p After nearly two decades of warnings about the impending heterosexual AIDS epidemic, none has materialized. In contrast to the dire predictions and despite widespread HIV testing, AIDS has remained almost exclusively confined to the original risk groups.^^172^^ Even within risk groups, the numbers have never reached expected proportions and have been quietly diminishing for over five years. As AIDS in America has failed to live up to its terrifying reputation, our attention is directed to other parts of the world where harrowing estimates go unchecked and vastly exceed actual diagnoses.^^173^^

p Information from the US Centers for Disease Control reveals that the disparity between official AIDS reports and actual AIDS data began in 1987. At that time, public health agencies elected to ignore their own findings in favor of promoting the notion that “everyone is at risk for AIDS.”^^174^^^,^^175^^ Although epidemiology indicated this claim was not and would probably never be true, marketing research concluded that widespread support for AIDS would be impossible unless AIDS was considered a widespread health threat. Responding to Gallup Polls and PR studies, the CDC decided on a strategy that disregarded the facts in order to “mobilize support for public funding.”^^175^^ As CDC virologist Dr. Walter Dowdle admitted, “As long as this was seen as a gay disease, or even worse, a disease of drug abusers, this pushed the disease way down the ladder" of funding priorities.

p The CDC’s early decision to overestimate AIDS and magnify the risks launched one of the most successful advertising campaigns in history. In 1986, the majority of Americans did not feel at risk for AIDS; by 1988 more than twothirds thought a full scale epidemic was likely, and by 1991, most believed that even married couples faced a substantial risk of contracting AIDS.^^175^^ Federal tax dollars allocated to AIDS doubled the first year of the CDC ad campaign, and by the early 90s had topped $ 1 billion a year.

p While concern and support for AIDS has multiplied and spread among millions of Americans, AIDS itself has not. This discrepancy has required a careful management of information and the need for constant advertisements, predictions and news reports that perpetuate ideas about AIDS that are out of sync with reality. Instead of revealing hard numbers and cold facts, most public health and AIDS organizations, along with the media, dispense reports that employ misleading percentages, alarming estimates, or cumulative totals for AIDS that disguise the realities of the epidemic.

p The use of cumulative totals makes it possible to cite ever-growing numbers for AIDS even as AIDS is actually declining. Until 1997, despite steady decreases that began four years earlier, AIDS in America was almost universally described as an increasing problem, an image supported by the use of cumulative case numbers. For example, the total of new adult AIDS 46 cases in the US in 1996 was 5,000 less than in 1995, but by adding the 1996 cases to the total number of cases reported since 1981, the decline of 5,000 was portrayed as an increase.^^170^^

p Percentage calculations can turn drops into rises and are frequently used to make small numbers appear impressive. For example, in 1998 the number of new cases of AIDS among women decreased by more than 2,000, but at the same time, the percentage of total cases that women represent increased by 1%. This 1% difference in percentage is used to make the claim that AIDS is increasing among women.^^170^^ The warning that heterosexuals are the fastest growing AIDS risk group is based on this same misleading use of percentages. In fact, cases of AIDS have been declining in all risk groups since 1993.^^177^^

p Such statistical sleight of hand is not exclusive to the US media or American AIDS organizations. In Canada, a nation with an extremely low incidence of AIDS, government AIDS officials and the media play up the few cases there are and often perform their own magic with the numbers. For example, in 1995 new AIDS diagnoses among Canadian women totaled 175. This figure dropped to 165 in 1996, and then to 88 in 1997. News reports did not celebrate these decreases or the fact that in a country with some 15 million females, only 88 women were diagnosed with AIDS that year. Instead, the increased percentage of cases among women, from 8.8% of all AIDS cases in 1995 to 15.4% of AIDS cases in 1997, led Canada’s Laboratory Centre for Disease Control (LCDC) to pronounce that women with AIDS made up “the highest proportion [of AIDS cases] observed since monitoring of the epidemic began.”^^178^^

p Estimates that can make anything seem possible are commonly used in AIDS news reports and advertising campaigns, and although the word “estimate” is crucial to qualifying claims, it is often omitted from ads and media reports. To take just one example, advertisements for the “Until There’s A Cure" AIDS bracelet use blood-red capital letters to proclaim “16,000 people a day are introduced to HIV by testing positive.”^^179^^ It is necessary to contact the bracelet company in order to learn that the figure cited in the ad is an approximation based on global WHO estimates which are not even based on HIV test results.^^180^^

p WHO estimates for AIDS in developing areas of the world such as Africa are the basis for many news reports. Although these estimates bear little resemblance to actual numbers of AIDS cases, the discrepancy might understandably be explained by the need to estimate a certain amount of AIDS cases in undiagnosed persons. However, the ratio of diagnosed cases to estimated cases inexplicably varies among African nations, ranging from nine estimated AIDS cases for ever}- one case diagnosed, to as high as 69 for each single case.^^181^^ For example, the WHO ratio for AIDS in Zimbabwe is 10/1, while the ratio of 48/1 is used next door in Mozambique, which changes to 33/1 across the border in neighboring South Africa.

Estimates are often combined with predictions, a mix that can produce particularly spectacular results. One recent example is a Reuters news release that announced “China has an estimated 400,000 people with HIV although confirmed cases [since the beginning of the epidemic] are only about 11,000.” In this same report, “unidentified experts" went on to predict that these 11,000 cases could grow to “one million by the end of next year.”^^182^^