Human Exceptionalism

Life and dignity with Wesley J. Smith.

Why Not Prevent HIV Like We Do Smoking?


Society has been fighting the scourge of AIDS for decades. We have (properly) spent billions finding and providing what are now (thankfully) effective treatments extending lives and vitality. We have searched for a preventive vaccine. Our prevention efforts, it seems to me, have not been as successful, perhaps because we have tended to focus more on condoms and civil rights rather than public health techniques and behavior modification. 

At best, this has fought the disease to a draw. Yes, people with HIV live longer and healthier lives, but there has not been an appreciable reduction in new infections despite all our efforts.  And God help us if the retro virals stop being efficacious.

So I could only sigh when I read about a new program to fight HIV among at risk bisexual youth. From the Reuters story:

The Care and Prevention in the United States (CAPUS) project is a three-year program led by the CDC and other government agencies aimed at reducing HIV and AIDS among racial and ethnic minorities in the United States. The program focuses on addressing social, economic, clinical and structural factors influencing HIV health outcomes. “We are just beginning,” Thompson said, adding that the program would focus specifically on the lives of young men who have sex with men and the barriers to testing and treatment.

To address stigma and bullying in the community, the program would feature training in which straight leaders in the faith community, business leaders, and entertainers learn about stigma and how it affects HIV in their community. “It is a huge challenge, but I think if we do this from the point of view of trying to end an epidemic that is decimating our young people, and do it in a way that is science-based, I think we can make progress,” she said.

How is this any different than the same old, same old?  If it isn’t, why do we think this program will work any better than what hasn’t worked well enough so far?

So, here’s an idea from a non-expert based on what I think is common sense. Why not treat HIV like we do smoking? We don’t wring our hands about smoking. We don’t tell our young people that we would prefer that they didn’t smoke, but if they choose to, we hope they will use a filter cigarette.  Rather, from early childhood, we unequivocally tell kids: “Don’t smoke! It’s bad for your health. It’s bad for those around you. It’s bad for society.” In part, that is why smoking rates have plummeted.

Perhaps, we should similarly stop treating at HIV-risk youth as if they were fragile egg shells and bluntly warn about the dangers of promiscuity by saying unequivocally: ”Don’t sleep around! It’s bad for your health. It’s bad for those you sleep with. It’s bad for society.” 

Perhaps if we employed the same social strategies against HIV that we have successfully used to combat smoking, we would see similar results.


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