World AIDS Day 2000: Foreword

Denial, Stigma, and the Global Epidemic

I am sure you have shared my shock and disbelief as story after story has spilled out of Africa, detailing the devastation of the AIDS epidemic on that continent. Statistics difficult to comprehend build images of sickness, suffering and death on a massive scale. Even those of us who have been working in the field of HIV/AIDS for many years have been astounded at the escalation of the global epidemic that has resulted from years of denial and inaction.

So serious is the situation that most countries have ranked AIDS at the top of their national security issues. In the United States, in an unprecedented action, President Clinton has declared AIDS a national security risk. This is the first time a disease has been placed in the same class as other threats, such as bioterrorism and nuclear weapons.

We in the U.S. have much to learn from Africa, where denial, stigma, casual sex and heterosexual contact are the prime movers of the AIDS epidemic. Here, too, those same factors are fueling the spread of HIV and hampering our prevention efforts. For these reasons, we have chosen to expand our book this year to include a new four-page feature: "Special Focus: AIDS in Africa," in the belief that we all can and must learn from the experiences of others.

The price of denial is high, yet it exists in many quarters here in the U.S.. The man who does not face the dangers of his high-risk sexual or drug injecting behavior is in denial. The woman who does not insist on knowing the sexual history of her partner is in denial. The man who engages in sex with both men and with women and does not disclose it to his partners is in denial. The pregnant mother who refuses HIV testing because she is sure she is not at risk for HIV is in denial. Those who knowingly engage in risky behaviors because they believe the new AIDS drugs will save them are in denial.

The stigma that surrounds AIDS is, of course, the major cause of such denial here in the U.S., just as it is in Africa. HIV prevention campaigns in every village, town, city and state must work to tear down the wall of shame around HIV and AIDS. Only then will all those at risk feel fully free to face their risk and deal with it openly. Their lives depend on it.

We at AAWH hope you will accept this challenge and deliver the lifesaving messages contained in this resource booklet. This year the international theme of men and AIDS specifically challenges men to face their risk, change their risk-taking behaviors and accept responsibility for their own health and the well being of their loved ones.

This year more than ever, I feel, the American public has been sensitized to the seriousness of the global AIDS epidemic and is ready to listen more attentively to the dangers of HIV/AIDS. World AIDS Day provides the perfect opportunity to mount new initiatives, capitalizing on the national and international media attention that surround the global observance.

Best of luck in planning your World AIDS Day activities. We hope you will find this year's resource booklet more helpful than ever.

Richard L. Wittenberg
President and Chief Executive Officer
American Association for World Health