In the AIDS policy wars, who is really living in sin?

It was seven years into the epidemic and over 55,000 infections nationwide (less women died from breast cancer last year), before President Reagan uttered the name AIDS in public. His inaction on the issue was akin to throwing gallons of gasoline onto a stovetop fire. In fact, it is not too difficult to blame the magnitude of the United States AIDS epidemic on this one man alone. However such an act is complicated by the corresponding complacency of the American public.

Reagan and his cronies basically took the stance that homosexuals, intravenous drug users, etc. deserved what they got. Their sin brought on the wrath of God. This was before compassionate conservatism. Such a foundation for public policy alludes to a greater question: Do all humans have the same right to life?

If someone has unprotected sex or shares dirty needles does this mean that they no longer deserve the same protections, rights, and responsibilities from the state to which others are entitled? What is really the difference between a baby with AIDS and a 40 year-old with AIDS? Why does one deserve more sympathy than the other?

What is the difference between a poor, black heroin abuser and a rich, white Vicadin abuser? One gets AIDS the other does not. It is a matter of economics (i.e., privilege) and the drug of choice. In each case an individual is addicted to a mind-altering substance.

In the case of a baby or a 40 year-old it is easy to discount any responsibility on behalf of the newly born child. Of course the baby is just as guilty of throwing its life away as the 40 year-old injection user in most cases, we just fail to recognize this.

It is less obvious that the baby made a huge mistake by being born to a low-income woman (frequently a minority as well) whose husband used to shoot up a mix of cocaine and heroin five times a day. If the baby had exercised better judgment he could have been born to a rich suburban family, which would have helped him get into Princeton or something. However the baby was either lazy in choosing who to be born to or not as smart and capable as the other babies that made wiser decisions.

The last paragraph may be somewhat hard to follow. Most people (alright, maybe all) would quickly point out that the baby had no control over to whom he was born. So let me quickly ask what the baby does have control over and when he gains this control. Is it when he is subjected to second hand smoke in-utero? Is it when he isn't fed as a toddler? Is it when he is neglected or smacked around? Does the baby have control over growing up in a house lacking basic necessities (phone, heat, refrigerator, stove . . . ) or attending a school without sufficient textbooks or capable teachers or gym class? Does the baby have control over having a father in prison or three brothers in prison or half of its male family members in prison (one out of three black men born in 2003 will serve some time behind bars)? Does the baby have control over living in a neighborhood without a single college graduate or gunfire-free week?

At what age can we start blaming the baby for messing up its life? This is a really important question from a public policy perspective. If we can blame the baby for his own actions then we no longer have to feel guilty about living in a society where over 40 million people do not have health insurance, the minimum wage is impossible to live on and SUV's outnumber sedans in new auto sales. As long as we can fixate on the baby's personal responsibility we do not have to think about our own.

I completely agree that it is important to hold people responsible for their actions. However, I think we must evaluate decisions in the context in which they are made.

It is easy to demonize a drug user (that is a heroin or crack user) and it is easy to condemn "deliberate, disgusting, revolting behavior" as Jesse Helms once called the homosexual act of making love. The hard road involves understanding the humanity of an intravenous drug user and the normalcy of homosexuals because we are constantly barraged with media hype and political spin effective at keeping us divided and conquerable.

If you don't have a cousin who is gay you probably have an uncle who is a substance abuser. There is someone you care about who is HIV positive; you probably just don't know it. AIDS affects us all.

Of course a huge percentage of new HIV infections are among heterosexual, non-drug injecting Americansbut this column is about the high-risk groups of the 1980s, the people we did not care enough about in order to try to slow the epidemic in its early stages, the people we continue to persecute to this day.