Who Says Aids Is Hard To Get

Kramer, a writer who is HIV-positive, is cofounder of Gay Men's Health Crisis, and the founder of ACT UP, a worldwide network pledged to ending the AIDS plague.

I believe I know as much about AIDS as it's possible to know. When I first became aware of this disease, there were only 41 cases in the United States; now there are 12 million people infected with AIDS around the world; within the next eight years this figure could rise to 40 million. From 41 to 40 million should be enough not only to cause a level of panic, but also to make everyone ask: how is this plague spreading so quickly.? Indeed, 1 million people worldwide were infected with the AIDS virus last year alone.

I wonder if-despite everything we're being led to believe-AIDS is spread in ways we don't yet know about. These figures are growing with such alarming rapidity that I wonder if AIDS is transmitted in ways other than sex, dirty needles and infected blood.

In 1983, when the Centers for Disease Control presented these as the sole and definitive routes of transmission, interest in investigating any other possible routes or co-factors all but ceased. Meanwhile, we're testing for only one agent, the human immunodeficiency virus (which we are constantly told is "the cause " of AIDS). This concerns some scientists and doctors who have always thought it illogical there should be only one causative agent.

The test currently utilized to determine infection by HIV tests only for HIV-1, the most common American strain of the virus. However, HIV-2 is the dominant strain in Africa, and cases of HIV-2 infected people are showing up in America. Thus it can be said that the present U.S. "AIDS test " becomes more useless every day. (HIV-2 testing may at last become mandatory starting in June, according to the Food and Drug Administration.)

More worrisome, I wonder if this disease is much easier to catch than we are being told. We are constantly calmed with reassurances that sweat and saliva and kissing, for instance, are harmless. Perhaps they are, but there are no conclusive studies to eliminate these things totally. (At least they are not conclusive to me; I have been unimpressed by almost all of the AIDS researchers I've met.) And don't forget, the present length of incubation of the HIV virus in the body now exceeds 10 years. For the untested, there is no way of knowing if AIDS will develop until this lengthy incubation period has passed. And, as I have said, even those tested cannot be completely at ease.

But what is there out there that we don't yet know about? Are not 40 million infected people trying to tell us that something else-another means of transmission, say--might be going on?

I wonder if the world blood supply is safe. In France last year a major scandal broke involving the distribution of HIV-contaminated blood to hemophiliacs and other transfusion recipients. Of 3,000 known hemophiliacs in 1985, 1,200 are now HIV-positive. Transfusion patients also contracted the AIDS virus after receiving blood that government officials had reason to believe might be infected. Blood, too, is tested only for HIV-1 and not for HIV-2 or any other possible cofactor.

It cannot be stressed enough that many of the statements about AIDS put out as facts by the medical, scientific and bureaucratic representatives of the U.S. government have proved to be wrong or misleading. Trial and error is always present in any kind of new research, but I would feel a lot better if the government hadn't always been so inattentive to the AIDS crisis. The incubation period for full-blown AIDS was first said to be two years. Then three years. Then four, five and on and on until now it is more than 10. In 1986 the drug AZT was hyped as a breakthrough. Next, combination antiviral therapies and interferons were heralded as lifesavers. But every treatment in development is turning out to be a dud. Health-care workers are claimed to have remained uninfected but in fact some are infected. We are told infected health-care workers are not a risk to those they care for, yet there is no study to prove this. We have bought all our reassurances from people who are politically invested in painting the rosiest picture possible.

I wonder if everything being reported to the world by these bureaucrats is being reported simply in an attempt to stem a panic-a panic that I think is entirely justified. Since the state of AIDS research is still in the Stone Age, mainly because two presidents in a row have largely ignored it, I believe there is enormous cause for fear. How can we completely avoid contracting something we can't accurately test for and that might not be the sole cause of this plague even if we could?

The world must face the unfortunate fact that, after some 11 years of government apathy, precious little is known about AIDS, about the various causes of AIDS and about how this plague is being spread.

I have no idea if I am right or wrong about any of these explosive thoughts and worries and fears of mine, which I know are shared by a great many others. But I believe it can only be constructive to air them with the hope that, finally and at last, some intelligent attention might be paid to them.

Better still, presidents and congresspersons could worry less about who is giving what to whom and-also finally and at last--commence an all-out research effort to find the cure. As matters now stand, those 40 million HIV-infected people can all reasonably expect to die.