Sense Project

Some of you probably thought that I was crazy for asking this question. After all, HIV/AIDS is a serious issue affecting millions around the globe. However, Elizabeth Pisani, epidemiologist, journalist and author of The Wisdom of Whores, gave a talk last Thursday that really got me thinking about how HIV/AIDS is packaged and whether or not this packaging really reflects what’s going on.

For starters, Pisani argued that there is no global pandemic but rather, two separate epidemics that affect different and very specific groups of people around the globe. As many of us know already, there’s an epidemic in Eastern and Southern Africa. In the West, Pisani stated that only four key groups are at high-risk of contracting HIV; namely, male prisoners, drug injectors, people who buy and sell sex as well as gay men. Pisani warmly referred to these groups as “icky” in the sense that there’s no money or votes in relating HIV/AIDS back to them.

According to Pisani, it is precisely for this reason that HIV/AIDS has been repackaged to include everyone, with a special focus on innocent women and children. In this sense, governments are happy because they don’t have to deal with the “ick” groups, the UN and NGOs are happy because they get cash regardless of their mandate and activists are happy because HIV becomes less stigmatized. And, well, HIV is happy because it can keep on spreading.

Pisani, then, went on to show us lots of data. And, I got to say, the numbers and her explanations of them were pretty convincing. Millions of dollars are being spent every year on HIV/AIDS prevention and treatment and yet, there has been no significant decrease in rates of HIV infection. Interestingly, the data, also, showed that national clean needle programs were extremely effective in controlling rates of HIV infection. So, why aren’t we doing them?!

In addition, Pisani said that HIV is at its most infectious during the 3 months following infection. And, that when there are high levels of the virus in the blood, it is at its most contagious. Thus, the four “ick” groups are at high-risk of contacting HIV because they, generally, have multiple sex partners and/or inject with multiple needles within short periods of time.

In conclusion, Pisani makes a strong argument for HIV/AIDS to be reinvented or rather, repackaged. She urged us to stop thinking about AIDS and to gear our efforts toward reconceptualizing HIV as an infectious disease. Indeed, she argued that we need to reorganize our priorities - remove the gaze from the general population and focus on HIV prevention and not AIDS; that the HIV/AIDS industry needs to respond to evidence and start spending money on the right things such as clean needle programs and condoms. Ultimately, the science does not mirror the politics and HIV prevention and treatment should be tailored to fit the particularities of the two different epidemics.

Of course, Pisani might not be taking social factors into consideration. High HIV infection rates could be caused by patterns of migration and issues related to “development” in Africa, for instance. I’m also concerned that if we start doing as Pisani suggests, we might be exacerbating other problems like homophobia. And, we cannot forget the many challenges that we already face. For example, the far right in the United-States has made it extremely difficult for prevention programs to be implemented in many communities. This, of course, is without mentioning the fact that human behaviour is extremely difficult to change. After all, the condom is an old technology that is, generally, pretty available and yet, people still don’t make use of it when they should.

So, do we live in a post-AIDS world? Well, I suppose it depends on which “world” we’re talking about and whether or not you agree with Pisani’s research and suggestions.