“Contrary to the promises of most AIDS experts, the signs are that avaccine to prevent HIV will not be found for several decades—if at all.Those responsible for carrying on the global fight against AIDS do notaccept this grim outlook, at least publicly. Yet until the gravity ofthis scientific failure is openly acknowledged, a serious debate abouthow to end HIVs lethal grip on the poorest and most vulnerable in theworld cannot take place.

“The most important recent revelationis that the relations of women with men will determine the course ofthis plague. Women are now three times more likely to become infectedthan young men. What might help women most is a personal method toprotect themselves from HIV. If a condom is neither available norpracticable, microbicides might eventually be part of the answer. Butour long-term defense requires a deeper understanding of the conditionsin which AIDS is transmitted.

“Marriage—in which there can befrequent episodes of male violence and sex with multiple partners—hasbecome a serious risk factor for acquiring HIV. Is it too much to hopethat the searing catastrophe of AIDS may have put before women and menan issue that they can use to confront male violence, exploitation andstigma? By 2010, there will be 25 million children orphaned because ofAIDS. This is a human atrocity that women and men must contend withtogether—and without a vaccine.”

—Dr. Richard Horton, editor of The Lancet

ADAPTED FROM "AIDS: THE ELUSIVE VACCINE" AND EXCERPTED WITH PERMISSION OF THE NEW YORK REVIEW OF BOOKS © 2004 NYREV, INC.

PHOTO: Getty Images/Brent Stirton