Compared to other vaccines, this is not highly effective. But, as those involved in AIDS research are quick to note, it opens a door. The vaccine did something. There is now the opportunity to identify that something, analyze it—and turn it into something more. We are inching up on HIV prevention through immunization. And given the challenges involved, it may well be that breakthroughs in this area will spill over into the prevention of other difficult infectious diseases, and even cancer. This trial is ultimately about more than HIV prevention—it is about new means of communicating with the immune system.
That's the good news about the current study. But there are more sobering considerations in the broader war against AIDS. Needle exchange programs can slash HIV transmission among intravenous drug users by several hundred percent. Despite this, such programs are rare and lack widespread support because so many of us simply dislike the notion of “aiding and abetting” drug use. But perfect is the enemy of good, and good we could do but choose not to is, arguably, bad. We might cultivate more support for needle exchange programs if we think about the at-times completely unaware intimate partners of current or even former IV drug users whom we might save from the fate of AIDS.
And condom use is more effective still. Used correctly, condoms can virtually eliminate the risk of sexual transmission of HIV. Yet condom distribution, too, is less prevalent and widely supported than its utility warrants.
I understand that reservations about such "harm reduction" strategies can have deep roots in personal ideology. But epidemiology is non-denominational, and I believe the cold, hard data on which it is based should trump our opinions and preferences. When lives at stake, let's go with just the facts.
Yes, the new vaccine study shows we are developing new means of HIV prevention. And by all means, huzzah! for the truly great scientific breakthroughs that loom. But as we tally inches, I would greedily like to take a yard, and stride faster toward control of this scourge and the misery AIDS causes by making better use of the means already at our disposal.
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