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From: rrizzo@bbncca.ARPA (Ron Rizzo)
Newsgroups: net.motss,net.med
Subject: Re: Test for exposure to AIDS
Message-ID: <1245@bbncca.ARPA>
Date: Fri, 4-Jan-85 17:29:37 EST
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Posted: Fri Jan  4 17:29:37 1985
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Craig Werner writes:

>   [Incidentally, AIDS-associated Kaposi's Sarcoma generally only occurs
> in Gays, IV-drug users tend not to show Kaposi's but tend to show other
> opportunistic infections.]	  

There are two forms of KS associated with AIDS: the "traditional"
nonlethal skin cancer (call it KS1), & a novel (?) internal kind
found in lymph glands which also invades other organs (call it KS2).
I believe every KS1 AIDS patient tested for KS2 has had it, AND that
non-KS1 AIDS patients tested for KS2 have ALL had it.

Have searches for KS2 in nongay AIDS patients been made?

>	 Now there is a way to detect exposure to the virus that reputedly
> causes AIDS, HTLV-3. It is a simple blood test, easy to do and very reliable.
> .......The test is not in wide use, however, for several NON-MEDICAL but
> rather POLITICAL reasons.

There is at least one MEDICAL reason for not using the test: it's not "very"
reliable.  A group testing positive for HTLV-III on the bloodtest tested
NEGATIVE when a much more accurate & expensive test for HTLV-III was given.
The bloodtest can give FALSE POSITIVES.  See recent issues of the NYNative
for details.

"Political" as used here is basically a putdown.  It suggests less than
fully valid, serious, or relevant reasons.

There are many GOOD reasons (label them what you will: legal, monetary,
social, medical) for not using/taking the bloodtest, which can be subsumed
under the heading DISCRIMINATION & ABUSE.  Namely, serious & probable risk
of:

	loss of medical insurance:  Blue Cross/Blue Shield & other medical
		insurance plans were REFUSING to cover homosexuals a while
		back; I don't know if they still are 

	loss of job, career, & income

	loss of housing

	assorted discrimination by people around you who know if you've
		tested positive

	discrimination & abuse by doctors, nurses, other medical staff &
		institutions

All of the above have happened more than a few times to AIDS patients.
The 200,000-300,000 gay men who VOLUNTEERED for the bloodtest were told
after the fact by the highest medical official in the land that he &
others COULD NOT guarantee confidentiality of results, even though it
had been promised to them (subsequently, he & other top officials
& physicians have urged people NOT to take the bloodtest because they
could not guarantee that the results wouldn't find their way to insu-
rance companies & employers).  There have been reports of the above
happening in a few cases to people simply because they were gay, knew
AIDS patients, had ARC (AIDS Related Complex: vague symptoms that may
be a precursor of AIDS 10% or less of the time), or merely had been
tested.  Given public hysteria over AIDS (including within the medical
profession), homophobia in groups like the Southern Medical Association,
and maltreatment & panic among some health care & public employees,
use of the bloodtest has more than merely "partisan" obstacles.

These reasons are far more important than any "psychic risk" of inflict-
ing "AIDS anxiety" on poor gays who test positive:  many gay men have
lived with far more severe anxieties for years now without "succumbing"
psychologically.  Merely to exist as a gay person in this society is to
be a "survivor".

>	 Well, Gay groups protested vigorously. Look at the data and see why.
> The test is very good for identifying those with AIDS. But it is almost as
> good for identifying homosexuals (at least in SF - other parts of the
> country may vary.) and they feared labeling. Articles could be written on
> this alone, but I must go on.

Articles HAVE been written on this, for a number of years now.  Read the
gay press or Village Voice, & especially the New York Native, which has
the most extensive coverage.

Ignoring false positives, the test is very good for beginning the process
of testing for AIDS.  But given statistics to date, only a tiny fraction
of those testing positive can be expected to eventually develop full-blown
AIDS.  The test DOESN'T identify those with AIDS.

The main objection to the test is NOT that it will force people out of
the closet, but that ALL gays testing postive, whether "in" or "out",
will be TREATED as AIDS carriers.  (Of course, in some situations, being
suddenly & involuntarily "out" can create problems.)

I must admit I found Craig's first article very interesting, & thought-
provoking.  But he ought to be more accurate & up-to-date.  I'm a mere
layperson who simply reads the gay press regularly, yet I get the impres-
sion I'm better informed.  That's a little scary.


						Regards,
						Ron Rizzo