Interesting Times

The Ostrich Syndrome

The "ostrich syndrome" is a phrase I heard _used recently by a person with AIDS to describe his reaction to educational materials and information in general on the AIDS epidemic prior to his becoming ill The man related that he often came across materials on AIDS but chose not to read them. It was just so much easier to ignore it all This man's behavior was not unusual The "ostrich syndrome" is quite common in the gay male community of Denver.

The straight press became bored with AIDS sometime back and coverage of it has drastically decreased AIDS has not gone away, however, nor is it decreasing Dr. James Curran, Director of the AIDS program, Centers for Disease Control, speaking recently to the New York Physicians for Human Rights stated that the scope of the epidemic had been underestimated from the outset until now. Dr. Curran emphasized at this meeting that he believed AIDS would be the major cause of death for gay men into the 21st century. In a recent article in the New York Native, reporting on this meeting, it was stated "One statistical model of the epidemic projected that there would be 3,200 new cases of AIDS between January and June of 1985. Curran observed that statistical projections of AIDS cases for unmarried men over the age of fifteen in New York City would be 200 per 100,000 and that this was the same as the national fatality rate for heart disease"

All gay men need to be aware of these projec tions about the epidemic and several other issues that have arisen in the past several months around the AIDS situation. Many, but by no means all, researchers and medical authorities believe that the cause of AIDS has been found in HTLV-3, a retrovirus isolated in this country by Dr. Robert Gallo. By having a blood test done, that will soon be available, one will be able to know if he has been exposed to this virus. The test will detect the presence of antibodies to HTLV-3. Our bodies produce things called antibodies in response to the invasion of an alien organism. HTLV-3 is an alien organism and so our bodies respond to its presence by producing antibodies. This test, in the form it will be available to us, will only tell us if we have been exposed to the virus. A positive test will not necessarily mean one has been infected i.e. that the virus has been able to gain a foot hold and establish itself in one's body. If a person is positive for the antibody, it will not be known if he is infected or if he is infectious to others It will not tell one if he is immune to the disease It will not tell one if he is a chronic carrier — infecting others but not sick himself, nor will it tell him if he is going on to develop full blown AIDS. All of these scenarios are a possibility. So why are they bothering to develop this test? Because it will probably be an effective tool to use to protect the blood supply. Any blood coming into blood banks that tests positive for HTLV-3 antibody will simply. be pitched The following diagram taken from a recent article in the New York Native by Dr. Joseph Sonnabend will perhaps help in understanding this rather complicated situation. Remember that exposure is all that is needed for a positive test.

Whether or not gay men should avail themselves to this test at this time is proving to be very controversial to say the least In a study done recently in San Francisco, greater than 60% of otherwise healthy gay men were found to be positive for the antibody. This means that at some time they had been exposed to AIDS, When the test becomes available on a commercial basis, we will all have a difficult decision to make about whether to be tested or not We must remember that it will only tell us if we have been exposed and it appears that this may already be the case for a majority of gay men, at least in the large urban gay enclaves Anyone being tested at this time would want to be definitely assured that this information would remain strictly confidential One way gay men are going to be asked to be tested is in the various studies soon to be underway on AIDS. These studies could involve upwards of 200,000 subjects. Before agreeing to participate in any study that would involve the testing of one's blood for the presence of HTLV-3 antibody, consider carefully the following quotation taken from a fact sheet issued by the U. S. Department of Health and Human Services, dated September 1,1984:

"Are Blood Test Results Confidential?" In studies supported by the PHS, research institutions intend to keep information linking research subjects with test results confidential Only the research team will have access to this information, along with authorized staff of the institution. In addition, in some cases, the Food and Drug Administration, the Congress, State, health officials, and the courts may also have access to this information It has also been suggested by some that insurance companies may inquire about positive test results as a condition of coverage or continuance of coverage"

We cannot afford to have our heads in the sand around this issue Do not be shy about asking real hard questions or seeking legal counsel before agreeing to participate in any study where your blood will be tested for the presence of HTLV-3 antibody. It would be unwise to ask for these assurances from any health care provider or institution testing for this virus at this time.

Some very prominent researchers, including Dr. Robert Gallo, are suggesting though, that it is imperative that all high risk individuals be tested to learn their antibody status. The reason being that at this time we must assume that everyone positive for the antibody is potentially contagious to others. Presumably, then, all of us who are positive would then modify our behavior somehow to decrease the risk of infecting others. We, as individuals and as a community, must ponder the consequences of being tested very carefully. This should not be a decision made for us by straight men no matter how impressive their credentials.

So as the quagmire that has come to be called the AIDS crisis deepens, what do we do? The first step is to just pull our heads out of the sand and look the situation straight in the eye One very interesting way I have heard of shirking responsibility on the matter is to say, "Well, straights are getting it too— if s not just a gay problem." True - sort of. I think it is probably pretty certain that lots of straight folks are being exposed to the virus. However, it is still the same risk-groups that are getting AIDS: gay men 73% of all documented cases. IV drug users 17%, and hemophiliacs 1%. These statistics are as of Sept 24,1984 as compiled by the CDC.

Many gay men are also suffering under the illusion that a vaccine will soon save us. Despite the propaganda drivel coming out of the Reagan administration, an effective vaccine is many years down the road As far as the gay male community is concerned especially those sexually active with multiple partners since 1979, the vaccine will be useless because we have already been exposed to the virus in large numbers.

I would, rather selfishly, suggest that our first action with heads out of the sand is to look long and hard at our current sexual practices— many of us have already done this and many of us haven't If you are still engaging in sex with multiple partners and not using safe sex measures STOP IT. To dismiss this by saying to yourself, "Well, I'm probably already positive" just doesn't cut it It is not out of the question to say that repeated exposure to the virus may be needed to become infected and then to perhaps go on to develop AIDS. There is also the very real issue of infecting others. You may very well have the right to lead whatever lifestyle you choose as long as it isn't hurting others. Irresponsible sexual behavior at this time may very well be hurting others.

Once the careful examination of our sexual lives has taken place, the real work will begin. We will need to educate ourselves on the complicated social legal, spiritual, and psychological issues surrounding AIDS. This may very well entail a critical examination of gay male lifestyles as they developed in the large gay ghettos in the 70's. 1 am confident that we, as a people, can do this— our survival depends on it If we are anything it is survivors We also owe it to the hetero world— they need us healthy and productive We face some very difficult times ahead, ignoring these difficult issues just isn't going to make them go away.

 

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