HaCKeRz KrOnIcKLeZ 3/HaCKeRz_KrOnIcKLeZ.iso/anarchy/essays/term/aids-1.txt

Text File | 1996-04-27 | 23KB | 403 lines

                        AIDS and YOU (May 1987)
                        By Martin H. Goodman MD

                  (this essay is in the public domain)


    Introduction:

          AIDS is a life and death issue.  To have the  AIDS  disease
    is at present a sentence 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 currently is neither a cure, nor even an
    effective treatment, and no vaccine either.  But there are things
    that have been PROVEN immensely effective 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 originated 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 heterosexual folks.

          AIDS was first seen as a  disease  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 population 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
    and 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.   Gradually
    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 immune system 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 more between 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 months after  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 exposed to the 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.


    Safe Sex

          For those who wish to have sexual contact with folks  on  a
    relatively casual basis,  there have been devised rules for "safe
    sex".  These rules are very strict,   and  will  be  found  quite
    objectionable  by  most  of  us  who  have   previously   enjoyed
    unrestricted  sex.   But  to  violate  these  rules  is  to  risk
    unusually horrible death.  Once one gets used to them,  tho,  the
    rule  for  "safe  sex"  do  allow  for  quite  acceptable  sexual
    enjoyment in most cases.

          For those who wish to indulge in pentration of  the  vagina
    or rectum by a penis:  The penis MUST be sheathed in a condom  or
    "rubber".  This must be done "religiously", and NO exceptions are
    allowed.  A condom must  be  used  by  a  man  even  when  he  is
    receiving oral sex.  Cunnilingus (oral stimulation  of  a  womans
    gentitals by the mouth of a lover) is NOT considerd  to  be  safe
    sex.  Safe sex includes mutual masturbation,  and the  stimultion
    of one genitals by another's hand (provided there are no cuts  in
    the skin on that hand).   But  manual  stimulation  of  another's
    genitals is NOT safe if one has cuts on one's hands,  unless  one
    is wearing a glove.

          Note that even when one is  conscientiously  following  the
    recommendations for safe sex,  accidents can happen.  Condoms can
    break.  One may have small cuts or tears in ones skin that one is
    unaware of.  Thus,  following  rules  for  "safe  sex"  does  NOT
    guarantee that one will not get AIDS.  It does, however,  greatly
    reduce the chances.  There are many examples of  sexaully  active
    couples where one member has AIDS disease and the  other  remains
    seronegative  even  after  many  months  of  safe  sex  with  the
    diseased person.  It is particularly encouraging  to  note  that,
    due to education programs among San  Francisco  gay  males,   the
    incidence of new cases of AIDS infection  among  that  high  risk
    group has dropped massively.  Between practice of safe sex and  a
    significant reduction in the number of  casual  sexual  contacts,
    the spread of AIDS is  being  massively  slowed  in  that  group.
    Similar responsible action MUST be taken  by  straight  folks  to
    further slow the spread of AIDS,  to give our researchers time to
    find the means to fight it.


    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.

          There currently is NO treatment  for  AIDS  (this  includes
    AZT) that shows significant promise.


    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.


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