AIDS is a life and death issue. To have the AIDS disease is at present a
senten,ce of slow but inevitable death. I've already lost one friend to AIDS. I
may soon lose others. My own sexual behavior and that of many of my friends has
been profoundly altered by it. In my part of the country, one man in 10 may
already be carrying the AIDS virus. While the figures may currently be less in
much of the rest of the country, this is changing rapidly. There curreently is
neither a cure, nor even an effective treatment, and no vaccine either. But
there are things that have been PROVEN immensely effevctive in slowing the
spread of this hideously lethal disease. In this essay I hope to present this
information. History and Overview: AIDS stands for Acquired Immune Defficiency
Disease. It is caused by a virus. The disease origiunated somewhere in Africa
about 20 years ago. There it first appeared as a mysterious ailment afflicting
primarily heterosexuals of both sexes. It probably was spread especially fast by
primarily female prostitutes there. AIDS has already become a crisis of
STAGGERING proportions in parts of Africa. In Zaire, it is estimated that over
twenty percent of the adults currently carry the virus. That figure is
increasing. And what occurred there will, if no cure is found, most likely occur
here among heteroosexual folks. AIDS was first seen as a dise.ase of gay males
in this country. This was a result of the fact that gay males in this culture in
the days before AIDS had an average of 200 to 400 new sexual contacts per year.
This figure was much higher than common practice among heterosexual (straight)
men or women. In addition, it turned out that rectal sex was a particularly
effective way to transmit the disease, and rectal sex is a common practice among
gay males. For these reasons, the disease spread in the gay male populsation of
this country immensely more quickly than in other populations. It became to be
thought of as a "gay disease". Because the disease is spread primarily
by exposure of ones blood to infected blood or semen, I.V. drug addicts who
shared needles also soon were identified as an affected group. As the AIDS
epidemic began to affect increasingly large fractions of those two populations
(gay males andd IV drug abusers), many of the rest of this society looked on
smugly, for both populations tended to be despised by the "mainstream"
of society here. But AIDS is also spread by heterosexual sex. In addition, it is
spread by blood transfusions. New born babies can acquire the disease from
infected mothers during pregnancy.more and more "mainstream" folks got
the disease. Most recently, a member of congress died of the disease. Finally,
even the national news media began to join in the task of educating the public
to the notion that AIDS can affect everyone. Basic medical research began to
provide a few bits of information, and some help. The virus causing the disease
was isolated and identified. The AIDS virus turned out to be a very unusual sort
of virus. Its genetic material was not DNA, but RNA. When it infected human
cells, it had its RNA direct the synthesis of viral DNA. While RNA viruses are
not that uncommon, very few RNA viruses reproduce by setting up the flow of
information from RNA to DNA. Such reverse or "retro" flow of
information does not occur at all in any DNA virus or any other living things.
Hence, the virus was said to belong to the rare group of virues called
"Retro Viruses". Research provided the means to test donated blood for
the presence of the antibodies to the virus, astronomically reducing the chance
of ones getting AIDS from a blood transfusion. This was one of the first real
breakthroughs. The same discoveries that allowed us to make our blood bank blood
supply far safer also allowed us to be able to tell (in most cases) whether one
has been exposed to the AIDS virus using a simple blood test. The Types of AIDS
Infection: When the AIDS virus gets into a person's body, the results can be
broken down into three general types of situations: AIDS disease, ARC, and
asymptomatic seropositive condition. The AIDS disease is characterized by having
one's immune system devastated by the AIDS virus. One is said to have the
*disease* if one contracts particular varieties (Pneumocystis, for example) of
pneumonia, or one of several particular varieties of otherwise rare cancers (Kaposi's
Sarcoma, for example). This *disease* is inevitably fatal. Death occurs often
after many weeks or months of expensive and painful hospital care. Most folks
with the disease can transmit it to others by sexual contact or other exposure
of an uninfected person's blood to the blood or semen of the infected person.
There is also a condition referred to as ARC ("Aids Related Complex").
In this situation, one is infected with the AIDS virus and one's immunesystem is
compromised, but not so much so that one gets the (ultimately lethal) cancers or
pneumonias of the AIDS disease. One tends to be plagued by frequent colds,
enlarged lymph nodes, and the like. This condition can go on for years.One is
likely to be able to infect others if one has ARC.Unfortunately, all those with
ARC are currently felt to eventually progress to getting the full blown AIDS
disease. There are, however many folks who have NO obvious signs of disease what
so ever but when their blood serum is tested they show positive evidence of
having been exposed to the virus. This is on the basis of the fact that
antibodies to the AIDS virus are found in their blood. Such "asymptomatic
but seropositive" folks may or may not carry enough virus to be infectious.
Most sadly, though, current research and experience with the disease would seem
to indicate that EVENTUALLY nearly all folks who are seropostive will develop
the full blown AIDS disease. There is one ray of hope here: It may in some cases
take up to 15 years or morebetween one's becoming seropositive for the AIDS
virus and one's developing the disease. Thus, all those millions (soon to be
tens and hundreds of millions) who are now seropositive for AIDS are under a
sentence of death, but a sentence that may not be carried out for one or two
decades in a significan fraction of cases. Medical research holds the
possibility of commuting that sentence, or reversing it. There is one other fact
that needs to be mentioned here because it is highly significant in determining
recommendations for safe sexual conduct which will be discussed below:
Currently, it is felt that after exposure to the virus, most folks will turn
seropositive for it (develop a positive blood test for it) within four months.
It is currently felt that if you are sexually exposed to a person with AIDS and
do not become seropositive within six monthsafter that exposure, you will never
become seropositive as a result of that exposure. Just to confuse the issue a
little, there are a few folks whose blood shows NO antibodies to the virus, but
from whom live virus has been cultured. Thus, if one is seronegative, it is not
absolute proof one is not exposedothe virus. This category of folks is very hard
to test for,and currently felt to be quite rare. Some even speculate that such
folks may be rare examples of those who are immune to the effects of the virus,
but this remains speculation. It is not known if such folks can also transmit
the virus. Transmission of AIDS: The AIDS virus is extremely fragile, and is
killed by exposure to mild detergents or to chlorox, among other things. AIDS
itself may be transmitted by actual virus particles, or by the transmission of
living human CELLS that contain AIDS viral DNA already grafted onto the human
DNA. Or both. Which of these two mechanisms is the main one is not known as I
write this essay. But the fact remains that it is VERY hard to catch AIDS unless
one engages in certain specific activities. What will NOT transmit AIDS? Casual
contact (shaking hands, hugging, sharing tools) cannot transmit AIDS. Although
live virus has been recovered from saliva of AIDS patients, the techniques used
to do this involved concentrating the virus to extents many thousands of times
greater than occurs in normal human contact, such as kissing (including
"deep" or "French" kissing). Thus, there remains no solid
evidence that even "deep" kissing can transmit AIDS. Similarly, there
is no evidence that sharing food or eating utensils with an AIDS patient can
transmit the virus. The same is true for transmission by sneezing or coughing.
There just is no current evidence that the disease can be transmitted that
way.The same may be true even for BITING,though here there may be some increased
(though still remote) chance of transmitting the disease. The above is very
important. It means that there is NO medical reason WHAT SO EVER to recommend
that AIDS suffers or AIDS antibody positive folks be quarrantined. Such
recommendations are motivated either by ignorance or by sinister desires to set
up concentration camps. Combined with the fact that the disease is already well
established in this country, the above also means that there is no rational
medical basis for immigration laws preventing visits by AIDS suffers or antibody
positive persons. The above also means that friends and family and coworkers of
AIDS patients and seropostive persons have nothing to fear from such casual
contact. There is no reason to not show your love or concern for a friend with
AIDS by embracing the person. Indeed, there appears still to be NO rational
basis for excluding AIDS suffers from food preparation activity. Even if an AIDS
suffer cuts his or her finger and bleeds into the salad or soup, most of the
cells and virus will die, in most cases, before the food is consumed. In
addition, it is extremely difficult to get successfully attacked by AIDS via
stuff you eat. AIDS cannot be transmitted by the act of GIVING blood to a blood
bank. All equipment used for such blood donation is sterile, and is used just
once, and then discarded. How is AIDS transmitted? Sexual activity is one of the
primary ways AIDS is transmitted. AIDS is transmitted particulary by the
transmission of blood or semen of an infected person into contact with the blood
of an uninfected person. Sex involving penetration of the penis into either the
vagina of a woman or the rectum of either a woman or a man has a very high risk
of transmitting the disease. It is felt to be about four times MORE likely for
an infected male to transmit AIDS to an uninfected woman in the course of
vaginal sex than it is likely for an infected woman to transmit AIDS to an
uninfected male. This probably relates to the greater area of moist tissue in a
woman's vagina, and to the relative liklihood of microscopic tears to occur in
that tissue during sex. But the bottom line is that AIDS can be transmitted in
EITHER direction in the case of heterosexual sex. Transmission among lesbians
(homosexual females) is rare. Oral sex is an extremely common form of sexual
activity among both gay and straight folks. Such activity involves contact of
infected semen or vaginal secretions with the mouth, esophagus (the tube that
connects the mouth with the stomach) and the stomach. AIDS virus and infected
cells most certainly cannot survive the acid environment of the stomach. Yet, it
is still felt that there is a chance of catching the disease by having oral sex
with an infected person. The chance is probably a lot smaller than in the case
of vaginal or rectal sex, but is still felt to be significant. As mentioned
above, AIDS is also transmitted among intravenous drug users by the sharing of
needles. Self righteous attitudes by the political "leaders" of this
country at local, state, and national levels have repeatedly prevented the very
rational approach of providing free access to sterile intravenous equipment for
IV drug users. This measure, when taken promptly in Amsterdam, was proven to
greatly and SIGNIFICANTLY slow the spread of the virus in that population. The
best that rational medical workers have succeeded in doing here in San Francisco
is distribute educational leaflets and cartoons to the I.V. drug abusing
population instructing them in the necessity of their rinsing their
"works" with chlorox before reusing the same needle in another person.
Note that even if you don't care what happens to I.V. drug abusers, the increase
in the number of folks carrying the virus ultimately endangers ALL living
persons. Thus, the issue is NOT what you morally think of I.V. drug addicts, but
one of what is the most rational way to slow the spread of AIDS in all
populations. Testing of donated blood for AIDS has massivly reduced the chance
of catching AIDS from blood transfusions. But a very small risk still remains.
To further reduce that risk, efforts have been made to use "autotransfusions"
in cases of "elective surgery" (surgery that can be planned months in
advance). Autotransfusion involves the patient storing their own blood a couple
of weeks prior to their own surgery, to be used during the surgery if needed.
Similary, setting up donations of blood from friends and family known to be
antibody negative and at low risk for AIDS prior to schedualed surgery further
can decrease the already small risks from transfusion. AIDS and SEX: What are
the rational options? The "sexual revolution" of the 1960's has been
stopped dead in its tracks by the AIDS epidemic. The danger of contracting AIDS
is so real now that it has massively affected the behavior of both gay and
straight folks who formerly had elected to lead an active sexual life that
included numerous new sexual contacts. Abstinence The safest option regarding
AIDS and sex is total abstinence from all sexual contact. For those who prefer
to indulge in sexual contact, this is often far too great a sacrifice. But it IS
an option to be considered. Monogamy For those who would have sexual activity,
the safest approach in this age of AIDS is monogamous sex. Specifically, both
parties in a couple must commit themselves to not having sex with anyone else.
At that time they should take AIDS antibody tests. If the tests are negative for
both, they must practice safe sex until both members of the couple have been
greater than six months since sexual contact with anyone else. At that time the
AIDS blood test is repeated. If both tests remain negative six months after
one's last sexual contact with any other party, current feeling is that it is
now safe to have "unprotected" sex. Note that this approach is
recommended especially for those who wish to have children, to prevent the
chance of having a child be born infected with AIDS, getting it from an infected
mother. Note also that this approach can be used by groups of three or more
people, but it must be adhered to VERY strictly. What to AVOID: Unscrupulous
folks have begun to sell the idea that one should pay to take an AIDS antibody
test, then carry an ID card that certifies one as AIDS antibody negative, as a
ticket to being acceptable in a singles bar. This is criminal greed and
stupidity. First, one can turn antibody positive at any time. Even WEEKLY
testing will not pick this change up soon enough to prevent folks certified as
"negative" from turning positive between tests. Much worse, such cards
are either directly or implicitly promoted as a SUBSTITUTE for "safe
sex" practices. This can only hasten the spread of the disease. If you want
to learn your antibody status, be sure to do so ANONYMOUSLY. Do NOT get the test
done by any agency that requires your real name, address, or any other
identifying information. Fortunately, in San Francisco, there is a public place
to get AIDS antibody testing where you may identify yourself only as a number.
Tho that place has a three month long waiting list for testing, there are other
private clinics where one may have the test done for cash, and may leave any
false name one wishes. The reason I suggest this is that currently there are
some very inappropriate reactions by government and business to folks known to
be antibody positive. Protect yourself from such potential persection by
preventing your antibody status from being a matter of record. That information
is for you, your lover(s), and (if need be) your physician. And for NO one else
In Conclusion: It is my own strongly held view, and that of the medical and
research community world wide, that the AIDS epidemic is a serious problem, with
the potential to become the worst plague this species has ever known. This is
SERIOUS business. VASTLY greater sums should be spent on searching for
treatments and vaccines. On the other hand, we feel strongly that this is
"merely" a disease, not an act by a supernatural power. And while it
does not seem likely we will find either a cure or a vaccine in the forseeable
future, it may be that truly effective treatments that can indefinitely prolong
the life of AIDS victims may be found in the next few years. When science and
technology do finally fully conquer AIDS, we can go back to deciding what sort
and how much sex to have with who ever we choose on the basis of our own
personal choice, and not by the coercion of a speck of proteins and RNA. May
that time come soon. In the mean time, we must all do what we can to slow the
spread of this killer. This article is intended to help accomplish that. Please
circulate it as widely as possible.