Today’s World AIDS Day marks the 30th anniversary of the AIDS epidemic, three decades in which the disease has killed 30 million people worldwide. But strides in understanding HIV/AIDS, both medically and in the way we respond as a society, have been so great that today, we dare to have hope for "an AIDS-free generation." Complacency, though, cannot take root — in Hawaii, nationally or globally.

In a policy speech to the National Institutes for Health just weeks ago, Secretary of State Hillary Clinton articulated this "AIDS-free" vision: that virtually no children are born with HIV; that as teens and adults, they are at far lower risk of becoming infected than they would be today due to a range of prevention tools; and that if they do acquire HIV, they can be treated to prevent them from developing AIDS and passing the virus to others.

Key to the battle against this health scourge is the critical distinction between HIV, the human immunodeficiency virus, and the full-blown disease of acquired immune deficiency syndrome (AIDS) itself. Worldwide, an estimated 34 million people are living today with HIV; in America, about 1.2 million. In Hawaii, events today to promote awareness include one at 10 a.m. at Kapiolani Community College and one at 5 p.m. at the state Capitol.

Encouraging news from the UNAIDS 2010 report shows that overall growth of the global epidemic appears to have stabilized; the yearly number of new HIV infections has steadily declined over the past two decades; and there are fewer AIDS-related deaths, thanks to antiretroviral treatments in the past few years.

In the United States, the fight against the fatal, mysterious disease that would later be called AIDS began in June 1981. Its first victims were young gay men, dying from rare forms of pneumonia and cancer. Virtually nothing was known about the disease then; today, we largely understand how it spreads, mutates, responds. "Now, AIDS is still an incurable disease," Clinton said, "but it no longer has to be a death sentence."

Over the 30 years, we learned a lot about ourselves — and it wasn’t always pretty, especially in the early years. Fears of the unknown reigned then, understandably, but how that manifested itself in some quarters turned downright ugly. Because of the early prevalence among gay men, homophobia intensified in some communities. Misinformed haters called the deaths a rightful plague that punished the lifestyle.

But it soon became clear that this disease, like others, does not discriminate. Men and women, straight and gay, became afflicted; so, too, did children. HIV transmission occurs via bodily fluids in many ways: sex, blood transfusion, contaminated needles, between mother and baby during pregnancy or breastfeeding.

The life of Indiana teen Ryan White, a hemophiliac who contracted AIDS from tainted blood, was a crucial turning point in understanding the disease medically and in tamping unfounded fears. When he died in 1990, his actions against discrimination in school, and national efforts for research and public education left a profound legacy. So, too, did public figures like Elizabeth Glaser, afflicted by a blood transfusion while giving birth, and Magic Johnson, who has kept his HIV controlled since 1991 with a daily medical regimen.

The calmer national attitude opened support, and funds, for needed research. Science, not fear or prejudice, drives action toward breakthrough, toward the chance of an AIDS-free generation. Thirty years later, that’s progress.