The XVII International AIDS Conference will run from 3 to 8 August 2008 in Mexico City and one can already hear the drums of war beating backstage. As a science editorial puts it, Money matters, and who is going to get it matters even more. Though evidence-based approaches should be favoured, this has not often been the case.

So who should get the dosh?

Children?

Over twenty-five years into the acquired immune deficiency syndrome (AIDS) epidemic, the children in its path remain at grave risk. In 2007, it was estimated that 2.1 million children under 15 years old were living with the human immunodeficiency virus (HIV), and 290,000 children died of AIDS and 420,000 children were newly infected. Over 15 million children under 18 have lost one or both parents to AIDS, and millions more have been made vulnerable.

Women?

Almost half the HIV-positive people in the world are now women, but in Africa, where the epidemic has stretched the furthest, young women are three times more likely to be HIV-positive than young men. Gender inequality leaves women with less control than men over their bodies and their lives. They have less information about how to prevent HIV, and fewer resources to take preventative measures. Many more resources need to flow into halting the spread of HIV/AIDS, and need to be targeted to women in particular.

Men who have sex with men?

In some parts of the world, men who have sex with men (MSM) have been disproportionately affected by the HIV epidemic. In countries where such information is gathered, HIV infection rates among MSM are often higher than in the general population. Multiple sex partners, unprotected anal sex and the hidden nature of MSM sexual relations in many communities all contribute to the prevalence of HIV among MSM.

Injecting drug users?

Injecting drug users (IDUs) have been among the groups most affected by HIV & AIDS since the epidemic began. Sharing syringes is a very efficient way to transmit blood-borne viruses such as HIV, which can spread rapidly through IDU populations. The sharing of needles and “works” (syringes, water, mixing spoon, etc.) is thought to be three times more likely to transmit HIV than sexual intercourse.

African Americans in the US?

In the United States, the HIV/AIDS epidemic is a health crisis for African Americans. At all stages of HIV/AIDS — from infection with HIV to death with AIDS — blacks (including African Americans) are disproportionately affected compared with members of other races and ethnicities.

Or maybe Hispanic/Latino?

The HIV/AIDS epidemic is a serious threat to the Hispanic/Latino community. In 2005, HIV/AIDS was the fourth leading cause of death among Hispanic/Latino men and women aged 35 to 44.

Teachers?

The population-based testing shows that the HIV prevalence among teachers was 12.7 percent in 2004 [in South Africa]. This is an appallingly high level of infection, but is much lower than the UNAIDS estimate of national adult HIV prevalence (21.5 percent at the end of 2003) and considerably lower than the national, population-based HIV estimates for most age cohorts in 2002. Although it is widely reported that women are bearing the brunt of the AIDS epidemic in Africa, prevalence rates among female and male teachers in South Africa are almost identical. Nor is there any difference in overall prevalence rates among primary and secondary school teachers.

Or fishermen?

Bali is a famed tourist playground, but there’s a side to the island most foreign visitors never see. Indonesian fishermen who often haven’t seen land for months put in at Benoa Harbour and make straight for the closest bar with two things in mind: getting drunk and finding women.

These habits have put fishermen at high risk of getting HIV or AIDS – especially in Asia, because it’s home to 2.5 million fishermen, or about 85 per cent of the world’s total. Yet fishermen have been largely overlooked since the virus began raging 21 years ago, with only a handful of surveys focusing on them.

One report found that out of 10 poor countries, all but one had fishermen with HIV rates four to 14 times higher than the general population

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