At Monday's Opening Plenary, luminaries Dr. Fauci, long term Person living with HIV/AIDS Phil Wilson (32 years with the virus), Secretary Clinton addressed the delegates. I am certain there was wide spread sound bite coverage in the media of their assertions, findings, recommendations and the US commitment to the global pandemic.
A day after, slept and woke up wrestling with a question. How can the largest industrialized nation in the world, have a Capitol city with 3% HIV/AIDS prevalence? It is recognized as the highest in the nation and matching or exceeding nations of the developing world specially Africa.
The easy pieces of the answer can be the ongoing racist or discriminatory policies, residual manifestations of trauma (slavery), and the unequal distribution of wealth and resources. There are certainly sufficient neighborhood and academic discussions and numerous publications that can be cited to support these constructs.
Knowing or intuiting these are part of the whole picture, where does the individual (choice), family (modeling and guidance), community (church, school) rest in this complex scheme of a particular reality, ours as a nation and within the context of a global community.
Are we assuaging our collective response to our sense of powerlessness and internalized anger by committing resources (monetary, technical, benevolence) to mother Africa? Whether my question has basis or not, it is curious that certain sectors of the AIDS community are extolling the gains in Africa, 8 million on ARV therapies, and yet all we say about our own epidemic "the AIDS pandemic is complex" when it comes to understanding and breaching a response to our nation's fight with what has become a global rights issues (human rights, social justice).
Numerous listening sessions, countless public comment opportunities on many proposed rulemaking, a national AIDS strategy and yet the political will, the grass root response, and the slow thawing of moral ideology all have contributed to our current homeostatic stasis.
The HIV virus was identified in SF in 1983, the first therapy was introduced in 1987, combination therapy in 1996. Yet with all the biomedical advances, education/prevention, testing, outreach has modest impact in addressing stigma, continued marginalization (Commercial Sex Workers, Intravenous Drug Users and Men who have Sex with Men, and "level" annual rates of HIV infection of 50,000 in the US.
Perhaps a deep silent reflection is warranted, not reactive policies, unconscious personal action, or denial and indifference. The epidemic has been with us for 30+ years. There is much to be hopeful for, in response to the crisis, in light of the changes we have witnessed. Nonetheless, we have done little with the crisis of conscience.
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