No, like a magazine-magazine. People will be reading me during takeoff and landing and in dental offices for days, son.
So I’m getting AIDS tested the other day in Berlin. I’m sitting in the waiting room and feeling like a Bad Gay, because I’ve lived here for three years and this is my first time getting tested. I’m surrounded by all these scared-straight brochures about HIV and AIDS in Germany. Prevalence rates, treatment options, prevention methods, names and addresses of support groups. “Since the start of the epidemic,” one of them says, “more than 27,000 people have died of AIDS in Germany.”
Wait, that sounds triumphantly low for a country of 80 million people. I pull out my phone and check the Centers for Disease Control and Prevention (CDC) website, which tells me that, in the United States, 636,000 people have died since the epidemic began. That’s 23 times higher than Germany, for a country with four times the population.
This makes no sense. Germany has big cities, it has gay men and sex workers and drug users, it has all the same temptations for them to be uncareful that the United States does. How could so many fewer people have died?
Maybe it’s a fluke. I visit the Public Health England website and it says 21,000 people have died of AIDS there in total. If the rates were the same as the United States, it would be 128,000.
The further down the Google-hole I go, the more mind-boggling the numbers get. Since the beginning of the epidemic, AIDS has claimed more people in New York City than in Spain, Italy, the Netherlands, and Switzerland combined.
The next day I start asking epidemiologists about this divergence. The first thing they tell me is that it is real, even accounting for differences in methodology. Scan the columns on the stats sheets—incidence, prevalence, deaths—and you find the United States with a two-digit lead going right back to the start of the epidemic. Still now, no matter how much we’ve learned about how to prevent and treat AIDS, the United States loses more than 15,000 people to it each year. Germany and the United Kingdom lose fewer than 800.
The second thing they tell me is why.
My editor at TNR was great—cool about the fact that I’ve never done this before, patient with my rank amateurishness and constant ‘you can’t cut that no please don’t!’ tantrums. I only know one way to write a sentence (Refer to self, item list. Refer to self, item list.), and he taught me at least like two new ones. The fact-checker was super nice, too. I got a lot of stuff wrong (C. Everett Koop is with a K?), and she had a way of pointing that out that didn’t make me feel like I was an idiot. Even though I sort of am. So thanks guys!
Before I even sent it to TNR, I got comments on it from friends and family. So Ian, Nathan, Lane, Alison, Mom, Dad: Thanks for being the people who told me that it wasn’t ready for the rest of the world yet.
And most importantly, I need to thank all of the epidemiologists and researchers and authors I talked to for the story. I interviewed about 18 people, some of them for more than an hour, and everyone was, without exception, patient and gracious and charming and fascinating, and I hope I’ve done justice to the great work they put into producing the information I’m stealing and paraphrasing.
I don’t do this for a living, so being published anywhere, anyhow, is really special for me. That someone would take the time to put something I wrote on actual pages, to ensure that I get my facts and my words right, to help and hope that I get better at this, it’s just, wow.
I’ll be posting some outtakes and further thoughts on the process and the article in the next few days. But for now, I’m going to take like six minutes to just sit here and feel super lucky that I got to do this. Then I’m going to start working on the next one.