If HIV/AIDS hadn't been associated from the start with lifestyle, rather than biology.

Here we are, entering the fourth decade of our life with HIV as a human nation. And much of our country -- heck, much of the world -- still thinks HIV/AIDS is not so much a viral disease as it is the inevitable result of a bad decision.

Never mind that less than half of all people in the U.S. who get HIV/AIDS do so through male-to-male sexual contact, and that most Americans do not get it through injection-drug use. Or that HIV whittles away the immune system in the same manner regardless of a person's sex, gender, race, age, education level, wealth, geographic location or the manner in which they're infected.

It's the first impression that matters. And that first impression was that HIV/AIDS was something sinners got for doing things they shouldn't: Having sex with men. Using drugs. Acts of which God does not approve, as has been made clear by luminaries such as Pope Benedict XVI and Delaware's masturbation-averse Republican Senate nominee Christine O'Donnell.

That first impression persists to this day. It's a twisted, tightened, pulsing knot of assumption, judgment, fear and moral superiority, and it lies at the core of our society's willful ignorance of HIV ("surely, I'm too pure for HIV/AIDS to affect me") and intolerance of those who have it. Well, except for African AIDS orphans. They win our pity, since they're the innocent, powerless victims, and they live really far away.

We talk -- and talk, and talk, and talk -- within the HIV/AIDS field about how to stem the tide of new infections. (A tide, incidentally, that has flooded the U.S. steadily for years, so that now more than a million Americans are living with HIV, and 56,000 more join the ranks each year. Among the hardest-hit groups? African-American women and people living in the rural South.) Some talk about the need for universal, routine HIV testing; some talk about the need for worldwide access to HIV treatment; some talk about the need for wealthy countries like the U.S. to pump more money into the fight against HIV/AIDS.

All of these are valiant ideas. And all of them are futile if we can't find a way to re-teach our communities about what HIV is, who gets it, and why having it doesn't make you a bad person. Because you're not gonna get tested if you're afraid of how your family, your friends, your boss, your religion or your community will treat you if the test is positive. And you're not gonna get treatment if you haven't been tested. And all the HIV funding in the world won't help you if you die in silence.

In our culture today, if you have syphilis, gonorrhea or chlamydia, you're a regular person with an infection. If you have HIV, you're a deviant. To beat this pandemic, each of us needs to sweep away that mistaken first impression and create a new one. We need to understand that living with HIV/AIDS is something to respect -- not fear, not loathe, not revile, not discriminate against. HIV is a virus. People get it. It usually happens through sex, needles or childbirth, just like a lot of other diseases. (And decidedly not, by the way, through spitting, sharing sandwiches or shaking hands.)

HIV can't be cured, and it's dangerous. But it can be prevented, it can be treated, and the pandemic can be stopped. Provided we each stop instinctively judging those who live with it, and instead start learning more about it. Watching films like The Other City, a new documentary being shown in New York City this week and in Los Angeles starting Sept. 24, is a good way to begin. ( interviewed two of the filmmakers earlier this year, and we'll be hosting a discussion following the 7 p.m. screening in New York on Sept. 23.) But it's the responsibility of each of us to recast HIV/AIDS as a disease of humanity, not a disease of the damned.

UPDATE: Thanks to an astute observation from a commenter, I changed the beginning of the fourth paragraph to more faithfully reflect 2008 CDC surveillance figures. The sentence had read, "Never mind that more than half of all people in the U.S. who get HIV/AIDS are heterosexual, and that most people who get it are not injection-drug users." It now reads, "Never mind that less than half of all people in the U.S. who get HIV/AIDS do so through male-to-male sexual contact, and that most Americans do not get it through injection-drug use."