"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 carryingon the global fight against AIDS do not accept this grim outlook, atleast publicly. Yet until the gravity of this scientific failure isopenly acknowledged, a serious debate about how to end HIV’s lethalgrip on the poorest and most vulnerable in the world cannot take place.…

Themost important recent revelation is that the relations of women withmen will determine the course of this plague.… Women are now threetimes more likely to become infected than young men. What might helpwomen most is a personal method to protect themselves from HIV. If acondom is neither available nor practicable… microbicides mighteventually be part of the answer. But our long-term defense requires adeeper understanding of the conditions in which AIDS is transmitted.

Marriage—inwhich there can be frequent episodes of male violence and sex withmultiple partners—has become a serious risk factor for acquiring HIV.Is it too much to hope that the searing catastrophe of AIDS may haveput before women and men an issue that they can use to confront maleviolence, exploitation and stigma?
By 2010, there will be 25million children orphaned because of AIDS. This is a human atrocitythat women and men must contend with together—and without a vaccine.”

—Dr. Richard Horton, editor of the “The Lancet”
ADAPTED FROM “AIDS: THE ELUSIVE VACCINE” AND EXCERPTED WITH PERMISSION OF THE NEW YORK REVIEW OF BOOKS © 2004 NYREV, INC.