How much could US policies have reduced the initial growth of the epidemic had we moved earlier to institute Harm Reduction drug policies such as needle exchange programs for injecting drug users? The US Centers for Disease Control estimates 50 000 HIV infections annually in the United States (156 per million population), but the more populous European Union estimates 5000 (less that 10 per cent of the US incidence) - a measure of the failure of US prevention policies for HIV. The earliest official responses to AIDS in the United States expressed official fear and condemnation of victims and denial of the magnitude and seriousness of the population risks in the epidemic's early stages. These failures with AIDS prefigure current US crises in general health policies and interfere with efforts to successfully inform public understanding of the meaning and value of scientific evidence about health have diminished public confidence in credibility and trustworthiness of professional and political leadership for US health polices.