“Contrary to the promises of most AIDS experts, the signs are that a vaccine to prevent HIV will not be found for several decades—if at all. Those responsible for carrying on the global fight against AIDS do not accept this grim outlook, at least publicly. Yet until the gravity of this scientific failure is openly acknowledged, a serious debate about how to end HIVs lethal grip on the poorest and most vulnerable in the world cannot take place.

“The most important recent revelation is that the relations of women with men will determine the course of this plague. Women are now three times more likely to become infected than young men. What might help women most is a personal method to protect themselves from HIV. If a condom is neither available nor practicable, microbicides might eventually be part of the answer. But our long-term defense requires a deeper understanding of the conditions in which AIDS is transmitted.

Marriage—in which there can be frequent episodes of male violence and sex with multiple partners—has become a serious risk factor for acquiring HIV. Is it too much to hope that the searing catastrophe of AIDS may have put before women and men an issue that they can use to confront male violence, exploitation and stigma? By 2010, there will be 25 million children orphaned because of AIDS. This is a human atrocity that women and men must contend with together—and without a vaccine.”

—Dr. Richard Horton, editor of The Lancet

ADAPTED FROM “AIDS: THE ELUSIVE VACCINE” AND EXCERPTED WITH PERMISSION OF THE NEW YORK REVIEW OF BOOKS © 2004 NYREV, INC.

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