Fourteen years old and sullen, he came to the hospital on a Sunday afternoon for evaluation of long-standing abdominal pain. As a first-year pediatric intern, I thought of incredible diagnoses: An intermittent twisting of the bowel? A rare parasite? When the preliminary tests came back negative, I told my patient the good news. He just cried, looked away, and held his stomach.
With clinical trials now underway, it is natural to expect that a safe and effective vaccine against HIV will soon spell the end of AIDS in this country. But consider a more likely scenario:
Immediately after the Food and Drug Administration licenses the vaccine, the Centers for Disease Control and Prevention (CDC) recommend the immunization of all high-risk gay men, prostitutes, and intravenous drug users. Congress and state legislatures, however, do not rush to approve the funds needed to reach these groups. Years pass, and HIV infection rates barely budge.