America Living With AIDS

EXECUTIVE
SUMMARY
he people of the United States have
arrived at a crossroads in the history of the HIV epidemic. In the months to come
they must either engage seriously the issues and needs posed by this deadly disease or
face relentless, expanding tragedy in the decades ahead. In just ten years the human
immunodeficiency virus (HIV), the causative agent of AIDS, has claimed more
American lives than did the Korean and Vietnam wars combined. If, from this day
forward, there were never another instance of new infection, the upcoming decade
would still certainly be much worse. The amount of human suffering and number of
deaths will be much greater.
The face of AIDS will change as well; thus far it has focused its devastation predominantly on young men. In addition, it is also a disease that affects an entire
family-now, all too often, mothers, fathers, and children die swiftly, one following
the other, leaving a few orphans as a grim reminder of what was once a family.
Workers on the front lines are struggling heroically to cope with illness and death,
but their tools have been too few, their resources too constrained, and their logistics
too crippled by the sabotage of disbelief, prejudice, ignorance, and fear.
Nor has the virus followed rules of fair play. Gay and bisexual men still bear much
of the burden of HIV disease. Disproportionately and increasingly the epidemic has
attacked segments of society already at a disadvantage-communities of color,
women and men grappling with poverty and drug use, and adolescents who have not
been effectively warned of this new risk to their futures. And with these shifts have
come new anger, mistrust, and attempts to assign blame, which have drowned out
the warnings that should signal the magnitude of the mounting crisis. Sadly, this has
permitted too many Americans to detach from the fray, to feel the problem is that of
others different from themselves, and to retreat into resentful indifference. Diversity,
which should be our greatest strength as a nation, has for the moment become a
weakness, and has sanctioned a begrudging and sometimes callous response. Even
the language of prevention, which should be tailored to the myriad subcultures and
ethnicities of people at risk, is constrained in the name of morality, withholding