By Alex Garner Editor-at-Large

For months now we’ve been hearing people talk about an “AIDS free generation.” The phrase was the term du jour at the International AIDS Conference. It sounds good. It sounds exciting. It sounds optimistic. But what exactly does an AIDS free generation mean and will it be possible to accomplish?

When I first heard Secretary of State Hillary Clinton use the term, “AIDS free generation,” I thought she was simply engaging in rhetorical flourish. I didn’t think she actually believed we’d be able to achieve an AIDS free generation with just biomedical intervention and other prevention strategies. I thought we might be able to greatly reduce the number of infections but that would be all we’d be able to accomplish.

When I heard Secretary Clinton speak at the International AIDS Conference, I realized I was wrong. I was wrong because I wasn’t taking her literally. She wasn’t talking about HIV eradication. She was talking about a generation free of AIDS not a generation free of HIV.

“HIV/AIDS” is what has confused most people. For far too long people have been using the term HIV/AIDS when they talk about the subject but it’s really not very accurate. HIV and AIDS are not exactly the same thing. Human Immunodeficiency Virus - HIV is a virus and AIDS is Acquired Immune Deficiency Syndrome- a syndrome caused by the virus.

Some one can test HIV-positive and not have AIDS. When someone is diagnosed with AIDS they are also HIV-positive. AIDS was a syndrome that was arbitrarily defined by doctors based on CD4 counts and a list of opportunistic infections. In fact, it took political action by groups like ACT UP, to get the CDC to change the definition of AIDS so that it would include conditions that are specific to women. AIDS is a syndrome created by man to describe a condition caused by a virus. HIV is a virus detectable in the blood.

To complicate matters, in the early days, when you were diagnosed with AIDS it was a diagnosis that never went away. The vast majority of people who had AIDS ended up dying. The advent of combination therapy changed all that and people who were once diagnosed with AIDS were now living healthy lives and didn’t fit the category anymore. Unfortunately, few made the effort to make the rhetorical adjustment and we were stuck with HIV/AIDS.

It’s understandable the people would get confused. For years HIV/AIDS has tripped off the tongue when people talked about the epidemic. The Associated Press uses the term HIV/AIDS as part of its standard terminology. Secretary Clinton has now reminded us that using them interchangeably is not a good idea.

It’s perfectly reasonable to think that we could actually achieve an AIDS free generation. If all people with HIV have access to antiretroviral medications, they will stay healthy and people with not die of the diseases caused by HIV. Mothers will not transmit HIV to their children and babies born with HIV could become quite rare around the world, just like in the U.S.

Thank you, Secretary Clinton. Thank you for reminding us that words matter. Thanks for demonstrating that using catchall phrases is inaccurate and lazy and that we are all better served by speaking precisely. And we can indeed achieve an AIDS free generation but it’s going to take concerted efforts from various fronts. Not only will we have to make sure people have access to treatment but we’ll have to work to combat stigma, homophobia, sexism and social injustice. If we are ready to do all that, which is quite an undertaking, then we can see and AIDS free generation. Shall we get to work?

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