Why AIDS?

In the King of Swaziland/AIDS thread, commenter "anonymous" (another one? or the same? who knows?) writes (and, by the way, in case you're interested, here's the latest update on King Mswati of Swaziland's newest shady antics):

I've always wondered why AIDS is such a "hip" and "cool" cause. Malaria kills 3 times as many and there are very effective ways to prevent and cure it. I hear nothing but crickets chirping when mentioned as number 4 on the list of "worlds deadliest killer". So pardon my skepticism at the tears shed for AIDS victims. It has nothing to do with caring. I guess Bono or Elizabeth Taylor don't have friends with malaria.
10,700,000 children died in the world last year and 57% were from causes incident to malaria. That's just the children.

I haven't checked on anonymous's statistics, but it's my impression that the general point he/she is making is correct: fighting the scourge of malaria is not particularly chic or popular in this country as compared to combatting AIDS. So, what goes on here?

I'll take a stab at an answer. My take on it is that a new disease will always gets more attention than an old one because people are accustomed to the latter, and the new one grabs their interest at first merely because it is new. And I am in agreement that a disease that affects the US and western Europe instead of mainly Africa or other third-world countries (AIDS, as opposed to malaria) will definitely provoke more interest, because in the case of the former, "the bell tolls for thee." It is just human nature to be more upset about something that can potentially affect you and your loved ones rather than strangers in a far-off place.

I think there's something else going on as well. The idea of a disease spread by the type of sexual behavior that was championed during the sexual revolution of the 60s is particularly threatening to the generation that grew up during that time. There was supposed to be no downside to such liberation, and it's a bitter and difficult pill to swallow when the dreams of the 60s die (sometimes it seems as though there are no dreams of the 60s that haven't died). The fact that AIDS first appeared, at least in the western world, in the gay male population--which had so recently undergone its own liberation--was also highly ironic and difficult for those who had championed that cause. So it's no surprise that the anti-AIDS campaign would be especially well-supported among people who believe in those other causes.

Furthermore, a disease such as AIDS would seem to have almost no natural limits (unlike malaria) in terms of how widespread it could become in an area such as Africa where it is spread primarily heterosexually, and where sexual practices favor it and don't seem to be changing any time soon. Although in the West the transition to heterosexual spread has not kept pace with early predictions, that transition is still the unspoken (and sometimes spoken) fear of many who believe conquering that AIDS is of the utmost importance for us, too. One has only to look at Africa to see a demonstration of how bad things could get if this spread were to occur. Although sub-Saharan Africa has many special characteristics (read my previous post for a description) that make AIDS particularly likely to spiral out of control there, the great fear is that it could also happen here.

Another commenter, Huck (who, if I'm not mistaken, is an "anonymous" who came in from the cold), points out that public health authorities have not been allowed to use their resources fully to combat AIDS in this country because of concerns about invasion of privacy and the like. Coincidentally, back in the early 90s when I was in graduate school, I researched and wrote a paper on that very issue. I am old enough to remember the use of such tools as contact tracing against venereal diseases, and in the earlier days of the AIDS epidemic, when there were fewer victims, I was wondering why the public health system wasn't employing the old tried and true weapons to combat the new threat before it increased exponentially. The answer boiled down pretty much to "politics," although there were other and more practical reasons (or in some cases, excuses) given, too. Some day I might try to exhume that old paper of mine and summarize it here--my recollection is that it contained some interesting nuggets of information.