Nearly 30 years after the Centers for Disease Control announced the discovery of this new and deadly disease, AIDS, the feds just recently released the first-ever “National AIDS Strategy”. This new plan unveils what many of us known for years, HIV can infect anyone, but not everyone is at equal risk. And as such we need to target our limited resources to those areas where the risk is greatest.   That may mean targeting resources by geography (Northeast and Southern states), by sexual orientation (gay and bisexual men), by race (African American and Latino), by race and gender (African American women) and by gender identity (transgender). What is exciting about this plan is that these groups are actually named – for years we have tip-toed around using language that may be perceived as not politically palatable. 
 
The plan further points out what many of us already knew to be obvious. Controlling HIV, like many other public health threats, has no easy “one size fits all” solution. What we talk about with an adult gay man is very different than what we need to teach a 15 year old heterosexual girl. The message for a 60 year old recent heterosexual widower who is back on the dating scene for the first time in 35 years is very different from the message targeting a suburban injecting drug user. We need to tailor our messages and deliver them in a manner understood and respected by the target audience. 
 
Despite these differences, the core of the message is the same. HIV is a preventable disease and each of us has the power to protect ourselves. Whether that means abstinence from sex, creating and staying in a mutually monogamous relationship or consistently and correctly using latex barriers (condoms) to prevent infection – the result is the same.  HIV can stop with me. 
 
Simple message, correct? Not so much. It seems as if when we talk about AIDS, there’s lots of finger pointing  and the fingers rarely point back to ourselves. “It’s those people’s fault (fill in the blank)”. In a perfect world we would all abstain from all high risk behaviors be they binge drinking to driving too fast. Or eating too many sugar-filled donuts to crossing the street mid-block. We would always wear a seat belt even if only driving around the block, always cover our cough and unfailingly wash our hands after using the restroom. But that’s not the real world we live in. People take risks, and yes, people make mistakes. Sometimes those risks are calculated beforehand, sometimes they just happen on a whim. And yes, people have to live with the consequences of those mistakes.  
 
And what exactly is the message?  Just like with smoking cessation, we've learned long ago that the simple, and true message, "smoking kills", didn't work.  We still use that message on the side of the cigarette pack (albeit in polite terms), but we've expanded that message to include the financial cost of smoking, the physical smell that results from smoking that is a turn-off to others, the risk of second-hand smoke.  Simply put, there is no one easy message to stop smoking just like there is no one easy message to change any private behavior.  We each march to the tune of a different drummer.
 
Furthermore, why do we point the finger of shame at those living with HIV more than most other health conditions? Perhaps we do so because we’re fundamentally uncomfortable with thinking about “how” that person became ill. It’s easier to accept someone’s so-called mistake of becoming diabetic as the result of eating too many pieces of sugary wonderfulness -- we can be sympathetic because we also remember our own donut overdose.  But when it comes to a sexually-transmitted disease, suddenly we don’t want to be associated with “those people” – you know, those who unlike me didn’t abstain, those who didn’t use a condom and those who should have known better. 
 
But really, haven’t we all made decisions at some point in our lives that we came to regret? It is the rare soul who goes out looking to become infected with HIV – the thousands of people I have come to know over the past 25 years who have been infected never thought it would happen to them. But it did and now they have shouldered the responsibility of protecting others. The overwhelming vast majority of those living with HIV take extreme measures to prevent the transmission of this virus to others. Sure there’s the odd ball case that makes the 10 p.m. news of someone who was reckless or lied about their status to their partner – just like there are always those oddball news stories regardless of the topic.  Just turn on the 24/7 news and within a few minutes you’ll run across a story or two of some evil perpetrated on someone else.  Doesn’t mean the entire community is evil – it just means that people are people.
 
The announcement by President Obama challenges all of us to learn about HIV. Yes, some 30 years later people still don’t have all the correct information. People still believe HIV can be spread casually or that people with HIV should be shunned. As long as we don’t accept that HIV stops with each one of us based on the decisions we make, we won’t make progress towards stopping this disease’s relentless march forward. Protecting yourself from HIV also protects you from other unwanted STD’s and for those who are heterosexual, unplanned pregnancies. And that’s a good thing. 
 
So next time you point that finger – turn it around and ask yourself, “What have I done today to stop HIV?”