COLUMN: Answering AIDS questions

From Michael Pereira's, "The Raw and the Cooked," Fall '97 By the year 2000, doctors estimate 12 million people will have died of AIDS, 1 million of them in the United States. As of 1995, the total number of AIDS cases reported to the U.S. Centers for Disease Control was 513,486, including 74,180 in that year alone. In the middle of 1993, the CDC confirmed 8,737 cases of AIDS in Pennsylvania -- 4,749 (54 percent) were in Philadelphia. There's more: in 1993, the CDC also reported college students and women were the fastest-growing caseloads for HIV infection. In the same year, 23 percent of people with AIDS were in their twenties -- indicating they were infected in their mid-to-late teens, or early twenties. Roughly 80 percent of Americans have sexual intercourse at least once by the age of twenty. Yet according to a 1991 survey of college students, only 17 percent of sexually active men and 21 percent of sexually active women reported using condoms regularly. ?AIDS, in short, is the most insidious sort of plague: both disease of body and pathology of culture. Not plague in the quaint historical sense -- no flagellation trains, no locusts or cabalistic pronouncements -- but the same blinding hysteria and misinformation. Understanding AIDS requires more than empathy and red ribbons (though it requires those too). It demands a complete revaluation of how we love, how we act in public and in private, how the government uses its resources. In short, how we live. Reactions to AIDS have resurfaced old philosophic questions, and thereby, unwittingly, shifted our focus from the medical to the melodramatic. The American media has successfully deified a retrovirus, turned AIDS into a popular icon; in a sense, attributed giant sci-fi fangs to a microscopic invader. AIDS the icon enjoys a deceptive celebrity -- a dangerous, misleading distance from the uninfected public. AIDS the acronym -- a medical phenomenon or the image of docile bodies on an IV drip -- permits us to become expansive. It transcends the solemn geography of human limits; it reveals the skull beneath the skin; it betrays the hubris of science; it exposes the frailty of human life? And so on, until we forget HIV is not a random, all-mighty storm trooper, but merely a disease, an adversary to be outwitted and conquered. The war is against HIV, not against people with AIDS, and our best weapon is -- Education. AIDS education takes on many forms -- awareness, prevention, testing, funding, research and treatment (perhaps, a cure). But it also has shortcomings. An unbearable flood of acronyms and shorthand has grown up around sexual education and talk of AIDS. A sort of AIDSspeak isolates the issue in a difficult, dull jargon. When we hear riddles like "A PWA, or someone with HIV or an STI, HPV or any STD, should use FDA approved AZT to combat AIDS," we switch to autopilot or tune out altogether. Neat abbreviations support the dangerous illusion that you can know it all, and that knowing is enough. But knowing is not enough. In the case of AIDS, you have to know the facts and act accordingly. This includes knowing how HIV is transmitted (in a word, unprotected sex), and how it is not transmitted (for example, donating blood). It includes knowing how to protect yourself and how effective various protective methods are (abstinence: 100 percent; condoms: 88 percent to 98 percent). Awareness also includes educating your peers. And yes, education is the duty of all of us, since the government (local and national) is disgracefully tight-fisted with funds for AIDS. Universal awareness is not a chimera -- it is a goal. And with that sort of optimism in mind, the Office of Health Education and the students of FLASH (Facilitating Learning About Student Health) have named February "Safer Sex Awareness Month." The point is education: to answer honest questions with honest answers, to make a sober subject palatable? perhaps to overcome that other HIV-- the Human Ignorance Virus -- which endangers so many lives. We have come a long way in the 17-year battle with AIDS. In the arts, Tony Kushner's epic play -- Angels in America -- proved a masterpiece can emerge from the ashes of hopelessness. Although a vaccine still seems improbable against HIV and its ten known subtypes throughout the world, 1996 witnessed awesome breakthroughs in drug and genetic treatment. The FDA approved a new medication called saquinavir, an antiviral "cocktail" that has successfully forced the disease into remission in a number of patients. Scientists have also discovered a group of men with a "natural immunity" to HIV: a double dose of defective copies of a genetic protein called CKR-5. Since HIV uses CKR-5 as a gateway into cells where it then reproduces its own genetic material, the defective copies serve as a barrier. This might be the first step towards the development of a cure. But AIDS isn't dead yet. And while the disease is around, educational and preventive measures should be our first concern. That is what this short month of "Safer Sex" is all about. It is a celebration of possibility, an expression of empathy and a kick to the groin of ignorance. While there is awareness, there is dialogue, direction, education, progress, and all the other longish words that add up to one very short word: hope.