Elsewhere on About.com: HIV and AIDS

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Human Immunodeficiency Virus (HIV) budding out of an infected T cell, from which it will spread to infect other T cells. If HIV infection has disabled the immune system, the resulting vulnerability to infection is referred to as Acquired Immune Deficiency Syndrome (AIDS). Image courtesy of the National Institutes of Health.

Today was World AIDS Day, and the situation is gloomier than ever. AIDS has now become a bona fide pandemic: At least 25 million people have died of the disease since 1981, and 40 million people are living with HIV worldwide. It is projected that by 2010, 100 million children worldwide will be orphaned as a result of AIDS. AIDS is the leading cause of death for African-American women, and for all American men, aged 25-44. (It is the fourth leading overall cause of death for American women aged 25-44, but the rate of infection is climbing.)

HIV and AIDS activism focuses on three obvious areas: Prevention, nondiscrimination, and treatment. When it comes to prevention, our government is failing miserably. Safe sex statistically reduces the odds of contracting HIV by at least a factor of ten--studies have estimated that the chances of contracting HIV as a result of vaginal sex with an infected partner when a condom is used are 1 in 5,000, and that the odds of contracting HIV as a result of vaginal sex with a member of the general population when a condom is used are 1 in 50 million. (I went with vaginal sex because that's how HIV is most commonly transmitted, but data on the risk of transmission through other means is available.) The U.S. government has responded to this research by doing all that it can to reduce safe sex education, both at home and, unforgivably, in developing nations where basic safe sex education could do an astonishing amount of good. It has replaced this with a sex-stigmatization program that it euphemistically refers to as abstinence education, a program that, on the rare occasions when it accomplishes anything at all, only encourages people to be more ashamed of, and secretive about, their sex lives. It is exactly this kind of social stigma that led to the spread of HIV among gay men in the 1980s, and there is no reason to believe that it will be any more humane if it is carried over to the heterosexual population. To say that the federal government has failed in its responsibilities vis-a-vis the prevention of HIV transmission would be the kindest of understatements.

Featured Links from HIV and AIDS Guide Mark Cichocki HIV Prevention and Safer Sex: HIV Prevention Course Your Rights as an HIV-Positive American: HIV in the Workplace HIV and the Americans with Disabilities Act HIV Patient's Bill of Rights Treatment and Research: Health Insurance for HIV-Positive Americans HIV/AIDS Medication News HIV and AIDS Medication Fact Sheets

The situation vis-a-vis nondiscrimination is almost as depressing, but considerable progress has been made over the past decade. In Bragdon v. Abbott (1998), the U.S. Supreme Court ruled that HIV-positive status can be classified as a disability under the Americans with Disabilities Act, even if no symptoms have technically emerged. Many civil antidiscrimination lawsuits, as portrayed in the 1990 film Philadelphia, have also gone well.

But there have also been some setbacks: In Chevron v. Echabazal (2002), most notably, the Supreme Court ruled in favor of a company that denied a promotion to an employee due to his Hepatitis C-positive status "for his own good," on the basis that the job would pose a health risk to him. Although this precedent (as far as I know) has not yet been successfully used against HIV-positive individuals, the groundwork is in place for such discrimination. The Supreme Court also refused to hear a challenge to Alabama's prison policies segregating HIV-positive prisoners from the rest of the population, denying the prisoners the level of education, training, and chaplaincy benefits available to non HIV-positive prisoners. Clearly a great deal of work needs to be done, but there have been some encouraging steps. My home state of Mississippi, for example, had a program identical to Alabama's until 2001, when it was discontinued. Now Alabama is the only state with an HIV-positive prisoner segregation program, and it is probably only a matter of time before Alabama joins the rest of the country on this issue.

Treatment is the one area in which there has been clear and unambiguous progress, particularly as the necessity of HIV and AIDS treatment has become championed by many of the same religious groups that opposed such treatment 20 years ago. But even in this area, progress on civil liberties needs to be made--particularly with regard to equitable distribution of federal funds, and individual access to adequate health care. This cause was not especially helped by the Supreme Court's decision not to hear Doe v. Mutual of Omaha (2000), in which the 7th Circuit Court of Appeals upheld discriminatory and disease-specific health insurance treatment price caps for HIV-positive customers.

There is considerable opportunity for activism on these civil liberties issues. The Campaign to End AIDS has what may be the most useful web site vis-a-vis HIV and AIDS activism, and great opportunities for local activism and networking. The ACLU's AIDS Project focuses on issues affecting HIV-positive Americans, particularly vis-a-vis job discrimination. Lambda Legal's HIV Project has similar objectives.

And if you're new to all this and wondering where to start, or just want to look at a more general informational resource, it would be difficult to find a more useful resource than my colleague Mark Cichocki's About HIV and AIDS site. If you know of any particularly useful or compelling sites on HIV and AIDS related issues, please do feel free to share them with me and with other readers in the Comments field below.