About AIDS

The current issue of Esquire magazine has a cover title that captures AIDS and the United States in 1999: “The Four-Letter Word We All Forgot About.” America’s ADHD attention span has, indeed, already lost any meaningful focus on HIV/AIDS, and we appreciate Esquire‘s attention.

However, the primary article, “The Virus at the End of the World,” takes a bizarrely negative viewpoint on the current status of HIV disease, treatment, and survival. The scientific premises from which the author leaps are not incorrect and are nothing new: mutation, resistance, therapy failure, toxicity, side effects, adherence difficulties, and viral persistence are part of the picture. Her leaps, however, are sensationalist speculation.

It’s true the drug cocktails fail with many patients, but her hyperbolic portrayal of the whole treatment environment as nearing collapse, with mass death ensuing, ignores the positive realities: effective therapy still yielding higher quality lives, even though not for everyone, plus numerous advanced drugs becoming available over the next several years. Any given individual’s outcome is uncertain, but HIV infection is not again becoming a death sentence in 1999. She criticizes researchers for optimistic conjecture based on inadequate evidence, but her article is just pessimistic conjecture based on inadequate evidence. At least the optimism of the last two years, while over-blown, has given poz folks and their caregivers an important element: hope.

In the US, media hype often determines the agenda. The media pushed unrealistic optimism about AIDS treatment until the public believes that the disease is no longer really a problem. Perhaps Ms. Garrett’s unrealistic pessimism will engage people’s attention in a wake-up call. But what we would actually plead for is a realistic, balanced view, rather than roller coaster extremes.

This article appears in March 19 • 1999 and March 19 • 1999 (Cover).