AIDS nomad: author Susan Hunter has studied AIDS in 29 countries. She says the epidemic in the United States is not all that different from that in the developing world.

Author and AIDS expert Susan Hunter spends much of her time in the developing world studying the AIDS epidemic. Her many works on the subject--which are as comprehensive as their titles are straightforward--include AIDS in Asia: A Continent in Peril; Black Death: AIDS in Africa; and AIDS in America, which was published this year. At press time Hunter spoke to The Advocate via e-mail from Ethiopia, where she has been working on AIDS prevention and treatment.

What have you learned about AIDS from studying it on a global scale?

I've confirmed my belief that most, if not all, human epidemics are 5% pathogens and 95% social factors, economics, and politics. In other words, humans decide through their political and social systems how epidemics are distributed in countries--that is, who gets sick--and who has access to treatment, care, and support. Marginalized groups--be they the poor, people of color, people with alternative sexual identities, or drug users--are the most impacted by HIV/AIDS. The powerful want to stay in power and sacrifice the interests and lives of the less powerful to do so.

Why have you focused so much attention on other parts of the world?

I've worked on AIDS in the U.S., but my background as a medical anthropologist drew me to my work in developing countries, where AIDS epidemics are generally worse. I've worked on the epidemic in 29 different countries for most of my career, but after writing books on Africa and Asia, I realized that most of the same factors driving the epidemic are found in the U.S.--and are perhaps worse. That's why I decided to write AIDS in America, to confront these issues at home and in my own mind and heart. It was a truly difficult book to write because I was talking to people in my own country who suffered the same problems as poor Africans and Asians.

What are we failing to recognize about the epidemic in the U.S.?

The media and even public-health experts have been lulled into complacency about the U.S. epidemic because they assume a rich country will never have a large-scale epidemic. But we now have the largest epidemic of any developed country, and it's about time the media and government turned their focus to the home front. All the stories about Africa contribute to our misperception that somehow we are invulnerable, but it's catching up to us now. It's time for hard stories about our own epidemic and the inequities that drive it.

What's the most threatening issue we face now?

Probably issues arising from our failure to address social injustice in the past. We have to confront the damage we've caused by failing to demand that those who have resources respond to the needs of those who don't. We've put the foxes in charge of the henhouse, and lots of feathers and fur must fly before we get back on track.

So what should Americans do?

Most Americans are very caring, and they have to return to the sense of community and social responsibility that's been a hallmark of our culture in the past. We've become a very harsh state, the land of the unhelping hand.