We’ve all known for ages that there are essentially two HIV epidemics in the world: a heterosexual epidemic in East and Southern Africa (some would say all of sub-Saharan Africa) and an epidemic driven by drug injection, sex between men and commercial sex in the rest of the world. Now there’s another distinction, too. There are HIV epidemics that lead to AIDS epidemics, and there are those that don’t.
I’m not joining the ranks of the AIDS denialists, here. I’m just recognising that in countries with very good access to antiretroviral medicines, AIDS has all but disappeared. The same can sadly not be said for HIV. Indeed HIV is rising as AIDS vanishes. The UK’s influential political monthly Prospect asked me to write about this phenomenon in the gay community in the UK, and the more I looked at it, the more worrisome it seemed. In the article, The plague is over, let’s party!, I argue that HIV continues to spread among gay men in part because “AIDS survivors” are setting standards of risky behaviour that are being adopted by a younger generation that has never known AIDS. I’d be interested to know what others think of this thesis.