HIV/AIDS

"..."That disease he has does an awful job on you. Your lungs fill up." "Well, he should have kept his penis out of other men's bottoms then," Janice says, lowering her voice though, so the nurses and orderlies in the hall don't hear."

"The Catholic bishops of South Africa, Botswana, and Swaziland categorically regard the widespread and indiscriminate promotion of condoms as an immoral and misguided weapon in our bat-tle against HIV/AIDS for the following reasons. The use of condoms goes against human dignity. Condoms change the beautiful act of love into a selfish search for pleasure-while rejecting responsibility. Condoms do not guarantee protection against HIV/AIDS. Condoms may even be one of the main reasons for the spread of HIV/AIDS."

"You want to know why I don't have AIDS, why I'm not HIV-positive like so many other people? I don't fuck around. It's as simple as that."

"The need to predict and prevent transmission of HIV has provided a valuable impetus to both sexual behaviour and intervention studies in the past two decades. Data are sparser in some regions than others, in particular those with low HIV prevalence or strong prohibitions surrounding sex, or both. African countries, for example, have received hugely disproportionate attention from researchers compared with Asian countries, and so the evidence base is partial. Even so, a reasonable global impression can be gained from the large number of developing countries with comparable data (those for which a Demographic and Health Survey (DHS) has been undertaken), and from other countries with comparable national surveys. Data are accumulating too, from assessments of the effect of interventions to improve sexual health."

"Uganda’s success in reducing HIV prevalence and improving reproductive-health status compared with neighbouring countries has been attributed to the selective emphasis on the abstinence and being faithful strands of the ABC strategy in the country’s HIV programmes. The suggestion has been made that later onset of sexual activity and a reduction in non-regular sexual partners (a 65% reduction from 1991 to 1998) have been more important than condom use in curbing the HIV epidemic. These conclusions have been interpreted as providing evidence of the merit of abstinence-based approaches to HIV prevention generally. Several features of Uganda’s epidemiological situation and social-context suggest that Uganda’s success should not be attributed to a few specific interventions. The first feature relates to the timing of events. The fall in prevalence of HIV corresponds to a drop in incidence from the beginning of 1985, when Uganda did not have public national HIV-prevention programmes in place. Furthermore, as our data show, the trend towards older age at first intercourse occurred gradually for women from the 1970s to the present—i.e., before the start of HIV-prevention programmes—for men remarkably little change in age at first intercourse has taken place in recent decades. However, evidence shows that other changes in behaviour have taken place. Condoms were cautiously and gradually introduced in Uganda and were largely unavailable to the general population during the 1980s, but rates of condom use were high in high-risk groups, such as sex workers."

"In the midst of the AIDS epidemic, which has already killed tens of millions and preys disproportionately on the poor, the condom acts as a contra mortem and its use is justified by the Catholic consistent ethic of life. At least, this is the view of many Catholics at the front lines of the global HIV battle. Catholic organizations mercifully provide around 25 percent of the care AIDS victims receive worldwide. Many of the clergy and laity involved in treating people with AIDS, who otherwise fully ascribe to the church’s teachings on sexual ethics and the sanctity of marriage, nevertheless endorse the use of condoms. They argue that the preservation of human life is paramount. Fr. Valeriano Paitoni, working in São Paulo, Brazil, summarized this perspective: “AIDS is a world epidemic, a public-health problem that must be confronted with scientific advances and methods that have proven effective,” he says. “Rejecting condom use is to oppose the fight for life.”"

"Bishop Kevin Dowling of South Africa has also been imploring the Vatican to view condom use as curtailing the transmission of death rather than precluding the transmission of life. In South Africa, 5.3 million people are infected with HIV and 25 percent of all pregnant women test positive for the virus. Dowling prays that the Holy Spirit will intervene to change minds in Rome. He believes Pope Benedict XVI’s view on the use of condoms would change, “if his visits to poor countries were done in such a way that he could sit in a shack and see a young mother dying of AIDS with her baby.” Not long ago, Belgian Cardinal Godfried Danneels stated on Dutch television that although sex with a person infected with HIV is to be avoided, “if it should take place, the person must use a condom in order not to disobey the commandment condemning murder, in addition to breaking the commandment which forbids adultery.” He added: “Protecting oneself against sickness or death is an act of prevention. Morally, it cannot be judged on the same level as when a condom is used to reduce the number of births.”"

"Although it is true that condoms are not 100-percent effective in preventing HIV infection, they do reduce the risk of transmission significantly. Comparing condom use to a suicidal dare, as Cardinal Trujillo does, is scientifically inaccurate and socially irresponsible. A preponderance of medical research demonstrates that condoms help prevent the spread of HIV. For example, the European Study Group on Heterosexual Transmission of HIV followed 124 discordant couples (in which only one of the pair is infected with HIV) who consistently used condoms. Over a two-year period and roughly fifteen thousand sexual acts, none of the HIV-negative partners contracted the virus. Thai investigators examining the impact of condom use among the military reported that new infections dropped from 12.5 percent in 1993 to 6.7 percent in 1995. The number of new HIV infections in Thailand plummeted after the introduction of a “100-percent condom use” program. Uganda earned its reputation as a paragon of HIV prevention for its now-famous ABC program: Abstain, Be faithful, and Consistent, Correct use of Condoms. Following the implementation of ABC, HIV infection in Uganda decreased from between 15 and 20 percent of the population in the early 1990s to 5 percent in 2003. A comparative analysis of Ugandan population-based surveys in 1989 and 1995 concluded that delaying the age of first sexual encounters, decreasing the number of casual partners, and increasing condom use all contributed to Uganda’s success."

"Benedict XVI made his first comments as pope regarding condom use at a June 2005 papal audience. His listeners included bishops from South Africa, Swaziland, Botswana, Namibia, and Lesotho. After reviewing the importance of catechesis and recruiting African men to the priesthood, the pope turned his attention to AIDS: “It is of great concern that the fabric of African life, its very source of hope and stability, is threatened by divorce, abortion, prostitution, human trafficking, and a contraception mentality.” He emphasized that contraception leads to a “breakdown in sexual morality.” In the speech, the pope made a diagnosis: condoms increase sexual immorality, and sexual immorality increases the spread of AIDS. The logical treatment for sexual immorality is Christian marriage, fidelity, and chastity. Cardinal Javier Lozano Barragan, president of the Vatican’s Council for Pastoral Assistance to Health Care Workers, had reached a similar conclusion in his Message for World AIDS Day (December 1, 2003): “We have to present this [lifestyles emphasizing marriage, fidelity, and chastity] as the main way for the effective prevention of infection and spread of HIV/AIDS, since the phenomenon of AIDS is a pathology of the spirit.”"

"Fidelity in marriage and abstinence for everyone else would be the only indicated intervention if a “pathological spirit” were the only cause of AIDS. Unfortunately, many victims of HIV are blameless. Currently, 25 million HIV-infected individuals and 12 million AIDS orphans are living in sub-Saharan Africa. The communities hardest hit by AIDS are among the world’s most impoverished. Sub-Saharan Africa, which has the world’s lowest per capita annual income ($450 US), and where half of all individuals live in extreme poverty (earning less than a dollar a day), is ground zero of the epidemic. Over 70 percent of all infections, 80 percent of all AIDS-related deaths, and 90 percent of all AIDS-orphanings occur here. And with over six thousand new infections per day, the epidemic shows no signs of abating."

"Obviously, the poor are limited in their access to education and to health services. Ignorance kills. When accurate information is not available, myths multiply. Surveys from forty countries indicate that more than 50 percent of young people aged fifteen to twenty-four have serious misconceptions about how HIV/AIDS is transmitted. Research by the Nelson Mandela Foundation has shown that 35 percent of twelve- to fourteen-year-olds thought that sex with a virgin could cure AIDS, or were unsure whether or not that statement was true. In other impoverished nations, AIDS is thought to be spread by witchcraft, mosquito bites, or through polio vaccination."

"In Africa, the legacy of colonial racism, and especially of apartheid, still plays a role in determining one’s risk of contracting HIV. In South Africa, a migrant labor system separated husbands from wives and made normal family life impossible. That pattern continues in the mining industry today, where the conflation of harsh working conditions, separation from wife and family, and the invariable proximity of brothels facilitate the spread of HIV from sex worker to laborer, and thence to his wife and children."

"Acknowledging the role that poverty, racism, and gender inequality play in fueling the spread of AIDS in no way diminishes the need for personal responsibility and moral restraint. Indeed, even the correct and consistent use of condoms will require behavior change and individual accountability. But by narrowly diagnosing AIDS as a problem of morality and by discrediting a vital component of HIV prevention, the church is advancing a remedy that is woefully inadequate. In medicine, partial therapy is at best ineffective-and at worst lethal."

"Back in the early 1990s, Nathaniel Landau was a young virologist just starting his career in HIV research. But he and his colleagues were already on the verge of a landmark breakthrough. Several labs around the world were hot on his team's tail. "We were sleeping in the lab, just to keep the work going day and night because there were many labs all racing against each other," Landau says. "Of course, we wanted to be the first to do it. We were totally stressed out. " Other scientists had identified groups of people who appeared to be completely resistant to HIV. "People who knew they had been exposed to HIV multiple times, mainly through unprotected sex, yet they clearly were not infected," Landau explains. And so the race was on to figure out why: "Are these people just lucky or did they really have a mutation in their genes that was protecting them from infection?'" he says."

"By far, the most famous virus superdodgers are people protected against HIV — the ones Landau and his colleagues were studying back in the early 1990s. In 1996, his team was getting really close to solving that puzzle. One morning they found a huge clue. The night before, they had set up an experiment to test which molecules HIV needed to infect a human cell. The experiment garnered spectacular results. It showed that HIV didn't enter cells the way scientists had believed. Instead it needed a little bit of extra help. Specifically, HIV needs a specific molecule, called CCR5, on the surface of the cell to "open the door" and let the virus enter, Landau says. Without CCR5, the virus only sticks to the cell's surface but can't enter. "It's kind of like the virus is knocking at the door, but nobody's opening the door. The door is locked," he says. "That was what we call a eureka moment," Landau says. "That was the moment where we could say, 'We found something that had never been seen before.' ""

"[I]n collaboration with a research group down the hall, Landau and his colleagues sequenced the CCR5 gene in two people completely resistant to HIV. Lo and behold! Both people had the same mutation in the gene – and it's a powerful mutation. It completely cripples the molecule so that it doesn't appear on the cells' surface, the group reported in the journal Cell. Remember, without CCR5, HIV can't infect the cell. "You can put as many virus particles as you want onto those cells, and they will not get infected," he says. "So in the case of resistance to HIV, the story was very clear." The finding completely shifted the field of HIV. It led to the first – and only – way to cure a person of HIV and suggested a new route, using gene editing with CRISPR. But it did something else: It showed scientists that one mutation could make a person completely resistant to an infection. One mutation in their genes could make them a true superdodger."

"About 17% of adults 18-59 have had an STD and the lifetime infection rate is likely to be over 20% (Laumann, Michael, Gagnon, and Stuart, 1994). Moreover, with the advent of AIDS the medical problem of STDs has taken on increasing urgency (CDC, 2002; Div. of HIV/AIDS Prevention, 1995 and Yankauer, 1994). Deaths from AIDS rose at a rapid pace in the 1980s and early 1990s. By 1992 AIDS had become the number one cause of death among men 25-44. Then due to improvements in medical treatments, cases diagnosed as AIDS peaked in 1993 and deaths from AIDS in 1995. The death rate fell by more than two-thirds and has continued declining through 2002 (CDC, 1998; 2000; "AIDS Falls," NCHS, 2005; 1998; State and Local, 1998; State and Territorial Health Depts. et al, 2000; Surveillance Branch, 2001). Likewise, newly diagnosed HIV cases have also fallen (Espinoza et al, 2005). Most HIV infections have resulted from sexual behavior and heterosexual intercourse has become a major mode of transmission ("Heterosexuality," 1994; CDC, 1998; 2002; Espinoza et al., 2005)."

"AIDS is a deadly and infectious disease that has mainly been transmitted through tainted blood products, sexual intercourse, and the sharing of needles by users of illegal injection drugs. With the safeguarding of the blood supply current transmission occurs largely through sexual intercourse or the sharing of needles with a HIV positive individual. The only means of restricting the spread of the disease is to have people adopt safer sexual and injecting drug use behaviors. On the one hand, the long latency period of AIDS greatly complicates matters since infected people often are not aware that they are HIV positive and therefore pass the infection on to others. On the other hand, since the mid-1980s over 90% of the public have known that HIV is spread by sexual intercourse and knowledge about AIDS in general has grown over time (Herek, Capitanio, and Widaman, 2002; Lentine, et al., 2000; Rogers, Singer, and Imperio, 1993; and Singer, Rogers, and Corcoran, 1987).12 Given the existence of widespread, if imperfect, knowledge about the role of sexual intercourse in spreading AIDS, the question arises whether behavior has been modified in light of the known risk."

"By the time AIDS was identified, its mode of transmission via sexual intercourse documented, and tests for HIV infection developed, the disease was already widespread among the gay population, especially in San Francisco and New York City. Combined efforts by gay community organizations and public health officials led to the rapid dissemination of knowledge about AIDS and the adoption of safer sex practices by gays. The result was "a dramatic decline in risk practices for HIV transmission...gay men have reduced the number of sex partners, have fewer anonymous sexual encounters, have switched from shorter to longer term relationships, and engaged in less anal intercourse or consistently used condoms (Ehrhardt, Yingling, and Warne, 1991)." More recently however, there has been little further increase in safe sex practices among homosexuals and even some back sliding among some who have tired of the diligence and restrictions required by safer sexual practices, among some minority groups, and among younger gays who did not experience the initial onslaught of the epidemic (Catania, Stone, Binson, and Dolcini, 1995; Ehrhardt, 1992; Ehrhardt, Yingling, and Warne, 1991; Goldbaum, Yu, and Wood, 1996; Kalichman, 1996; Osmond, et al., 1994; Ostrow, Beltran, and Joseph, 1994; Carballo-Dieguez and Dolezal, 1996; and Ostrow, Difranceisco, and Kalichman, n.d.). As a result, same gender sexual intercourse among men remains the most frequent mode for the transmission of AIDS ("Update," 1995; Levin, 1995; and State and Local, 1997; CDC, 2002).17"

"Undoubtedly because of the advent of AIDS and the dissemination of safer sex messages, condom use doubled from the late 1970s/early 1980s to the late 1980s (Table 18)(see also Anderson, 2003; Anderson, et al., 1999; Bankole, Darrocht, and Singh, 1999; Cates, 2001; Douglas, et al., 1997; Graham et al., 2005; Moran et al., 1990; Murphy and Boggess, 1998; and Ringheim, 1993). From the mid-1960s to the mid-1970s just over a fifth of women used a condom at the time of their first intercourse. By the mid-1980s this had almost doubled to 42%. Similarly, in 1979 21% of teenage males reported using a condom at the time of their most recent intercourse and in 1988 the level increased to 57.5%.22 Condom use has continued to increase since then (Beckman, Harvey, and Tiersky, 1996; Catania, Binson, Dolcini, Stall, Choi, Pollack, Hudes, Canchola, Phillips, Moskowitz, and Coates, 1995; Catania, Coates, Peterson, Dolcini, Kegles, Siegel, Golden, and Fullilove, 1993; Catania, Stone, Binson, and Dolcini, 1995; Ford and Norris, 1995; Ku, Sonenstein, and Pleck, 1994; Moore, et al., 1992; Division of Epidemiology and Prevention Research, et al., 1992; Pleck, Sonenstein, and Ku, 1993; Ku, Sonenstein, and Pleck, 1993; Strunin and Hingson, 1992; Piccinino and Mosher, 1998; and Peipert, Domagalski, Boardman, Daamen, McCormack, and Zinner, 1997; Manlove, Ryan, and Franzetta, 2004; Mosher et al., 2005). For example, the YRBS shows that condom use increased for both males and females in the 1990s through 2003 and condom use at last intercourse among never married males 15-19 grew by 10 percentage points from 1988 to 1995 (Table 18). However, while condom use has grown appreciably, it is still far below the general and consistent use called for by safer sex practices (Kost and Forrest, 1992; Pleck, Sonenstein, and Ku, 1991; Potter and Anderson, 1993; Leigh, Morrison, Trocki, and Temple, 1994; Peterson, Catania, Dolcini, and Faigeles, 1993; Sabogal, Faigeles, and Catania, 1993; Grinstead, Faigeles, Binson, and Eversley, 1993; Catania, Coates, Golden, Dolcini, Peterson, Kegeles, Siegel, and Fullilove, 1994; Nguyet, Maheux, Beland, and Pica, 1994; Binson, Dolcini, Pollack, and Catania, 1993 and Douglas, et al., 1997). Among sexually experienced college students in 1995 only 38% reported always using a condom (Douglas, Collins, et al., 1997). Likewise, a 1991 national survey of men 20-39 found that only 26.5% of sexually active men had used a condom during the last four weeks and even among unmarried men with no regular sexual partner only 46% had used a condom during the prior month (Tanfer, Grady, Klepinger, and Billy, 1993, see also, Grady, Klepinger, Billy, and Tanfer, 1993 and Catania, et al, 1992). Similarly, among unmarried women 15-44 in 1990 with 2+ partners in the last 3 months only 16% always used condoms and 39% never did (Mosher and Pratt, 1993). Also, among both men and women 18-24 in 1996 whose most recent sexual partner was not someone they were in an ongoing relationship with only 56% had used a condom (Smith, 1998)."

"Given the deadly nature of AIDS, the near universal knowledge of the disease, and the widespread understanding that it is transmitted through sexual intercourse, its impact on sexual behavior has been limited. The largest changes occurred among gays in large metropolitan centers who adopted considerably safer sexual practices. But the on-going spread of AIDS from male-with-male sexual contact indicates the continuing shortcomings in safer sex practices among gays. Among the heterosexual population the largest change has been the increased use of condoms. However, condom use is incomplete and haphazard with condoms being used much less consistently than called for by safer sex standards. In addition, the small decreases in the number of partners among adolescents and youths may also results from the AIDS epidemic. But most people still have numerous premarital sexual partners and many sexual partners represent casual and short-term relationships. Moreover, it is unclear whether the somewhat moderated number of teens and young adults involved with multiple partners will lead to a reduction in the lifetime number of partners. The continuing high level with multiple partners and the sporadic, if improved, use of condoms means that millions continue to expose themselves each year to the risk of AIDS and other STDs (Anderson and Dahlberg, 1992; Dolcini et al, 1993; Kaestle et al., 2005; and Smith, 1991b)."

"HIV is still a problem worldwide, and the more we learn about what makes certain populations more susceptible to HIV, the more we can help. Understanding that biological component, whether it’s in women or in men, helps us define ways that we can help modulate that."

"HIV/AIDS is a threat that is still invisible to the Malaysian public but it is nevertheless there. Already we have lost many citizens to an otherwise preventable disease because we have not been able to see the enemy. The enemy in this case is a tiny virus whose sole survival is dependent on the ignorance and denial by many that such a virus exists. HIV has been able to take advantage of all of man's weaknesses, but specifically man's unwillingness to accept the existence of what it cannot and does not want to see. And in so doing has wreaked devastation and suffering far beyond what man has ever been able to do by himself. Consider this: in 1999, 200,000 Africans were killed due to conflict. But two million Africans died of AIDS. We may be able to see a human enemy, we may equip ourselves with expensive guns in order to fight that enemy but we cannot inflict the sort of suffering that a tiny virus can inflict. This suffering is not limited to those who have been infected. 13.2 million children around the world have become orphans because of AIDS. In some countries in Africa, life expectancies have been shortened by some 20 years and the entire demographic picture of those countries have changed. A generation, those in the young productive ages have been lost and the impact on countries cannot be easily rectified. Essentially, AIDS is an impoverishing disease for countries because it strikes at the very people who can help to develop a country. In addition, AIDS is altering the global economic scenario, perhaps in a more unfair way than globalisation itself. It is clear from the global AIDS pandemic that the countries that are suffering most from AIDS are those that are the poorest, the ones most crippled by debt, the ones least stable. In addition AIDS makes them even poorer because these countries have the least capability to provide treatment for those who have become infected. The net result is that the gap between the rich and the poor, the North and the South, becomes even wider."

"‘The body of Christ’ is a phrase Christians use to describe the whole church – all the people who believe in Jesus Christ. By sharing in one bread at Holy Communion, we believe that we stand together, in solidarity with other Christians and all people. Saying ‘the body of Christ has AIDS’ signifies that members of the Church are affected by AIDS, and that it is an issue for us to care about. We also show that people who are HIV positive should not be excluded or stigmatised, but rather they should be welcome to live a full and active part in life."

"In 2003 the Methodist Conference adopted a resolution, Notice of Motion 18, which read: “AIDS is the new apartheid. In the name of Christ the healer, who reached out to touch and comfort the marginalised of his day, Conference stands alongside all who are suffering from the HIV/AIDS pandemic in the world today. We are one body in Christ; when one suffers, we all suffer. To this end: 1. We urge the churches to speak openly and courageously about HIV/AIDS: *to embrace – and not reject – afflicted family members *to encourage persons to confesstheir HIV/AIDS positive status *to uphold sufferers in our worship, liturgy and songs *to speak openly about preventative measures including safe sex practices *to advocate for the free distribution of condoms, which save lives. 2. We urge all governments to fight HIV/AIDS: *to acknowledge the extent of HIV/AIDS in their countries * to fund education, health care, and nutrition programmes to combat the spread of the disease and to provide life-saving drugs to all persons regardless of their ability to pay, especially pregnant women and those marginalised by war, poverty, gender or age. * to pressurise pharmaceutical companies and multi-national corporations to release cheap generic drugs to the millions suffering from HIV/AIDS * to promote legislation and judicial practices that protect women and children from sexual violence and domestic abuse. 3. Conference resolves to learn from and work with our overseas partner churches.”"

"[Josh, with Henry Rios] "Do you want to?" he whispered. I raised myself on my elbow and said, "Of course I do, but I haven't carried rubbers with me since I was sixteen." "Just this once," he said. "You could pull out before - you know." I squeezed his neck between my fingers. "No," I said softly. "There's AIDS, Josh. It's not worth the risk.""

"A variety of international treaties and human rights statements support the rights of all people to seek and receive accurate sexual health information, including the 1994 International Conference on Population and Development Program of Action, Cairo, 1994 and the 2003 report of the U.N. Committee on the Rights of the Child. The latter emphasized that ‘children should have the right to access adequate information related to HIV/ AIDS prevention and care, through formal channels (e.g. through educational opportunities and child-targeted media) as well as informal channels,’ and that, ‘effective HIV/AIDS prevention requires States to refrain from censoring, withholding, or intentionally misrepresenting health-related information, including sexual education and information … State parties must ensure that children have the ability to acquire the knowledge and skills to protect themselves and others as they begin to express their sexuality’."

"I can't write about love in the same way we've been writing about it, because it ain't the same deal anymore. "You Can't Do That"'s kind of tongue in cheek about some very serious stuff. This is no joke here folks - you've got to be a little careful."

"AIDS is a world epidemic, a public-health problem that must be confronted with scientific advances and methods that have proven effective. Rejecting condom use is to oppose the fight for life."

"Since the mid-1970s, more than 30 new diseases have emerged, including AIDS, Ebola, Lyme disease and SARS. Most of these are believed to have moved from wildlife to human populations."

"In 1984, the US Secretary of Health and Human Services Margaret Heckler announced at a press conference in Washington, DC, that scientists had successfully identified the virus that later became known as HIV -- and predicted that a preventative vaccine would be ready for testing in two years. Nearly four decades and 32 million deaths later, the world is still waiting for an HIV vaccine. Instead of a breakthrough, Heckler's claim was followed by the loss of much of a generation of gay men and the painful shunning of their community in Western countries. For many years, a positive diagnosis was not only a death sentence; it ensured a person would spend their final months abandoned by their communities, while doctors debated in medical journals whether HIV patients were even worth saving. The search didn't end in the 1980s. In 1997, President Bill Clinton challenged the US to come up with a vaccine within a decade. Fourteen years ago, scientists said we were still about 10 years away. The difficulties in finding a vaccine began with the very nature of HIV/AIDS itself. "Influenza is able to change itself from one year to the next so the natural infection or immunization the previous year doesn't infect you the following year. HIV does that during a single infection," explains Paul Offit, a pediatrician and infectious disease specialist who co-invented the rotavirus vaccine. "It continues to mutate in you, so it's like you're infected with a thousand different HIV strands," Offit tells CNN. "(And) while it is mutating, it's also crippling your immune system.""

"The sexual revolution of the 60’s almost put an end to condom use. “Good girls” were willing sex partners, so fewer men turned to professional sex workers, the most prevalent sexually transmitted infections – gonorrhea and syphilis – were easily treated, and the pill and IUD provided the most effective reversible contraception the world had seen (Valdiserri, 1988). When the virus that can cause AIDS was identified, it became clear that condom use and other methods of safer sex could stem the epidemic. Many public health professionals believe that local, state, and federal governments have ignored or denied the severity of the problem, and have behaved a lot like the social hygenists of the World War I generation (Brandt, 1985). Until 2010, about $100 million in federal funds was spent annually for abstinence-only sexuality education designed to discourage unmarried young people, regardless of sexual orientation, from having sex. None of this money was allowed to be used for any program that talked about the effectiveness of condoms to reduce the chances of infection or unintended pregnancy among those young people who are already sexually active. Meanwhile, 50 percent of all HIV infections occur among people under the age of 25, and 63 percent of infections among those between the ages of 13 and 19 are among women (NIAIAD 2001)."

"We owe it to Ryan to make sure that the fear and ignorance that chased him from his home and his school will be eliminated. We owe it to Ryan to open our hearts and our minds to those with AIDS. We owe it to Ryan to be compassionate, caring and tolerant toward those with AIDS, their families and friends. It's the disease that's frightening, not the people who have it."

"In the early '80s, the public discourse about AIDS was divisive and ugly. Some elected officials said the disease was God's revenge on people who lived a certain lifestyle. The federal government wouldn't fund research for a cure. But, today, the NIH spends $1.8 billion on AIDS research annually, and the virus is no longer an epidemic in this country. So, how did we get from that climate of fear and animosity in the early '80s to where we are today? Well, it's by the extraordinary efforts of ordinary individuals, then change occurred, as it has time and time again throughout our history."

"In 1984, the government spent zero dollars on AIDS research, because AIDS was thought to be a death sentence, and the virus was far too complicated to deal with. Today, the government spends annually $1.8 billion a year on research, and people who would have been dead four or five years ago now have the virus virtually undetectable in their bloodstream, and they're living normal lives. That was something thought impossible until we put money and talent together and aimed it toward a problem."

"During the darkest days of the HIV/AIDS epidemic, when Republicans and religious conservatives controlled the federal government and were doing everything in their power to harm the sick and dying, queers organized and protested and volunteered and mourned. We also made music and theater and art. We took care of each other, and we danced and loved and fucked. Embracing joy and art and sex in the face of fear and uncertainty made us feel better — it kept us sane — and it had the added benefit of driving our enemies crazy. They couldn’t understand how we could be anything but miserable, given the challenges we faced — their greed, their indifference, their bigotry — but we created and experienced joy despite their hatred and despite this awful disease. We turned to each other — we turned to our lovers and friends and sometimes strangers — and said, "Fuck them. Now fuck me.""

"HIV criminalization assumes that society itself is negative, and that the threat to society is positive. HIV criminalization is making it easier for the negative person to avoid communication and instead call on the state to punish the positive person. It encourages the HIV negative person to see themselves as victimized instead of as an equally conflicted party in a human relationship, with mutual responsibilities, feelings, and accountability. It is a governmental privileging of anxiety and punishment over communication, thereby dividing people between those who claim to be good and clean and normal and therefore deserving of state protection, and those whom the first group wish to separate from and hurt whether it is justified or not; whether it makes things better or not."

"In the end one cannot avoid the conclusion that AIDS unites certain human themes — homosexuality, sexual disease, and death — about which society actively resists enlightenment. These are things that we are unwilling to address or even think about. We don't want to understand them. We would rather fear them."

"All that is required of us, in our "new sexual ethic," is that we have sex in a way that favours us more than it favours our diseases."

"The church's policy of abstinence before marriage and natural contraception has also drawn criticism from groups dealing with HIV and AIDS. O'Brien says the church's policies are inhibiting the fight against the epidemic. "When the United States government was deciding to spend billions of dollars in some of the poorest parts of the world on HIV and AIDS prevention, the church, the Catholic hierarchy, lobbied hard to stop family planning from being included in that. And they won," he said."

"There are many who wish to believe that premarital sex causes venereal diseases, that homosexuality causes AIDS... This is simply not true; infectious diseases are caused by infectious agents."

"AIDS was diagnosed and recognized as a new disease in 1981 in the USA with the subsequent discovery of HIV-1 as the causative agent in 1983. The two types of HIV identified to date, HIV-1 and HIV-2, display similar morphology, tropism, and modes of transmission; however, they are genetically and antigenically divergent. HIV-1 is responsible for over 95% infections worldwide, and the different strains of HIV-1 are classified into four groups: major (M), non-outlier (N), outlier (O), and P. The group M HIV-1 is the predominant circulating strain responsible for >90% infections worldwide, and hence, for the global HIV/AIDS epidemic; viruses belonging to the other three groups are endemic in certain African countries and cause fewer infections. HIV arose from cross-species zoonotic transmissions of simian immunodeficiency viruses (SIV) from monkeys to great apes and ultimately to humans. Four independent cross-species transmissions of SIV from chimpanzees (SIVcpz) or gorillas (SIVgor) to humans gave rise to the four HIV-1 groups: M and N from SIVcpz, and O and P from SIVgor. Notably, the pandemic HIV-1 group M strain arose in Cameroon almost a century ago from a single transmission event involving an SIVcpz-infected chimpanzee and a human. The group M strains are further classified into nine subtypes (A, B, C, D, F, G, H, J, and K); each subtype is genetically distinct but phylogenetically equidistant from each other. Two or more of these subtypes can further recombine their genetic material to generate mosaic strains known as circulating recombinant forms (CRFs); around 97 CRFs have been reported to date. The globally dominant HIV-1 subtype C accounts for nearly 50% infections worldwide and is concentrated in Southern Africa and India. The HIV-1 subtype B is dominant in the Americas, Western Europe, and Australasia, and accounts for around 10% global infections. Unlike HIV-1, HIV-2 is largely endemic in West Africa, although the virus has spread to other parts of world in the past decade. Approximately 1-2 million of the PLHIV are infected with HIV-2. The different strains of HIV-2 are classified into nine different groups-A to I, which arose from nine independent cross-species transmission events involving the SIV from sooty mangabey monkeys (SIVsmm). Relative to HIV-1 infection, HIV-2 infection is generally marked by lower viral load, longer asymptomatic period, slower target cell depletion and disease progression, and lower transmission rates. However, in the absence of cART, HIV-2 infection eventually leads to AIDS and, ultimately, death."

"A tragedy that cannot be overcome by money alone, that cannot be overcome through the distribution of condoms, which even aggravates the problems."

"Benedict said condoms were not “a real or moral solution” to the AIDS epidemic, adding, “that can really lie only in a humanization of sexuality.” But he also said that “there may be a basis in the case of some individuals, as perhaps when a male prostitute uses a condom, where this can be a first step in the direction of a moralization, a first assumption of responsibility.”"

"The most authoritative recent report is by the US National Institute of Health which concluded: "Intact condoms are essentially impermeable to the smallest sexually transmitted virus, and that the consistent use of male condoms protects against HIV/AIDS transmission." The World Health Organisation insists it is imperative to continue promoting condoms for HIV prevention."

"What's really heartbreaking is that the sisters here seem kind, they seem intelligent, they're hard working and they could be the front line in the war against AIDS, and yet what they're doing is peddling rumour and superstition, and the question is really, who has made them believe it? We've come across what the WHO calls "The dangerous allegation that condoms let HIV through before." The Archbishop of Nairobi had put his name to a pamphlet making the claim, and we'd heard the story from Catholics in two other continents, from the Head of the Pro Life Clinics in Manila City."

"Mr. Reagan resisted the suggestion that more money was needed. He said that AIDS had been one of the top priorities with us and that the Administration had provided or appropriated some half a billion dollars for research on AIDS since he took office in 1981. He included in that figure the $126 million that the Administration is seeking for the next budget year. So this is a top priority with us, he said. Yes, there's no question about the seriousness of this, and the need to find an answer. When told that the top AIDS scientist had said the Administration's budgets were not nearly enough at this stage to go forward and really attack the problem, Mr. Reagan replied: I think with our budgetary restraints and all it seems to me that $126 million in a single year for research has got to be something of a vital contribution. Albert R. Brashear, a White House spokesman, said that Mr. Reagan intended to suggest that current spending levels, which have been increasing steadily, were enough."

"When AIDS was at its most brutal, frightening, my-God-what-are-we-going-to-do era, that was when vampire stories and stories about blood and trust swept the literary world."

"Our more recent work (in progress) provides further evidence on the intricate development effects of the Christian influence in Africa (Cagé & Rueda 2016b). We study the role played by early missionary investments in sub-Saharan Africa to explain HIV/AIDS prevalence nowadays. On the one hand, missionaries were the first to invest in medicine in a number of countries. The history of modern medicine in sub-Saharan Africa is indeed closely linked to the development of missionary activity. According to the World Missionary Atlas (Beach and Fahs 1925), there were 150 missionary physicians in Africa in 1925, and more than 235 nurses working with nearly 500 trained native nurses in 116 hospitals and 366 dispensaries. Moreover, the early Christian provision of health care persisted after colonisation and is particularly influential in the design of health care in poor countries (Idler 2014). On the other hand, health investments are not the only way through which missionary activity may have affected the propagation of HIV/AIDS. Christian values also affect sexually transmitted diseases and there is quantitative and historical evidence that missionaries actively changed sexual behaviours (Vaughan 2007, Doyle 2013, Mantovanelli 2014). We show that the net effect of proximity to historical mission settlements on HIV prevalence is negative. As seen in Figure 4, regions far from missions tend to have less HIV prevalence today. This general correlation cannot be fully captured by the fact that missions tend to be located in what are today more densely populated areas, or by any other geographical determinant of missionary activity. However, this negative effect can be captured by negative perceptions of condom use and contraception. Among regions historically close to missionary settlements, proximity to a health investment is associated with lower prevalence rates, more acceptance of contraception, and lower exposure to risky behaviours, such as buying the services of sex workers."

"Transmission of the human immunodeficiency virus (HIV) primarily occurs across mucosal surfaces. In particular, the rectum and colon mucosa are important as a portal of entry and during early disease progression, respectively. In the United States, 66% of all new HIV infections in 2017 were in men who have sex with men (MSM), with receptive anal intercourse being the main mode of transmission. Substantial gut microbiome compositional shifts have been previously described in HIV-infected populations; however, we now know the most prominent compositional changes are associated with sexual behavior. The MSM gut microbiome is dominated by Prevotella species compared with the Bacteroides-rich microbiome of culturally westernized men who have sex with women (MSW). Microbiome shifts associated with HIV infection are more subtle, typically require a large cohort to observe, and have been linked with low current and nadir CD4+ T cell counts and viremia. Our group investigated HIV-associated microbiome compositional effects on immune activation in vitro 9 and recently published an evaluation of the effects of human fecal microbiota transplant on immune activation in a gnotobiotic mouse model. These studies revealed the fecal microbiota of MSM, regardless of HIV status, elevates immune activation over that seen with the fecal microbiota of MSW. Additionally, we observed that the MSM microbiota enhanced in vitro HIV infection. Here, the discussion will focus on the question, can the microbiota of MSM influence HIV transmission? We provide additional data that suggests the unique gut microbiota in MSM drives the influx of a population of CD4+ T cells expressing the HIV co-receptor CCR5 into the gut, supporting a link between the gut microbiota in HIV-negative MSM, the mucosal immune environment, and HIV transmission."