Americans face epidemic of fear about spread of AIDS. Misunderstandings and injustice flow from deep public anxiety
| San Francisco
Much like the response to leprosy in biblical times, it is strong misconceptions about the disease AIDS that have given added force to a wave of fear sweeping the United States, say some public officials and medical experts. Because of misunderstandings about the disease, they add, many AIDS victims are receiving unjust treatment in much the same way lepers have been mistreated over the centuries.
Public reaction has sometimes bordered on hysteria, these officials say. Hospitals have refused to admit AIDS patients; schools have kept out children with the disease; employers have threatened to screen job-applicants for AIDS before hiring; local authorities have proposed screening employees in certain job categories, such as food-handling; and some have even suggested making transmission of the disease a felony.
The fear seems ``very real but it's very incorrect,'' observes Dr. John F. Murray, a professor of medicine who has treated AIDS patients at the University of California, San Francisco.
Worry about AIDS is finding a foothold in community consciousness for a variety of reasons:
AIDS is not considered medically curable. Neither is there a cure yet seen on the medical horizon.
The disease appears to be rapidly increasing. US medical officials estimate the 12,736 cases of AIDS now on record will double in 1986 and keep rising thereafter. About 500,000 to 1 million Americans are believed to have been exposed to the disease, but only 5 to 20 percent have developed the disease.
AIDS arouses deep emotions because it has been associated with homosexual and bisexual life styles. About 73 percent of the cases have been identified in this category and 17 percent of the cases have been found among illicit drug users. ``Our researchers do not believe AIDS even to be epidemic in the general population.
It may be considered epidemic in the gay community or among heavy IV [intravenous] drug users in New York City,'' explains Charles Fallis, of the Atlanta-based National Centers for Disease Control.
The disease, like leprosy, is erroneously considered communicable through casual contact. A New York Times poll last month found that about half the American people believe that it can be transmitted through casual contact. Medical experts say, however, that a direct portal into the bloodstream is believed to be the only way the disease can be spread -- which is relatively hard to do.
``Unfortunately people think that AIDS patients need to be quarantined and that's not a fact,'' says Mr. Fallis.
Misconceptions about AIDS have erected an array of challenges that go beyond medical considerations to the ethical, says Dr. Murray, and they increase the community's responsibility to understand the disease. All types of unjust treatment occur because of a lack of availability of information, he says.
The disease, in fact, has raised some basic civil rights issues. For example, in some areas in the US it has been suggested that paramedics and police not be required to give a suspected AIDS victim emergency help such as mouth-to-mouth resuscitation. One problem arising from this, civil rights activists say, is that a person could be denied that help simply because he looked like a homosexual or a drug user, two of the largest categories of AIDS victims.
Another example of the confusion over AIDS is the paradox over hospitalization of its victims. Some hospitals have refused to take AIDS patients while, elsewhere, there has been talk of forced hospitalization of AIDS victims.
``There's a moralistic tenor to this disease and we need to educate the public that this is a health problem and not a moral problem. We don't need to punish the victims,'' explains Dr. Michael Gorman, Epidemic Intelligence Service Officer with the National Centers for Disease Control (CDC).
There are those, however, who do see the disease as a moral issue. For example the National Council of Churches (NCC) reports a great diversity in response to the issue among its member churches.
``There are two viewpoints,'' explains Carol Fouke, director of news services for the NCC. ``Some would say that while they feel compassion [for AIDS victims] this is obviously God's punishment [for those involved in homosexual behavior and illicit drug use], while others see it as a critical pastoral issue.''
``So far the religious community in general has not reacted to this appropriately,'' comments Dr. John Frame, director of the Associated Mission Medical Office of the NCC. He says a great portion of the religious community ``believes this is a punishment from God for human misbehavior.''
Dr. Frame and others in the religious and medical communities see promiscuity as being a key problem since it enables the disease to spread more rapidly. This, therefore, is one aspect coming near the heart of what many see as the moral issue. Some members of the homosexual community itself concede that a tolerance for promiscuity has made the AIDS crisis worse.
Dr. Frame says there is ``no question that among gays there is a completely different approach [to their sexual life styles]. There's an increasing sense of responsibility'' as a result of the AIDS situation. But he claims that, because the moral issue remains in dispute, churches have often shown less compassion than the gay community in responding to the human need in the AIDS cases.
Often it is not clear whether discriminatory treatment is rooted in the fear of AIDS or in the basic moral dilemma over homosexuality, says Nancy Langer, of the Lambda Legal Defense and Education Fund, a gay rights organization specializing in homosexual civil rights cases. But the organization reports that AIDS discrimination often affects more than just homosexual victims.
AIDS victims of all backgrounds are targets of unfair treatment, says Dr. Gorman.
There are two ways -- the right and the wrong -- that communities have reacted to the disease, says Dr. Fred Kroger, deputy director of the Division of Health Education for the CDC.
``The Indiana boy,'' says Dr. Kroger of one of the young AIDS victims who have not been allowed to attend school, ``is the absolute classic example of hysteria. It suggests that the strength of hysteria goes beyond people's ability to deal with the problem rationally. After you lay out the medical facts people say `yes, but . . .' and they refuse to believe the facts.''
``Los Angeles on the other hand approached the issue by passing an ordinance making it illegal to discriminate against AIDS victims,'' says Kroger. ``This suggests that if a group is well-educated you can head off the hysteria.''
Deborah Gemmiti, the nationwide AIDS hot-line manager for the National Centers for Disease Control, monitors hundreds of calls to the hot line and says that ``paranoia'' swings like a loose cannon. For example, Haitians were a target for discrimination when they were identified early-on as a high risk AIDS group. That has largely passed, and now the homosexual community is the broader target for discrimination.
US health officials admit that AIDS education was slow to be promoted and that this may be a reason for many of the problems that exist now for AIDS victims.
But a study of nine high-risk cities by the National Centers for Disease Control shows a proliferation of state, federal, local, and private funding behind education programs.