Time To Move Beyond 'Language Of Blame' In Discussing HIV/AIDS, New York Times Column Argues

On the subject of HIV/AIDS, "the fact is that for most new infections, the language of culpability and blame simply no longer applies," infectious disease expert Abigail Zuger writes in a New York Times opinion piece. Although "[y]ou don't hear much about AIDS in America anymore," the disease "endures right here in the U.S.A.: our outpatient clinics are bursting at the seams, and new cases show up daily," Zuger states.

"A million domestic stories are languishing untold, but they are not the operatic tragedies we have grown used to," Zuger continues. Rather, "these are nuanced and complicated fables, with morals that extend beyond the disease itself," she writes.

As an example, Zuger cites a Florida case in which Olympic athlete Darren Chiacchia "was charged a few months ago with what is a first-degree felony in Florida: repeatedly exposing a sexual partner to HIV." Many states have similar laws that were enacted "back in the hysterical old days of AIDS, a period lasting roughly from 1981, when the first reports of the syndrome were published, to 1996, when combination drug 'cocktails' proved remarkably effective against HIV," Zuger writes. Today in the U.S., for a person with HIV "to die of AIDS in the future would probably require a substantial amount of bad judgment or back luck: the medications, if properly prescribed and properly taken, appear almost infallible," according to Zuger.

Despite the scientific advances, Zuger acknowledges that HIV "still sows terror, uncertainly, shame and endless complications." However, "at the same time, we believe deeply in prevention," she says. Zuger asks, "And so whose fault is a new HIV infection, really? Is it mine, for giving it to you, or is it yours, for being stupid and cavalier enough to get it?"

Zuger continues that an article published last month in the New England Journal of Medicine demonstrates that new HIV infections are "increasingly concentrated in specific pockets" of the U.S., "among the poorest of the poor, the disenfranchised and socially marginalized, where substandard education means no escape." The prevalence of HIV is "so high" in these places "that simply living brings risk of infection," according to Zuger. "In other words, if you are a woman in some ZIP codes, falling in love and getting married, with no sexual partner but your husband, puts you at risk for HIV," Zuger states, concluding, "We see these women in our clinics, more and more of them, but you won't find them in court. Whom would they sue?" (Zuger, New York Times, 4/20).


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