When Pauli Gray, a veteran community and volunteer educator at the San Francisco AIDS Foundation, flew to Addis Ababa to train hotline counselors for Ethiopia's Wegen Helpline, he brought 25 years of HIV/AIDS activism along with him.

Pauli has worked at SFAF for ten years. He has taught volunteers and staff how to respond to callers on the California AIDS Hotline. He has equipped volunteers for the HIV Prevention Project, distributing clean syringes and injecting equipment at needle exchange sites throughout the city. And he has done all of this with a consummate interest in the mental and physical health of our clients. But while Pauli Gray's accomplishments are his own, he stands on the shoulders of thousands who devised and refined the community-based solutions now being deployed in resource-limited countries in Africa, Asia and Latin America, where HIV is exploding.

In the public health community, people often talk about global and domestic HIV/AIDS as if they were two separate epidemics. While the differences are stark, from the number of people affected to the lack of treatment access for those infected, the global HIV/AIDS pandemic and the epidemic that began in the United States more than 25 years ago have roots in the same virus.

The lessons of community activists -- individuals like Reggie Williams, Laura Thomas, and Martin Delaney, groups like ACT UP and TAG, and service organizations like Shanti, Project Inform, and of course, the San Francisco AIDS Foundation -- are called upon every day to inform similar responses in the developing world. Actions developed in San Francisco, New York, and Chicago are being deployed in Cape Town, Phnom Penh, and Kiev as these communities shape culturally appropriate strategies for addressing local epidemics. In turn, the experiences of international activists illuminate policy and advocacy efforts back in the U.S.

Although local circumstances vary throughout the world, lessons learned in one place resonate elsewhere. For instance, we've learned that people living with HIV should have an understanding of their condition, the medications they need, their cost and their possible side effects. AIDS rewrote the script of doctor-patient communication for many illnesses and alerted drug manufacturers that their marketing and promotional efforts would face serious scrutiny from the community.

We've seen that government and political leaders need to provide bold leadership -- from national prevention programs to expanding access to treatment and care. In spite of epidemics that might easily have exploded, the few developing countries whose national response was swift and urgent, such as Brazil, Thailand, and Uganda, saw dramatically reduced HIV/AIDS rates and became regional models.

Above all else, we've learned that frank discussions of sexuality and drug use are vital to teaching people how to stay safe. No matter where people live, the prevention information they receive must be based on scientific evidence about HIV transmission, not determined by ideological agendas. Discomfort about potentially risky behavior, including anal intercourse and injecting drug use, must not keep the life-saving messages of safer sex and harm reduction from people vulnerable to infection.

In the United States, more than one million people are estimated to be living with HIV. Although many are unaware that they've been infected, the opportunities for an individual to receive information about HIV prevention and treatment are far greater here than in many other parts of the world, in large part because of stalwart community activists who have been working against the odds for more than 20 years. When we bring those lessons where they are still desperately needed, we honor the vision of those who led the way.