The virus can be brought under control, but it’s complicated
as a major public-health threat by 2030, building on the staggering success of the past two decades., which weakens the immune system, has killed about 40m people—more than covid-19. However, the pace at which people are dying of it has fallen dramatically. In the early 2000s it was 2m a year, largely in poor countries, where hardly anyone could afford $10,000 a year for life-prolonging pills.
There is no male equivalent of a prenatal clinic. Also, some men have a macho reluctance to seek medical help. They “get very sick before they get tested”, says Sibongile Tshabalala, the chair of the Treatment Action Campaign, an“As men, we’re embarrassed to go to a clinic. We’re taught we need to be strong, so we cannot be seen to be sick,” says Ronnie Sibisi, a 60-year-old from Vosloorus, a township near Johannesburg. He was “a player” with many girlfriends, he says.
Male violence is another obstacle. A study in six African countries found that women who had been physically abused in the previous year were 3.2 times more likely to have been infected withrecently. Women who live in fear may find it harder to say no to unprotected sex. And the first wave of, by killing so many parents, made families in some countries even poorer and more unstable than they already were.
Sometimes stigma is compounded by law. Some 168 governments criminalise aspects of sex work. This deters sex workers from seeking help. Nokwanda Gambushe, an activist in Durban, complains that cops search sex workers’ handbags and, if they find condoms, arrest them. This hardly encourages safe sex.