Sex sells and Elizabeth Pisani knows this. If you ask her she's in the 'sex and drugs' business. That would be true, except for the fact that she's actually an epidemiologist, who has written a fascinating - and controversial - book on the history and politics of HIV/AIDS.

In The Wisdom Of Whores: Bureaucrats, Brothels, And The Business Of AIDS she argues that the Bush Administration - and, of course, the US Congress that went along with the plan - bears a large responsibility for a continued rise in global HIV infections.

Pisani writes that the Bush Administration's take-it-all-or-leave-it approach to HIV/AIDS world prevention funding - about $65 billion - leaves most of it wasted. Governments accepting the aid cannot use it for the most effective prevention programs – programs that specifically target the sex industry (such as educating prostitutes and clean needle programs). The money can only be used for promoting abstinence, an ineffective strategy for dealing with the disease. Not only are US dollars attached with this string, rules also stipulate that a government accepting aid from the US for AIDS abstinence programs cannot use its own taxpayers' money for programs that engage the sex industry . This rule is called the Loyalty Oath. Some countries, such as Brazil, have refused the aid altogether.

Where governments have accepted the aid, Pisani says, the programs do little in combating the spread of the disease. In Africa, where the disease is widespread, Bush's policy has meant higher infections. That's because abstinence programs reach the people least likely to contract HIV.

In fact, Pisani writes, the most effective strategy for combating the disease is to target the people, and their behaviors, most at risk: Gay men, prostitutes and drug addicts. And, in fact, that's just the problem. If the risk of heterosexual infection is small, then can governments expect the support of the general population in funding prevention – and even research - programs?

Pisani says the answer to that question is no. With the exception of Africa – where, she explains, heterosexuals have multiple simultaneous sexual partners – there is little risk of infection in the heterosexual population. Then, what about all the data and grim scenarios of a world pandemic?

Politics, explains Pisani. AIDS organizations, suchs as UNAIDS, understood the need to “massage” the information in order to make it palatable for politicians and voters. For there to be an interest in the story, these leaders felt there needed to be an ongoing threat to all of humanity.

Back to sex selling, then. If Pisani's book is about anything it's about sex, sex, and sex. And the reality on the ground - who acquires HIV and why. She argues that white-picket fencing the problem is not helping. Pisani wants governments to look at the disease differently: From a cultural behavior standpoint. Honest programs that reach at-risk groups – gay men, prostitutes, and drug addicts – would help stem the rise of new infections.

“It would mean spending lots more of the available money on prostitutes, addicts and gay guys, and lots less on school kids, pregnant women and church groups,” Pisani writes. “It would mean making fun things (sex, drugs) safer, instead of trying to make safe things (abstinence, monogamy) fun.”