Marcus Conant at the Commonwealth Club of California

Today's episode of the Commonwealth Club of California podcast featured Marcus Conant discussing the state and future of HIV/AIDS; a video feed is available here; right now there's no link to the audio podcast. Here are somethings we learned today:

• The average American male will have twenty-five sexual partners in a lifetime
• The average African male will have twenty-five sexual partners in a year
• Homosexuals comprise roughly four percent of the population in the States
• Twenty percent of black men in New York City are HIV-positive
  
• A heterosexual HIV epidemic requires a substantial pool of low-risk HIV-positive people

This last point was news to me: Conant discusses the fact that HIV in Africa spread around truck routes, mostly due to the fact that truck drivers, who were the primary vector for the disease, passed it on to prostitutes, bar girls, etc. who lived near the truck route, who then passed it on to their domestic partners, who passed it on to women in the area who had nothing to do with truck drivers. In this case the low-risk people are the second group of local women, who by comparison to the truckers, prostitutes, bar girls, etc. lead low-risk lifestyles.

What a depressing story.

Conant goes on to suggest that a similar low-risk HIV-positive group is forming in the States among black and Hispanic groups and in regions where crystal meth is popular, but he didn't speculate on when the long-awaited heterosexual HIV epidemic will arrive in the States.

Have I mentioned recently that And The Band Played On is one of my favorite books? It's a shame Randy Shilts died and nobody picked up the mantle. Edward Hooper's book The River takes a speculative look backward from about 1976 toward the origins of HIV in Africa, but so far as I know nobody has taken a wide-angle look at HIV/AIDS from the end of Shilts's book forward.

Shilts's book is an excellent mix of small stories and big ones, and the resulting HBO movie is worth watching even if you don't have time for the book. As I recall, though, the book chooses a somewhat artificial end point: the identification and classification of the virus. And as I recall Shilts took the position that somehow Ronald Reagan prevented the discovery of an AIDS vaccine; that position hasn't aged especially well. I wonder what changes Shilts would make if he were alive today and could revise and expand his book.

Here's an update: the World Health Organization says the threat of a global HIV pandemic outside high-risk groups is over.