There’s a saying: You have to stand away from the wall to raise an echo. Indeed, it takes awhile to process the impact of any International AIDS Conference. Trying to accurately characterize the impact of more than 25,000 people gathered from around the world to discuss every aspect of how best to fight the AIDS pandemic requires some perspective.

The conference always seems overwhelming at first. Watching tens of thousands of people—HIV positive and not—flow through the registration area is amazing. As I read people’s nametags, I counted the seemingly countless countries and organizations from which people hail. And as I migrated from media registration to the main conference hall this year (struggling to wheel my heavy luggage that contained laptop, cameras, plugs, cords and pounds of paper), I realized I was following some folks from rural Africa. One of the men had ankles as thin as my wrists. As he raised each knee, his shoes hung off the ends of his legs like anvils on ropes. He marched very slowly, and with great dignity, despite a body that was clearly battling the virus with all its might. Suddenly, my suitcase wheeled more lightly behind me.

For an American AIDS journalist and activist, especially one living with HIV like myself, being amidst a throng of people whose hearts and minds are dedicated in so many different ways to ending the suffering of HIV-positive people is incredibly invigorating. The whole experience is like one giant, never-ending shot of B-12.

But the gathering is also physically, emotionally and spiritually daunting. We spent a week enumerating the exceptionally arduous challenges associated with fighting HIV around the world. Considering the sheer volume and complexity of the issues, there are moments when you can’t help but wonder whether we will ever be able to stop AIDS once and for all. From fighting the gender-based violence that leads to the spread of HIV to addressing the challenges of getting care and treatment to displaced or migrant populations; from preventing mother-to-child transmission of HIV in the developing world to expanding treatment access to all who need it globally; from developing effective prevention messaging to combating stigma, discrimination and criminalization of positive people around the world (and so much more), there is nothing quite like the International AIDS Conference for re-establishing the mammoth nature of the global AIDS fight. And there is nothing like it for helping you ante up your resolution to fight.

For some reason, people in Mexico City have a fascination with lucha libre, a type of professional wrestling. The sparkly masks worn by the fighters are sold all over the city; kids done them as U.S. kids wear football or baseball jerseys and in the airport, I bought twin beaded bracelets for my sister and myself depicting caped, masked fighters. It seemed an appropriate sign from the universe—a reminder to stay firmly on one’s feet, fists at the ready to spar with AIDS.

This year, no earth shattering news emerged from the conference. There were no newsflashes on the treatment, vaccine, microbicide or prevention fronts. In fact, some of the biggest news had to do with the rate of new HIV incidence in the United States as reported by the U.S. Centers for Disease Control and Prevention. The rate is 40 percent higher than previously estimated.

But even the fact that the AIDS epidemic in the United States has been underestimated failed to provoke shock and awe. That is partially because the numbers did not indicate that we had a massive spike in new infection rates, but rather that we’ve developed better methodology that allows us to report more accurately the number of new people becoming HIV positive (56,300 rather than 40,000 in 2006, for example). Still, the figures clearly show that we are not in control of AIDS in America and that we need to redouble our efforts to do better than allowing more than 55,000 new infections a year of a disease that is truly preventable.

It was interesting to see how many different AIDS organizations and AIDS service organizations (ASOs) used the revised overall CDC number, as well as numbers more specific to subgroups (53 percent of all new infections among MSM! 45 percent of all new infections among African Americans! 34 percent of all new infections among people younger than 30!) as justification for their individual missions. We need housing! We need better prevention! We need more awareness among gay men/women/African Americans/teenagers/Latinos! We need condoms in jails!

The fact is we need all these things—at once. As soon as the embargo on the CDC numbers was broken, the press releases went flying as everyone pitched for their piece of the federal funding pie.

In America, AIDS groups often have to lobby for their constituents in a way that is directly competitive with other AIDS organizations (this is not as common in other countries where there are often fewer AIDS groups and more money); there isn’t enough money to fulfill everyone’s agenda at once. Inadequate funding of key AIDS programs in the United States causes this infighting within the AIDS community (e.g., witness how northern and southern states wrestle to secure Ryan White CARE Act funding when both areas have adequate need for funding). Sometimes I wonder whether this is intentional. When I was in college in Hartford, Connecticut, the cops spared themselves the effort of going head-to-head with the many gangs that threatened the city’s safety; instead, they left them to duke it out with each other. It was a strange position I thought—leaving the gangs to cull each other. And it has occurred to me more than once that perhaps the best way to weaken the collective force of the AIDS community is to pit its many factions against one another.

While I recognize that inadequate levels of funding leads ASOs to fight for their own needs, I think more AIDS organizations should pool their outcries and yell until Capitol Hill listens to their communal complaint and figures out a way to address all the issues critical to fighting AIDS in America—together. Because they are all interrelated. If we can get housing, for example, for people newly released from prison, or better access to care to people who test positive and have no health insurance, we will be more successful at stopping the spread of the disease. But if we have to choose, for example, to help only the uninsured newly diagnosed while ignoring HIIV-positive people re-entering society after being incarcerated, we’re not going to shut down the spread of AIDS as effectively—or quickly. And time is a wasting.

I think that even the new CDC numbers don’t give us a truly accurate picture of the U.S. epidemic. The data does not represent infections in all 50 states and, notably, leaves California and Puerto Rico off the list. Including new infection rates in this state and U.S. territory could really change what we understand, for example, about the spread of HIV among Latino/Hispanic people.

I have a theory that the numbers of who has HIV in the U.S. are skewed because who gets tested in America for HIV has a lot to do with erroneous assumptions on the part of doctors and people who worked in testing sites. If I had a dime for every time people told me a story of how they were talked out of getting an HIV test because they didn’t fit the “profile” of someone at high risk for HIV…

In many other countries around the world where HIV testing is even-handed and widespread, the virus is shown to have moved fairly quickly and evenly into every sector of the populace. This is because HIV doesn’t discriminate; only people do. We can talk all we want about certain factors that lead to higher risk for HIV, but the virus can and will go anywhere and everywhere nature allows it to go—which is clearly to every type of person on the planet. A lack of promiscuity or a certain color of skin or socioeconomic standing or gender has long been proved not to protect a person against HIV. In the United States, if you embody the inverse of factors people associate with HIV (say, you are monogamously married, as opposed to “promiscuous”; straight, rather than gay; a drinker, rather than an IV drug user) you are far less likely to get tested for HIV, but you are not necessarily proportionately at a much lower risk. While it’s true that certain factors and behaviors can increase your risk for HIV, not embodying a certain factor or avoiding certain behaviors is not insurance against getting HIV. Another way to put it is that while someone who has multiple acts of unprotected sex may have a higher risk for contracting HIV, a person who has unprotected sex once can also get HIV, so therefore everyone who has ever had unprotected sex should qualify for an AIDS test.

I wonder, what percent of America has had an HIV test? And if everyone in America got tested, would the CDC numbers look very different?

The XVII International Conference made me think about how strange it is that HIV appears to disproportionately affect certain sectors of the populace—only in America. In countries where testing is more common, the reported profile of who has HIV dovetails more closely with the composition of the general populace. The diversity of people living with HIV is a testament to the power of the virus’ ability to be an equal opportunity offender.

While there’s no question that the virus will infect any—and every—body it can, based on the best data we have to date, there is a clear skew to the concentration of infections and an indication that certain groups may be at elevated risk for contracting the disease at this point in America. It is of critical importance that we acknowledge that we have a real need to address the spread of HIV among MSM, African Americans, young people, women and Latino/Hispanic people in particular.

One of America’s most prominent AIDS journalists, Lawrence Altman, in his recap of the International Conference in the August 18 edition of The New York Times, did not mention the AIDS crisis in black America. Perhaps he did not attend the press conference in which Phill Wilson of the Black AIDS Institute (BAI) and a handful of the most powerful black American AIDS activists discussed the BAI’s new report “Left Behind,” which chronicles the chilling impact of AIDS on black America. I mean no disrespect towards Altman. But since there were precious few American media at IAC, I feel that those there had a responsibility to be tuned in to big news—like how AIDS is disproportionately affecting the black and MSM communities stateside. In his summary article about the conference, Altman did not reference the revised CDC incidence numbers, nor did he mention that hundreds of AIDS organizations and more than 1,000 individuals have signed on in support of the call for a National AIDS Strategy.

As an American HIV-positive journalist, I blame, in part, the media for perpetuating the myth that AIDS is under control in America. It may be a crime of omission, but it is time that we give the rest of the world—as well as our current and future governmental leaders—a clear picture of what it’s like to live with AIDS in America. If AIDS journalists in the United States aren’t reporting on the key news about the American AIDS community, how will the rest of the world see that our own fight is far from over?

Now that the travel ban for HIV-positive foreigners has been lifted, we can entertain the idea of hosting a future International AIDS Conference stateside (we hope the Department of Health and Human Services’ will soon remove “HIV” from its list of communicable diseases, a fact that means that an HIV-diagnosis can still prevent an HIV-positive foreigner from entering the United States). I would love to see the international AIDS community come to America. I would love to see those tens of thousands of people, positive and not, from all over the world, spend time in the old U. S. of A. Partially, I want the chance to return the hospitality the rest of the world has shown us, and partially, I want people to see the truth of AIDS in America, firsthand.

And I want to engage my country in the battle against AIDS. Remember the film Fight Club? It was a biting commentary on American culture, but one of the catch phrases from the movie was, “The first rule of Fight Club is that you don’t talk about Fight Club.” That seems to be the first rule of AIDS in America. We must change that. Unquestionably, we need to take our battle out in the open, to the mainstream—much like those fearless and wildly popular lucha libre warriors I encountered in Mexico.