And babies come from the stork. . .

The UN agency coalition known as UNAIDS long has insisted that countries everywhere formulate a national plan to address HIV/AIDS. In fact, the half-dozen cooperating bodies in UNAIDS, such as UNESCO, UNICEF and WHO, slowly made their very ample AIDS funding contingent upon it. But one yawning irony in this correct if rather coercive ‘suggestion’ is that the largest donor to these multilateral bodies—the United States—has not had a similar plan for itself despite the 1.1 million people estimated to be living with HIV within our borders.

The Obama White House corrected that anomaly Tuesday with the launch of its National HIV/AIDS Strategy for the United States, a product of extensive consultations including 14 community forums around the country in recent months. It’s not a bad document, and the presenters, including HHS Secretary Sibelius and her top deputy along with the White House AIDS policy guy, Jeff Crowley, hit many of the right notes.

I was following a live blog of some of the old-time advocates and nonprofit folks, and they were guardedly positive about the document and the officials’ comments. There is recognition of the need to target prevention work among the hardest-hit groups, no shyness about explicitly mentioning IV drug users and gay/bisexual men, attention to the ongoing impact of HIV-related stigma, proposals for handling certain funding needs while waiting for the 2014 health reforms to kick in. And so on.

What I found sorely missing, however, was one three-letter word that appeared neither in the hour-long unveiling of the plan or in the document itself: sex.

Sure, there were plenty of references to heterosexuals, bisexuals, sex partners, sex disparities and the god-awful neologism, ‘men who have sex with men (MSM)’. There was even a brief nod to the need for an approach to sexual health of which HIV prevention would comprise a part.

But any idea that we should reverse the decades of intimidation by yahoo Christian sexophobes and resuscitate the discussion about sex and sexuality that our society requires was entirely absent. For example, there’s no mention in the Strategy of sex education as if we could generate knowledgeable and prepared young people—many of them born after HIV became a chronic illness—without providing them with competent and comprehensive training in the workings of sex, gender, desire and romance as the Europeans have shown can be done.

On this front the Obama team, like the cowed Democratic Party it leads, has ceded the center stage to the abstinence-only Bible-thumpers. Unwilling to assume any political costs by recognizing the obvious—that marriage and sex have been effectively delinked for vast swaths of our population—they pretend to lead a national campaign to reduce new HIV infections by 25 percent without a national conversation about the main way it is transmitted—via the genitals.

Without that conversation, I fail to see how any of the ‘targeted’ interventions that are supposed to get gay men or straight guys with multiple partners to consider their behavior are going to work. I’ve hung around some of the gay bars of New York for six years now since coming back from South America, and I can confidently attest that there is NOTHING happening in that ambiance related to HIV or sexual behavior except what people are working out on their own, one by one, partner by partner.

But community noise about HIV or sexual practices to avoid it? Totally last year. Last decade. Decade before that. Nada, zip, zero. I have not seen in these six years one poster, one flier, one announcement, one ad on the ubiquitous video screens about managing sexual practices. Oh, there is plenty of buzz to support the main agencies, join the AIDS walk, support the new treatments or volunteer for the vaccine research. But the ‘safe-sex’ discussion of yesteryear is history.

I attribute the silence to the religious fanatics’ hysterical screaming about immorality and abstinence and their clever leveraging of the ‘social issues’ into seats in Congress and several presidencies. Obama’s plan suggests there is little stomach for standing up to them.