On this World AIDS Day, the focus is on prevention justice, a paradigm shift in understanding the epidemic: HIV transmission is a social condition that requires systemic change.

Julie Davids is the Executive Director of CHAMP (Community HIV/AIDS Mobilization Project).

Twenty years ago, AIDS was burning through the country and decimating whole communities while Reagan fiddled away. ACT UP New York burst onto the scene with a rallying cry of "drugs into bodies," shutting down Wall Street over the price of AZT, the only treatment and the most expensive drug ever marketed.

The group grew into a powerful and innovative social force—with hundreds of independent chapters worldwide—and racked up hard-won victories from the accelerated approval of the drugs that turned around the epidemic in the U.S., to changing the very definition of AIDS, to include the conditions seen in women and injection drug users so they could access research and benefits, to the establishment of underground and legalized needle exchanges, to the vigilant defense of the civil and human rights of people living with HIV.

Julie Davids is the Executive Director of CHAMP (Community HIV/AIDS Mobilization Project).

Imagine that you live in a country where HIV infection rates are on the rise. In your nation's capital, one out of every 20 people is HIV positive. In some socially marginalized communities, nearly half of people are HIV positive.

In this place, about half of all people who need to be taking HIV medication to stay healthy are unable to access medication on an ongoing basis, and some have died while on waiting lists for drugs. Hundreds of thousands of HIV positive people pass through prisons and jails each year, and no effort is made to coordinate education, prevention or social services for them.

If you are reading this post from the United States, you live in that country. The epidemic in Washington, DC rivals that of some African nations; people in South Carolina and West Virginia have died on waiting list for AIDS drugs; and Black gay and bisexual men, at the intersection of the gay and Black epidemics that comprise the majority of cases in our nation, have rates of HIV that average 46% across urban centers.