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
History and Overview:
AIDS stands for Acquired Immune Deficiency Disease. It is
caused by a virus. The disease originated somewhere in
Africa about 20 years ago. It first appeared as a
mysterious ailment afflicting primarily heterosexuals of
both sexes. It began to spread rapidly and has reached 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
AIDS was first seen as a disease of gay males in this
country spread through rectal sex. It then spread to drug
addicts who shared needles and were exposed to infected
blood. As the AIDS epidemic began to affect increasingly
larger 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.
This "untouchable" attitude began to change when the rest
of society was affected and the virus began to spread.
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 and can be transmitted through heterosexual
sex, blood transfusions and by pregnant females to the
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 viruses
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
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
pneumonia 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, but when their blood
serum is tested they show positive evidence of having been
exposed to the virus.
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 significant fraction of cases. Medical
research holds the possibility of commuting that sentence,
or reversing it.
Transmission of AIDS:
The AIDS virus is extremely fragile, and is killed by
exposure to mild detergents or to Clorox, 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
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
wasy. The same may be true even for BITING,though here
there may be some increased (though still remote) chance of
transmitting the disease.
How is AIDS transmitted?
Sexual activity is one of the primary ways AIDS is
transmitted. AIDS is transmitted particularly 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 likelihood 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
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 Clorox before reusing the same
needle in another person.
Testing of donated blood for AIDS has massively 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
his/her own blood a couple of weeks prior to the surgery,
to be used during the surgery if needed. Similarly, setting
up donations of blood from friends and family known to be
antibody negative and at low risk for AIDS prior to
scheduled 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.
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.
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 those who have previously enjoyed
unrestricted sex. But to violate these rules, is to risk
unusually horrible death.
For those who wish to indulge in penetration 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 woman's genitals by the mouth of a lover)
is NOT considered to be safe sex. Safe sex includes mutual
masturbation, and the stimulation 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.
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 sexually
active couples where one member has AIDS and the other
remains seronegative even after many months of safe sex
with the diseased person. It is particularly encouraging to
note that, education programs among San Francisco gay
males, has significantly reduced the incidence of new cases
of AIDS infection among that high risk group.
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.
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 still practice safe sex for at
least six months. 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 born infected with AIDS.
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.
The AIDS epidemic is a serious problem, with the potential
to become the worst plague that the human race has ever
known. This is SERIOUS business. VASTLY greater sums should
be spent on searching for treatments and vaccines.