Interesting review in Spiked this week, looking at Elizabeth Pisani's "The Wisdom of Whores" and James Chin's "The AIDS Pandemic: The Collision of Epidemiology with Political Correctness" two of the current generation of "AIDS Heretics". While the earlier generation of "heretics" questioned the science of HIV (and have now largely been discredited, although sadly not in South Africa), this new generation are attacking the accepted wisdom on HIV prevention.
One of the big challenges is that most HIV epidemics do seem to be confined to certain "risk groups" - i.e. gay and bisexual men, commercial sex workers, intravenous drug users, etc, etc. It is more generalised only in parts of the world (mostly Southern and Eastern Africa) where networks of stable, multiple sexual partnerships exist.
The problem with saying any of this is that it immediately becomes ammunition for those who would stigmatise and marginalise these groups even further than they already are - and cuts against a common belief that women are not promiscuous in the same way (or to a similar degree) that men are. It also puts in to question a lot of the HIV prevention strategies that have gone on for decades, and the way that funding is allocated by donors and international agencies. And there is undoubted resistance to such a challenge to the current orthodoxy, as I have catalogued elsewhere.
The reality is that we should welcome these "heretics" for making us think again about how we are undertaking prevention work. The great challenge before us is how we effectively slow and halt the spread of the pandemic, especially in high incidence countries. Asking these questions and looking again at what actually works is vital to the future effectiveness of any prevention strategies. We do not have to agree with all that the new "heretics" say or prescribe, but we can value the hard re-look at the facts that their diagnoses force upon us.
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