Express 215; AIDS: A Mixed Reaction

What if your not your. What do you got. Don't try to.

Say don't express follow killer disease AIDS claims a new victim every two hours in the United States and spreads to the straight community. Scientists are racing against time to discover the cure. A new test will soon be able to tell you whether or not you have been exposed to the AIDS virus. But some say the test is not accurate and others. Where is the test results may be used to discriminate against gays. The promise and the problems of the AIDS test tonight on Express. These mean I'm Spencer Michael. If there is an epidemic sweeping the land leaving death fear and anger in its wake AIDS acquired immune deficiency syndrome has also spawned a good deal of myth and misinformation. For example here is a quick true false test on AIDS. Question number one. AIDS is a virus and if you catch the virus you will get AIDS. Number two use of a condom also also often called Safe Sex will

protect you from AIDS. And three heterosexual couples with no sexual contact outside their relationship can't contract AIDS. And the answer is well not one of those statements is completely true. Tonight we're going to shed some light on the gray areas of medical knowledge and see what effect the AIDS epidemic has had on the community. Gays and straights alike. But first this report on the efforts to prevent the AIDS virus from entering the blood supply we all use in times of emergency. The blood banks. On human control of my body I should be able to see. Give my body to my body. But is there not cases where transfusions hands cause AIDS. When I called up and asked can you. Guarantee that that blood is 100 percent age proof. They said no we can't. If this center was a man made headlines when following an accident he refused blood from a local blood bank and demanded to choose his own donor. His peers

about acquiring AIDS from a blood transfusion were not entirely without reason. We did ask the doctors. Good heavens it was like where is borrowed. When Mary Johnstone went into the hospital for surgery in one thousand eighty two. It never occurred to her to worry about getting the deadly AIDS virus. Through a blood transfusion from a donor. Later developed AIDS Mary contracted the disease which eventually killed her. Late last year her husband William Johnstone is suing San Francisco's or one memorial bloodbath claiming they were responsible for his wife's death. The blood has got to be the most least possible and I feel they did not and still do not screen the dollars. And this is where it's going to get. Even deeper. Yes. I'm asking all sorts of questions.

Erwin does not yet have a test which can screen the blood. I have been attempting to protect the blood with other screening procedures and exclude most gay men. They require a questionnaire designed to exclude people who may have been exposed to AIDS. And they check blood for exposure to hepatitis B which is common in people with AIDS. No one knows how effective this screening. How can I prove that it's 100 percent effective. I hope and think it could be but I can't prove it. Certainly there is nothing else that could be done at the present time. Dr Perkins sits in a position of public trust public trust. Now I go to four or five occasions where I have that trust because Cooper died because of it. I very definitely feel that on the position of public trust. And I very strongly feel that responsibility and. I hope every single my medical career. Has been. Trying to preserve the public health and the

individual's health. Fortunately for the blood banks and for the thousands of people who will receive blood in the next year. Scientists have discovered the virus they believe to be the cause of AIDS. This discovery has led to the development of a blood test which shows if a person has been exposed to the AIDS virus the test works by identifying antibodies. Which are manufactured by the body to fight disease. Several companies are racing to develop this test commercially and expect to put it on the market any day now. The test does not however show whether a person has or ever will have AIDS. This does not prove that he is carrying the virus. It does not prove he's infectious if somebody else does not approve is going to come down with a. On the other hand we're really not able to guarantee that none of those things will have a genetic engineering firm in Emeryville called Kyron corporation is one company developing a commercial test. Iran is working with the virus isolated by Dr. Jay Levy a researcher at the University of California in San Francisco.

Kyron has reproduced Dr. Levy's virus of cloned viruses noninfectious there for Kyron says its tests will be safe for lab work with would happen is that he would come packaged in trades which would then be automatically loaded and then fed into a machine that you go into which tells you which samples are negative and those samples are positive. This test won't be on the market for nine months while Kyron works on its test. The FDA is pushing through approval of several other tests which promised to be ready in minutes. As with most tests the FDA does allow a certain number of false readings. Perfectly accurate test is nearly impossible. So even with FDA approval there will be some error a small number of people could appear to have the aids antibody. In fact they do not. I don't want to tell him that he has antibodies to the AIDS virus and then have to call two months later and say I made a mistake.

So when I'm going to be telling donors the results of these tests you are absolutely sure that these tests are telling us. Some worry that gay men or others who fear they have been exposed to the AIDS virus may donate blood test since the test is not foolproof. This would greatly increase the chances and emanated unit of blood going undetected. Horrendous thought if that happens. We have already begun working with physicians particularly in the gay community to get the message back to the gays of. This. The answer we get from the gays is Hank we get transfers to what's right. Before a license is the test. The FDA will set limits on the acceptable numbers of test readings but there are other aspects of the test over which they have no control and which have many people worried what the FDA tells us is that once the test is licensed they have no control about who uses it.

It can be used by anyone. And we understand that insurance companies can legally demand this kind of testing for people applying for coverage your employer may find some way to get rid of you or you may not be high Robel or your insurance company will no longer carry you because the costs involved in treating people with AIDS are phenomenal. Or it will be used as a means to test whether or not you're homosexual. While the test only indicates a potential for contracting AIDS. Many theories may be misconstrued as a diagnosis of AIDS a diagnosis which in many cases has cost people their homes their friends and their jobs. Some point to cases like trainers as an example of the kind of fear surrounding people with AIDS and of the devastating results that fear can produce trainer was a flight attendant for United Airlines several years ago he was diagnosed with AIDS but he still felt well enough to continue his work.

About a week after my diagnosis I informed United and if I was going to be taking chemotherapy for the cancer it may involve some schedule conflicts. That was fine there was no problem until six months later I was called in to the office at eight o'clock in the morning by one of the supervisors and told effective immediately that I was on a medical leave of absence and this was their choice not mine and that was the end of the discussion. Trainer filed a suit against United to get his job back as medical leave meant he was not being paid. He demanded back pay as well. United refused to comment on the matter but in a letter to trainer a united doctor stated the exact method of transmission is in fact not only controversial but it is. Point in time and Objection. Since the bulk of the duties as a flight attendant involve food and beverage handling. It was felt that in the interests of United's flying public that you not perform those duties as a flight attendant they do allow me to fly around on passes

and if I could pass AIDS from the aisle to a seat I would certainly think I could pass it on the seat to the aisle or to the person next to me. Doctors say there is no evidence that this disease can be transmitted through casual contact. The Centers for Disease Control in Atlanta has stated that no cases have been documented to occur. Such common exposures sharing meals sneezing or coughing or other such casual contact as we have worked with employers here in the Bay Area where we've had large number of cases. We have been able to reassure them that none of the epidemiological studies to date no one has suggested that this disease can be transmitted in any way other than by direct sexual contact or by receipt of blood or so that they understand that by having someone working as a steward of your money or as a food server. As a technician in a hospital that individual is not placing anyone else at risk for transmitting an arbitration board recently sided with

trainer in his case against United which put him back on the payroll with a year and a half of back pay. So far United has not allowed trainer to return to his job as a flight attendant. Trainer's case exemplifies the kind of public reaction many fear will become rampant. An AIDS test is used without the proper safeguards for confidentiality. The gay community already stigmatized by this disease is particularly careful that test results in the wrong hands could be misused and lead to further discrimination and isolation dissing homosexuality. In some 23 states and states it is an illegal act. And so there's concern appropriate concern among many gay leaders that the confidentiality in the civil liberties of their constituents of gay million is protected when you are so scared. We just don't have any trust in the government. I have absolutely not and as anybody and I and we've been down in times it's really

frightening if somebody were to try to get an a blood donor record to find out whether they were positive and we would refuse to give the record. We think that legislation should be introduced to protect Americans more far away than they are now protected. Blood banks are already considering combining the list of positive people positive people. The reason for exclusion from blood donation will remain confidential. But in its recommendation for a blood screening procedures the CDC has said that the information while remaining confidential could be used by public health officials to track down and test sexual contacts from suspected AIDS carriers. Doctors at the San Francisco Health Department have already said they want to get test results from a one memorial blood every time lists get made that are supposed to be confidential. Those lists somehow end up in the places they're not ever intended to be.

So on the one hand I see it being vital and useful on the other hand I see being as a vehicle to further discriminate against people who are not the most acceptable in our society. We don't to be irresponsible but we do want to stop the epidemic. And we're clearly not going to be able to do it a year from now if it's going to move into heterosexuals which I think most experts believe now is the only chance if if we can do it at all a big no no no to your two letters. The Food and Drug Administration expects to approve the blood screening test within the next two weeks. It will be at least a month before blood banks around the country will be able to put it to use. Over 400000 Californians are expected to take the test when it becomes available to keep people from rushing to the blood banks testing and potentially contaminating the blood supply. Legislation has been introduced in the California Assembly to make the test available free of charge at public health clinics. This program will cost the

California taxpayer three million dollars. With us tonight are Dr. Marcus Conant who is the head of the AIDS clinic at the University of California in San Francisco. Cleve Jones a gay activist in San Francisco and Dr. Mervyn Silverman who recently resigned as the head of San Francisco's public health department. Just before we went on the air we heard from Washington that the government pledged assistance to make sure that people who are worried they may have AIDS but are unable to pay doctor bills can get blood screening tests to check for the disease. Margaret Heckler the secretary of Health and Human Services said in a statement that the government effort is designed to ensure that the nation's blood supply is not contaminated by a virus believed to cause the immune deficiency illness. Gentleman do you think at this time Dr. Silverman Dr. CONAN If a relative of yours needed blood that you could go to the Irwin memorial blood bank and be sure that that blood was safe. I don't think there's any guarantee in any of these areas but I think the blood supply at this point in

time is very clean. And in fact the high risk people have stayed away from the blood banks. And that was of course the concern with this test coming out that it might draw people in to the blood banks unnecessarily and contaminate the blood supply. It was your pressure on Washington I believe brought about this statement that I just read from Margaret Heckler. Well I think so I've been on the phone all day with her staff and the commissioner of FDA and I'm very pleased that they're going to do this I still have some problems with the test and some problems with the timing because I don't think we can establish alternative sites in that time period. I also have some problems with the test itself even if we could establish it because there are false positives which means someone could be told that they've been exposed when in fact they haven't. And false negatives. They think they don't have it and maybe they donate blood and then it ends up contaminating this supply. Dr. Kahn of the test from what you know about it how how bad of the false positives how many how accurate is the test.

We don't we don't know yet. But this whole question of false positives and false negatives has plagued medicine for centuries. The test for syphilis which we have used traditionally to identify people have syphilis or not have faults positives and false negatives. And you have the difficulty of trying to confirm the test repeated to do additional tests to see if the information that you're getting is correct or a few false readings. One could understand but I understand that people who have the aids add a body and then there are 30 to 50 times more people who don't get the disease when they when they have the virus or they have the antibodies. You know it was it was a very very very easy to get a false reading on a test and you may never develop the disease. Well you know what we know is that there are large numbers of people who have seen the AIDS retrovirus their body has been exposed to the virus. That number may be 300000 in the United States today. Only about 8000 people have developed AIDS AIDS as defined by the CDC. And so there are

large numbers of people who have been infected and only a small number perhaps 1 percent or less who have actually come down with the disease. Now what we don't know from this test is does a positive test mean that you will eventually develop the disease or hopefully not. Does it mean that the virus is still in your system and you can transmit it to a sexual contact or to someone by giving blood or not. Have you produced a protective antibody or not. These are the questions that this test does not answer for us. It's not diagnostic we ought to make very clear this is not a diagnostic test for as many times as your say that I wonder if people are going to believe it or understand it. Do you think people in the gay community are going to want to take this test. Cleve Jones not currently depends on what happens over the next few months. As you mentioned we have a bill in the California Assembly now that was introduced by somebody in our diagnose that we think it's a very strong bill that will meet the needs of the gay community. Also the research community and the blood banks. And that's our goal certainly if there is a definitive

test everybody would want that to be available to the high risk populations. Currently I certainly would not advise any gay man to take that test. I think the questions that Dr. Conant raise are fairly large questions. I personally don't see the value in getting that kind of information especially when it would subject me or any other gay man in this country to the possibility of severe retribution at some time in the future. The test could it could indicate as much as a 100 percent error 90 percent in terms of who might have AIDS. What good is this test at all. That the test again at the doctor's Overman said it is not a diagnostic test. The test only helps those of us doing research determine who has been exposed to this virus or not. Let me give you an example. 95 percent of the American public have antibodies to facial herpes by the time they are five years old. About 40 percent of people have recurrent facial herpes.

But 60 percent do not. So what you're doing though it sounds as though what you're doing is in order to protect the blood supply you're excluding 50 60 80 percent more people than then would really infect that blood supply a vast NO NO NO NO NO NO because we don't know. The fact that the individual has positive antibodies. It does not in and of itself tell us whether that individual still has the AIDS retrovirus in his body or not. Unfortunately research to date which is in its embryonic stages it be only isolated the virus last May. Many individuals who are positive to the antibody test we can identify the aid retrovirus in their bloodstream. What the percentage of that group is see as a protector for the blood supply. If we didn't have false negatives would be very good test. It would make sure that the blood that was donated would not be contaminated. That's what it is it's not to diagnose AIDS it's not to tell people where they stand with the situation. It's the blood

supply. Yes or you have a questions. My name is George chippy. I'm the assistant pastor of Calvary Baptist Church here in San Francisco and I hear terms thrown around in the clip. Fact that folks are being discriminated against and I guess things like this really bother me because if we had a plague for example and we weren't sure what was going on people would be quarantined. I think a blood test is is so basic. Let me let me read a couple what you say are you suggesting a quarantine there ought to be if people really cared about was happening. And this is such an unknown quantity they would voluntarily do that. Whatever technology if they cared about other people if they really did. Dr. Silver when there have been suggestions in other cities in Euston for example of a quarantine because of the AIDS situation is there any merit to that whatsoever. Well you probably have to run out a few cities to do it because the real problem probably is reduced in the person who ends up with AIDS. The problem is in all the people who feel good who are carrying the virus and don't know it. And let me say

right now that is not just in the Gay or the Haitian community or some people have been transfused it's in the heterosexual community because we're starting to see cases there so we would literally have to quarantine hundreds of thousands and probably millions of the revenue. We want to say that where did it start. Let me read a couple quotes it's far more than AIDS can journal medicine in one thousand eighty reported in San Francisco an average of 10 percent of the people that were employed is food handlers had three types of rare intestinal diseases and also included Hepatitis A and B and that between 60 and 70 percent of those people were homosexuals. The Western journalist point of this though what does this have to do with what I'm going to make that we've got going right now. There's far more than AIDS as we're not sure what what passes aids on yet these other diseases we know are passed on through. Contact with for example food and I'm taking the risk of going to notice the rates in this city. First of all AIDS is not spread through food. Some of the other things you know if you're into that.

Well you know what but I do know from statistics and that is what determines if an epidemiologist. We also see that I could walk I can guarantee that there is no such no guarantees in this world but I can tell you this and I as the previous Director of Public Health know the statistics and know that our level of infections in the general public as a result of what you're talking about are no different than they are in any other city in fact we have a very good clean food supply and the fact that you may have a disease in the food handling doesn't necessarily mean that that's going to be a disease that's going to be passed on to consumers. The last thing it is self-evident that the gay sexual practices are assault on the upon the ecology of the human body you know these aren't my words that the gay communities of America's cities are polluted with disease with respect to age there exists a potential for disaster. I think it's pretty obvious what we're up against here. I thank the pastor assistant pastor raises some important questions

but those are our fears that are shared by the gay people as well. I mean after all it is we who are dying in record numbers in this country right now it's we who are nursing the ill who are watching them die who are trying to comfort their families we're very concerned about how it would spread. And every indication from every study shows that there has been a dramatic change in the behavior of the gay male community we are not being irresponsible we are responding well. What we need now are the federal dollars to make sure that gay men and all and the other people at risk with this disease which is now everybody gets the message and knows what they can and cannot do to prevent the spread of AIDS. So the issue to me is we're going to get off. Yes exactly are pretty straightforward guidelines on safe sexual behavior and that information needs to be made available to everybody and we need it available. No it is not. We in San Francisco are bombarded with information because we've had a very enlightened city administration a fine previous Director of Public Health and

active and strong gay community. And so and also we have the San Francisco Chronicle. So we're bombarded. But if you go outside of the city that is not the case. And I travel a lot and I've been out there and I've been in different parts of the world and the information is not available. You talk to people from England and France they have no information. You talk to people from Los Angeles and they have very little information. Yes sir my name is Ian Robertson. I work with one of the Hotline services here in the city of San Francisco for Dr. Silverman. So are there on a lot of cases everyone here is talking about. A I have direct exposure and experience with heterosexual people from all over the country because of our hotline service. Heterosexuals are very afraid of this. All of the information that is being put out to them is very open and very scary. There is nothing like is actually happening within the city of San Francisco. And as a matter of fact even among gay communities we do get many many calls. It is very fearsome for heterosexual

people because like Mr. Jones said we do have the San Francisco Chronicle which does give stipulations. However right now in Boston the Boston newspapers are opening wide. We're getting hundreds of calls literally hundreds Well it is the question is I mean as a result what is the what is the help that's going to be given to heterosexuals to ease and the late part of the fear that this is not people think of epidemic and immediately think. The plate. Well let's not doctor so I'm going to answer. Our system is actually at risk at this point first let's make it clear it is not casually spread. We have to continue to say this with all the information that casually spread I'm not going to get it from hugging clean eating in his home of being with next to him on a Saturday if you know if I'm going to that if Cleve had the problem another was I do not have to fear being next to gay people or people who I know have AIDS. What we're saying is we're starting to see some evidence that it's in the heterosexual population. This doesn't mean that everyone has to go out and commit suicide. It means that

what they have to do if they don't want to spread through the whole community is change their behavior. If they and their partner have not been mutually monogamous over the last three or four five years. So what we're saying is if you ignore what we're saying today you do it at your peril. So two years later we'll look back and say we wish we didn't have the second epidemic. So that's what we're saying but I don't think this is a good time to stress the incubation period for the viewers. We don't know what that is yet we don't know what we know because it could be as much as five years right now. Epidemic is only about six years old. OK let me get a question from the audience. You say gay men should not take the test. What is your argument for us to take the test. I don't have an argument for you to take this I agree with you. I don't think you should take the test because it's not going to give you information that you can work with. One has to assume that they have to observe safe practices regardless of whether their test is positive or negative.

If you get a positive test we can tell you has been stated by Dr. Cronin exactly what that means. So in many ways you're no better off with that knowledge and the knowledge could be wrong. Why then did you go to Washington and say you got to give us facilities to give this test if you don't think gay people should take the fact that Merv Silverman doesn't feel gay people should take it doesn't mean they're all going to listen. I'd love to have that kind of power but I don't. And so we're going to be people who for many reasons are very concerned and who are going to take the test the test have to use but the use is for research the uses for the blood test for the general population and should not be thought of that way at all. We're quickly running out of time you got a quick 20 was I mean dealing with the Human Rights Commission in San Francisco I want to echo statement. I would hope the federal government would move to release funds to find the cause of AIDS. As quickly as they've moved to release funds for this test and also encourage gay men in San Francisco we are seeing problems where

employers get on reasonably afraid and are firing employees if they do have problems. Please come to the same school AIDS Foundation Human Rights Commission. We have a project to document these problems so we can move to assist them. There are things people can do to protect themselves on the job. Let me end up with a very quick last question the idea that once the AIDS virus was discovered people thought well we would get a vaccine pretty soon. What's happening we're going to get a vaccine against AIDS not not pretty so there was a great deal of work you saw lots of clip of what's being done at Caron trying to look for subunit vaccines. But at the present time we don't even know if we will be able to make an effective baccy against this agent. OK well thank you this is a tough this discussion to stop but I'm afraid I've got a we are out of time. Dr. Silverman Dr. Cohen and Cleve Jones at our audience I wish we had got to more of you thanks for joining us. Next Wednesday Express takes a hard look at the world of banking to see what effect deregulation will have on consumers and the growing number of bank failures.

That's next Wednesday night at 8:00 p.m. Thanks for watching for KQED. I'm Spencer Michaels. Good night.