On what has been dubbed World AIDS day, James Pinkerton has harsh words for those who don't change their life styles in the midst of the epidemic:

Here's the formula for the AIDS epidemic: First, start with a deadly contagious virus. Second, take no serious measures as dangerous behavior patterns multiply. Third, ignore the obvious lessons of epidemiological and medical history -- try demagoguery instead. Fourth, apply copious amounts of sentiment and red-ribbon artistry to the issue, substituting, in effect, sentiment for science. Fifth, stand back and watch tens of millions of people die.

Repeat these five steps for as long as you wish. If you do so, you will find that AIDS is never cured, no matter how many press releases are issued, no matter how much money is spent, no matter how much earnest good will is expended, no matter how much intellectual capital is consumed.

To put it as bluntly as possible, the main reason that AIDS is spreading to its current deadly dimensions around the world is this: We are practicing the social and political equivalent of laissez-faire when dealing with a killer-virus. And while "hands off" is usually the best approach for generating economic growth, if a virus, on the contrary, gets the equivalent of a free hand, it will also flourish -- but that's the kind of explosive growth we don't want.

Two decades ago, American AIDS activists came up with the slogan, "Silence = Death." But the issue, in practice, wasn't talking about AIDS, but rather doing something about AIDS. So the American slogan became, in effect, "Behavior Change = Life." And the biggest single life-saving change, back then, was behavioral restraint. Gay bathhouses were shut down, and millions of Americans, many of them gay, changed their sexual patterns: They got serious about condoms, safe sex, or outright abstinence. Were these changes tough to live by? Sure. But they beat the alternative. Let's face it: Just as quarantining worked in the past -- remember leper colonies? -- so the same basic idea, of separating oneself from the threat, works today.

Currently in the U.S., it is common for gay men -- especially as one moves up the ladder, in terms of education and health-consciousness -- to say things like, "I don't know anybody who has died of AIDS in five or ten, or even fifteen years." That is, in their medically aware circle -- after the initial wave of deaths in the 80s -- people got the message. And of course, thanks to medical breakthroughs, many of those who are HIV positive can carry on functional lives for the long term.

Today in America, a few incredibly unlucky people get AIDS through freak accidents. But the blunt reality is that AIDS mostly afflicts those who can be diagnosed as terminally reckless. An example is junkies using dirty needles -- or any needle at all. How does society realistically save the life of someone who holds his or her own life in such obvious contempt? As with smoking, drinking, over-eating, gun-playing and drag-racing, some behavior choices simply defy life-saving. Or to take another example, it's recognized by now that anal sex without condoms, known as "barebacking," is widely recognized as a death trip, and yet plenty of people still seem to do it, with the full complicity of modern marketing. At some point, confronted by the lethal combination of lust and greed, even the best-intentioned American public-health advocates have to throw up their hands in defeat.