AIDS is a disease of accumulation.

The way to make a small disease look big is to talk about it only in terms of cumulative numbers. Other diseases classified as sexually transmitted are talked about in terms of cases annually. A bit of thought will point out why this is the only relevant number to consider, unless, of course, one wants to create an image of HIV that connotes enormity rather than accuracy.

Cases per year tells one what the disease is doing, how it is growing or shrinking compared to last year. It is striking when one looks at HIV discussed with other STDs. Numbers for all STDs besides HIV/AIDS are given as new cases per year. If HIV were to be presented in the same way it would seem a tiny number in comparison with the 53,000 new cases of sexually-transmitted hepatitis B infection, the one million new HPV infections or the three million new trichomoniasis cases.

Occasionally one can find a cumulative total for another disease, one that is killing enormous numbers of women, but which is less headline-able. Breast cancer, for instance, has killed more women in the last ten years than AIDS has killed - total - in the last fifteen in the US.

Why minimize the other illnesses and maximize AIDS? What about cumulative total influenza cases, cancer cases, syphilis cases, herpes cases? Why does HIV get all the limelight?

The point is not to minimize the tragedy of the deaths associated with immune suppression. The point is to draw attention to the fact that deaths attributed to AIDS are a small number of the total preventable deaths, and even of the preventable transmissible deaths. HIV and AIDS are in the headlines for other reasons, and those reasons are not conducive to saving lives.

The label of AIDS is a political entity. People with AIDS are tracked, imprisoned for reasons related to their outcome on an HIV test, marked as homosexuals or drug users or simply as underclass, studied, tested, treated with high-powered pharmaceuticals even against their will, and convicted of felonies based on their antibody status, potentially receiving years of imprisonment for failure to notify their partners. An Orlando man has even been sentenced to require future sexual partners to sign a consent form, acknowledging that they know their partner has tested HIV-positive (Union Leader, January 24).

Another way to get more minories shoveled into the prison system here in the Land of the Free.

There is good reason why HIV is talked about in cumulative numbers. The hysteria that can be whipped up around big numbers gets lots of other convenient things accomplished. The numbers associated with yearly cases minimizes hysteria. It is amazing how willing people are to believe these social changes are all for the purpose of protecting the public health. And it is scary to wonder how much more freedom people will be willing to give up on the advice of scientists and legislators.