RENEE MONTAGNE, host:
Today is World AIDS Day. It was designated by the United Nations to raise awareness about the global AIDS epidemic. The latest estimates indicate that more than 39 million people in the world are now infected with HIV. In the United States, more than 1 million people are living with the disease.
NPR's Brenda Wilson spoke with three experts who've been fighting AIDS since the epidemic began 25 years ago.
BRENDA WILSON: Until a decade ago, HIV infection rates were dropping. Dr. Anthony Fauci, the director the National Institute for Allergies and Infectious Diseases, explains why rates won't go lower.
Dr. ANTHONY FAUCI (Director, National Institute for Allergies and Infectious Diseases): We have not gotten to the people who are the ones that are most likely to transmit infection, and those are people who are infected and who do not know they're infected. Two hundred and fifty thousand plus or minus a few have in fact been infected and not know they are infected. And if you look at that group, those are the ones with a majority of transmissibility - comes from people who do not know that they are infected.
WILSON: So public health people are focused on getting everybody to get themselves tested and to know the status of their sexual partners. Prevention, Fauci says, is all we've got.
Dr. FAUCI: Right now, we don't have an effective vaccine, and we don't know really when or if we'll going to get one that's entirely effective in the way that the typical childhood vaccines are effective, like polio and measles, and mumps, et cetera. I don't think we can rely on getting a vaccine to solve the problem.
WILSON: The new cases are turning up mainly in young gay men and African-Americans. Dr. Ken Mayer, a professor of medicine at Brown University, has been seeing HIV patients since the epidemic began.
Dr. KEN MAYER (Medicine, Brown University): In the early ‘80s, if you walk in the streets of the Castro in San Francisco or the Village in New York, you'd see people who were gaunt, you'd see people who have Kaposi Sarcoma lesions. They're all kinds of obvious stigmata of HIV/AIDS. The face of HIV/AIDS now in big cities and gay communities is a largely invisible one.
WILSON: Affecting people who are largely invisible, whose circumstances contribute to risky behavior.
Dr. MAYER: It's more of I'm depressed. I'm actively using substances. I'm not really so worried about any of these things right now. So I'm not so worried about the consequences of fooling around, because who cares? My life is miserable anyway.
WILSON: Phill Wilson, the executive director of the Black AIDS Institute of Los Angeles, wants to see prevention messages targeted and affected communities mobilized. Just the way gays did in the 1980s, he's fought HIV as long as he sleep with it, for 25 years.
Mr. PHILL WILSON (Executive Director, Black AIDS Institute of Los Angeles): What is true for black America: Unless we are explicitly included, we are implicitly excluded. I think that's particularly true for young people. Unless you speak to them directly, unless you say this is about you, this is about your life as opposed as this is about some generic life. I think that's when we get young people's attention. Particularly when we're actively in denial. And so you have to break through that denial, and that takes bold confrontation. But once you break through that denial and you say it doesn't have to be that way, and here's what you can do, it is in my experience that people in fact do respond to the epidemic. And quite frankly, that's the only way that people will respond to the epidemic.
WILSON: And that he says is going to take every institution in the black community.
Mr. WILSON: I'm hopeful. I mean the only way that you can live with HIV for as long as I've lived with HIV I guess is to have faith.
WILSON: Well, may you live a long time.
Mr. WILSON: Knock on wood - from your lips to God's ears.
WILSON: Brenda Wilson, NPR News.
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MONTAGNE: This is NPR News.
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