Better Questions, Better Answers

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STATEMENT: The National HIV Prevention Conference

Better Questions, Better Answers

Almost a quarter century into the epidemic, we’ve still got far more questions than answers about HIV’s spread. Our brightest research minds have struggled to understand the virus’s unrelenting movement. They are often tasked with measuring the un-measurable—the murky emotions that underlie what we’ve come to call “risk.” But we continue groping for information, hoping to gain some small advantage against the virus back in our own neighborhoods.

The U.S. Centers for Disease Control and Prevention told us this week that it has launched a plan to at least give us more robust information about who is getting infected today, and through what modes of transmission. For more than a decade we’ve accepted the loose estimate of 40,000 new infections annually and resigned ourselves to a myopic view of those infections. By this time next year, according to Dr. Ronald Valdiserri, deputy director for the division of HIV, STD and TB Prevention, the CDC will be able to give us more concrete numbers. That would be a welcome development.

We already hold, however, what may be the most valuable piece of information about HIV prevention: To succeed, we have to take responsibility for ourselves. Who are “we”? Everybody, at every point of the prevention triangle: policymakers, communities and individuals.

Policymakers must understand that they are beholden to the communities they serve. Not all prevention is quantifiable, and it is irresponsible for government funders to exploit that difficult reality in order to starve nascent or innovative initiatives. And when community-based programs, in turn, exploit the epidemic’s murkiness in order to avoid being held accountable for the resources we spend, we’re being just as irresponsible.

But accountability is most important on an individual level. We are each responsible for keeping ourselves healthy, for keeping our communities engaged and for keeping our leaders vigilant. We may not know much about this epidemic, but we know this: If we all demand accountability of ourselves, we can make a change.

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