That’s the title of a new book by Elizabeth Pisani. She’s an AIDS scientist and epidemiologist, and there’s a good interview of her in today’s Guardian. Basically, her thesis is that more focus on prevention, rather than treatment, of AIDS would have better results. As an old gay man, having lived through the dark days of the 1980s, I find the casual attitude to bareback sex (sex without using condoms) of many of today’s young generation of gay men absolutely terrifying. As Pisani says:
ARVs reduce people’s viral load, she agrees, making them less likely to infect someone else – as long as they don’t miss a single dose. "But it also keeps them alive longer, and healthy enough to want to have sex. You only have to look at the experience of the UK or US gay communities where we’ve had more or less universal access to ARVs for at least eight or nine years, and the number of new infections are rising. More people are living longer with HIV, and there is what we call behavioural disinhibition: ‘Fuck the condoms, I don’t need them any more, because if he’s positive he’ll be on drugs, so he probably won’t infect me. And if I do get infected, it would be annoying, but not the end of the world.’"But having Aids is not a picnic. Yes, it’s great that all this stuff on treatment is happening. But it becomes all the more urgent to have effective prevention. And that’s not happening."
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