What Else Would an AIDS Vaccine Mean?

Last weekend Times health and science reporter Donald McNeil Jr. opened an article on the news that the Thai AIDS vaccine trials produced some limited but promising results with the following question:

What would an AIDS vaccine mean to the world?

This question is much more complicated than it seems at first blush. It requires more than imagining what would the world be like if we could prevent everyone from getting AIDS. If we want to understand what an AIDS vaccine would mean we need to think about our responses to such an event.

How would the media, the government, and educational systems frame an AIDS vaccine to a general public, most of whom don't understand what HIV is, how it's transmitted, and what their actual risk of acquiring it is? How would businesses, large and small, seek to benefit from it? And once this event has been mediated for us, how would this play out on an individual level?

When I read McNeil's question, it was the individual response that worried me first. I imagined at least one response the day the New York Times runs a headline "New Vaccine Promises End to AIDS"; condom sales are going to go way, way down.

The problem with this of course is that condoms aren't just for HIV. If everyone stopped using condoms other STDs would increase (many of which are incurable and some of which can kill you or the people you're loving). The rate of unwanted pregnancies would likely go up, the number of abortions would go up, and are we really so short sighted to imagine that a few decades of unbridled mixing of fluids and drugs won't result in some other kind of super bug?

There's another specter of the AIDS vaccine McNeil evokes in his piece which I found particularly worrying. This is the idea that we are living in a time of sexual darkness. That HIV has squashed the supposed sexual revolution, and that none of us are experiencing our full sexual potential because we live in fear of HIV. And that there will be some glorious day when AIDS is gone and people can be sexually free.

If AIDS is eradicated it will be a glorious day. But it will be glorious because it will mean we've reduced pain and suffering in the world. It won't set us free sexually. Condoms are just a convenient excuse for being sexually f-d up. What worries me is that this is precisely how it will get framed, and that just like the late 60s and early 70s an unprepared and unsuspecting public will be told that their emancipation is just a few casual sexual encounters away.

This isn't a morality tale I'm spinning. Morals have nothing to do with it (and for the record I'm a big fan of casual sexual encounters for emancipation or just plain fun). But I guess my message might be the same kind of wet blanket. What I'm saying is, it's all much more complicated than we like to think. Despite the enduring popularity of snappy self help books and happiness pills, there is not now, nor will there ever be a quick fix for sexual or any other kind of liberation.

I'm not complaining about any and all help we can get in reducing the impact of HIV and reducing the human pain that comes with AIDS. I'm just saying that we shouldn't think an AIDS vaccine is going to change anything other than how, when, and how often HIV is transmitted. It won't change us as people, and it won't "free" us from some kind of sexual dark ages we're living in. We'll have to do that on our own, and we don't have to wait for a vaccine to do it.