Elizabeth Pisani is an epidemiologist—someone studying the origin and trajectory of diseases. She’s also a journalist and an exceptionally good storyteller who has spent the bulk of her professional life in Southeast Asia, researching the spread of HIV and AIDS among those engaged in the sex trade in Asia, gay and straight. Her book, “The Wisdom of Whores: Bureaucrats, Brothels and the Business of AIDS” is, more than a report, a funny and deeply personal memoir, written to spur the average reader into emotion and action.

You really enjoy challenging the conventional wisdom about HIV and AIDS in your book—and it’s very funny, too.
I’ll tell you something funny about writing this book. I didn’t write it for people in the AIDS industry because those people already know this stuff. They may not want to look at or acknowledge it, and I’m one of the few who has been willing to say it openly. I’ve been saying these things from inside the industry for a long time, and I know many agree with me. I also know we’re not moving beyond a kind of inertia and that it’s difficult to move anything unless you shake it up from outside. One of the interesting things is that what upsets people in the AIDS industry seems just like common sense to those who are not.

You cover the science of HIV/AIDS research, but what of the psychological aspects of people like the waria in Indonesia—that whole transgender class?
The “why” is more part of my personal life, and I’m fortunate that my professional life lets me make friendships with really interesting people, so I’ve learned a fair bit of the “why” through investigating the “what” and the “how often”? If it’s about waria specifically, one fascinating thing is the extent to which social acceptance of a third gender in Indonesia is being altered by the slow acceptance of a gay identity. I should add that waria are not just in Indonesia but many Southeast Asian cultures; third genders exist in societies that haven’t traditionally accepted homosexuality.

Indonesia is a Muslim-majority nation, too.
It’s beginning to seep into the culture there, just as it took a very long time to seep in here. I think Indonesia looks a lot like the U.S. in the 1930s and ’40s. Did homosexuality exist? Yes. Did people want to recognize it in their families? No. Just this month Thailand banned castration in under-18s because they felt people were being pushed toward developing transgender identities at a moment when they’re still exploring different sides of themselves.

You have many anecdotes about people you know and their drug use and their sexual behaviors. Do you ever want to just shake them and tell them to stop it?
You want to slap them upside the head! It’s not just Indonesia and Southeast Asia that I feel this way. A few months ago in London, I’m talking to a new friend, absolutely delightful, and we’re chatting about esoteric Chinese movies and what he does and what I do. And he says, “I was diagnosed a year ago.” He’s 20 years old.

Just like stories in your book.
I said to him, “You idiot!” I mean, it actually came out of my mouth. He said, “Thank you for saying that…I know people are thinking it. We all do dumb things all the time.” And that’s how I deal with it—we all do dumb things related to sex and drugs at times in our lives. I happen to deal with a disease related mostly to both of them. The thing is, we tend to be dumb sort of cyclically in our lives. I call them “slutty phases”—your late teens and most of your 20s, too. Then you get into a relationship and everything nice and lovely, and then you dump him because all he wants to do is golf, and then you go through another slutty phase. If you’re punishing people, not keeping them safe—I mean, let’s just try and help people go through the dumb phases in a sensible way, without having them contract a fatal disease.

Can you explain more about the rise and fall and rise of HIV infection rates?
Pre-AIDS we had a joke: What’s the difference between love and herpes? Love is forever. Today I find it’s really two things. There’s what I call the survivor generation: people who lived the epidemic, people who came of age in the era of safe sex, but still spent a lot of time at funerals and seeing people getting sick and dying. Then when treatment came in 1995 and ’96, it vanished just overnight, or so it seems. AIDS—the disease that goes with HIV, it’s ugly, visible face—essentially evaporated from the public consciousness. It’s not visible in the same way that it was pretreatment and that has allowed certain behaviors to resume.

You express shock at some of the infection statistics you’ve discovered—do you have to have a cast-iron stomach for the stories that go with them?
You need a cast-iron stomach for the nonsense in the political realm—how politicians are not dealing with this thing that we know how to deal with. I’m saying we’ve got to prevent it, but it’s not a fatal disease—it’s an incurable disease that’s not necessarily fatal. More and more we fail to recognize what motivates people to get infected, what’s involved in getting high and getting laid. Unless we deal with that more honestly, we’re not going to get over it.