POZ ended 2007 with a story that eerily predicted the great AIDS controversy of 2008 (so far). Our December article “More Than Just a Number” detailed just how politicized AIDS statistics have become. As we reported, the process of counting the people living with HIV/AIDS by village, state, nation, continent, hemisphere and planet determines not only local, national and international funding levels. It also shapes policies and how each region perceives the disease. Is it manageable? Or lethal? Is a localized response in line with this person’s or that foundation’s charitable initiatives? The results can be used to justify almost any agenda.
So how many of us, exactly, live with HIV globally? The United Nations agency UNAIDS thought that it knew. But this past November, just as POZ’s story hit the newsstands, the group acknowledged that it had counted wrong. To intense criticism and political spin-doctoring, UNAIDS lowered its estimate. The figure fell from 39.5 million—which the agency had insisted upon as recently as late 2006—to 33.2 million.
Some U.S. Republican partisans said the reduction proved the effectiveness of President George W. Bush’s global AIDS efforts. (His Emergency Plan for AIDS Relief [PEPFAR] has committed $30 billion to battling the disease globally and has supported prevention and med access around the world.) Until, that is, the Bush boosters realized that the lower estimate didn’t mean that 6.3 million people had eradicated HIV from their bodies. Nope—it simply meant that those 6.3 million people had never existed. For the Bush administration—which, in its final year, is grasping at global AIDS relief as its only enduring bipartisan “legacy”—the news was problematic. Many of those same partisans morphed from Jekyll to Hyde, claiming that UNAIDS officials had inflated the count to woo treatment and prevention funds.
Meanwhile, Americans living with HIV counted only one truth amid all the confusion: Our government seems to care more about positive people overseas than it does about those at home. On January 5, 2008, The New York Times front page blared, “In Global Battle on AIDS, Bush Creates Legacy.” Indeed the article asserts, “[PEPFAR] may be the most lasting bipartisan accomplishment of the Bush presidency.”
It seems fair to evaluate, then, what’s been happening with domestic AIDS figures. How many people, exactly, now live with HIV in America? The Centers for Disease Control (CDC) thought that it knew. But this past November, in a separate stat spat, The Washington Blade newspaper reported that the CDC would soon acknowledge that it, too, had been counting wrong. Only this time, the Blade announced, the previous estimates had been too low. As this issue of POZ went to press, in mid-January, the CDC, somewhat mysteriously, had chosen to withhold its revised figure for new infection numbers. But additional reports in The Washington Post and The Wall Street Journal indicated that the leap could be significant: up from an estimated 40,000 new U.S. infections per year to as many as 63,000 per year. Other reports say the number is likely closer to 55,000, still a 37.5 percent increase. Meanwhile, between 2002 and 2007, Bush’s U.S. AIDS spending, adjusted for inflation, dropped 19 percent.
Advocates, researchers and people living with HIV don’t need the CDC to tell them how dire the situation has become. On January 2, 2008, New York City’s Department of Health and Mental Hygiene revealed an uncontested statistic: From 2001 through 2006, new HIV infections in the city rose 32 percent among gay men under 30. Then there are the well-rehearsed stats: One half of all new infections occur among people under 25 and that AIDS is the leading killer of African-American women 25–34. All of these statistics speak to the fact that the disease is continuing to spread more deeply into a more diverse swath of Americans.
POZ has some other, perhaps more pressing questions. How many people are HIV positive but don’t know their status? How many people live with HIV versus AIDS? How long had many people been living with HIV or AIDS before they were tested? How many cases of AIDS could have been prevented if people were tested/diagnosed sooner? How many documented HIV-positive people can’t access care? How many wish to but are afraid? In short, how can we begin to tally the quality of life with HIV, not just the sheer volume of it?