Stigma. This is a word that we in the West do not understand. We may be embarrassed to admit we attended an “inferior” school and hem and haw when asked where we went. That is not real stigma. Ask someone who is HIV+ in Western Kenya. Stigma for them means they would rather sell all their land and be on death’s door before seeking AIDS medication, despite having 8 dependents. We know nothing about that.

Traveling to the farm of a 79 year old HIV+ man living with his two sons, caring for all their children plus for eight children left to him by his HIV+ daughters, I saw nearly no one my age: there were children under twelve, and adults over 50. Gaggles of children, radiant with their smiles. A stark contrast to the kick in the gut I felt from the enormity of the challenge for those who are HIV+, the difficult yet vital task of the team I was with. So much joy, yet so much hardship. Life on an acre of maize, or less: How to survive? And thrive? Is it possible?

The Academic Model for the Prevention and Treatment of HIV (AMPATH) is one of Kenya's most comprehensive initiatives to combat HIV. AMPATH is a working model of urban and rural HIV preventive and treatment services in the public sector. AMPATH cares for more than 48,000 HIV infected adults and children, with nearly one-half of all patients on anti-retroviral drugs, and enrollment into the program rising by 2,000 patients per month. A robust program to prevent mother to child transmission of HIV has been initiated including an opt-out testing policy and programs fostering triple anti-retroviral therapy of pregnant woman and formula feeding of newborns. AMPATH has implemented programs that foster food and economic security for HIV infected persons and their families. AMPATH demonstrates the power of US and African academic medical centers united by common vision.