Myths, lies and the real truth about Aids

The very mention of Aids causes controversy, embedded as it has become in the puritanical psyche as a punishment from God for sexual libertinism, as a pestilence visited on gays, prostitutes, and the sharers of drug-laden syringes.

Whatever the global statistics may indicate about a very substantial and one would imagine conclusive 80% of Aids patients being heterosexual, when the Princess of Wales launched a high-profile campaign last month to show that Aids is not just a gay disease, she was accused by family groups of making mischief while Professor Michael Alder, chairman of the National Aids Trust, defended the princess as being ``extremely brave in being one of the first high-profile people to become involved on this issue''.

The funding of Aids charities has been criticised heavily since it was revealed that Government spending on the illness is now #250m a year, and the gay myth prevails despite the tragic heterosexual human evidence of victims such as Dr Sandy Logie, the Borders doctor who contracted the disease in Africa through contact with Aids patients, and Francesca, the beautiful daughter of writers Nicholas and Elizabeth Luard who died after contracting the disease heterosexually.

Today, The Herald examines why people prefer to believe the myths, rather than the realities about Aids.

ZOE was undergoing infertility treatment when the HIV bomb detonated in her confirmed heterosexual life. She had renewed a former relationship after a break of several years, but once more, it didn't work out. She married someone else, started further education, was enjoying life and hoping to start a family, when the Blood Donor Unit parked outside the college.

``A month later I got a letter saying there was a problem,'' she says. ``I thought perhaps I was diabetic because of my family history. The man said I had better sit down and told me I was HIV positive. There was no pre-counselling, nothing. He even had the cheek to make a joke of it. It was like putting a gun to my head.''

Her husband was telephoned and given a test on the spot. A few days later, he was given the all-clear, for which Zoe is eternally grateful. She says: ``I hadn't had many sexual relationships so it was easy to pinpoint where I had contracted it. It was the man I had got back together with, although he wasn't able to discover how he got it.

``We had been apart for a few years and could have had an encounter just after we split the first time. When I contacted him, he hadn't been well for several months, but it never crossed his mind it might be HIV. He died last year.''

She and her husband are still married, but live apart. He is, she says, her best friend and her carer. She has her ups and downs, and currently her CD4 cell count is 502, compared with the average of 1500. She had to track down help herself, finding Body Positive in Glasgow a great support.

She says: ``In a way it is best not to know. I know exactly how long I have had the virus in my body and you count down those years. I am not frightened of dying, only of the way I might die. You don't know if you will go blind, have brain infections or what. Nor do you know when you will die.''

Zoe (not her real name), who is 31 and lives in Glasgow, blames a lack of information and sections of the media jumping on a gay bandwagon for the fact that heterosexual people are not clued up to the fact that Aids is not just a gay issue. She wants youngsters to be informed and for there to be a change in attitudes towards sexually active girls carrying condoms. ``The girl who carries a condom will live longer than the one who doesn't,'' she says.

Counsellor Marion Bates, who is the initial contact at the support group Body Positive (0141 332 5010) for newly-diagnosed female HIV sufferers, says: ``HIV and Aids is a female problem, not just for those who are infected, but those who are affected. Mothers have to inform and protect their children. Mothers, wives, girlfriends and sisters become carers.''

Bates adds: ``The statistics blow the myth of Aids being a gay issue right away. The total infections in Scotland since 1982, when figures started to be collated, until March 31, 1996, number 2422. Of that total, 730 are believed to have been transmitted through male-to-male sex, 587 are women, and 1105 men who have been infected who are not gay.

``They may have contracted it through heterosexual sex, drug use, or blood tissue, such as transfusions. Among the drug users, it is assumed they contracted it through needle sharing, but many are unclear whether they got it through drugs or heterosexual sex.'

Jackie Pollock can confirm that confusion. She is a founder member of the Glasgow HIV and Aids Support Group (0141 353 2979) and lost her son Gary to Aids at the age of 20. She says: ``Gary was 16 when I was told about it. They said he got it through drugs, but what I have never told anyone is that he said to me that he got it from having sex with a prostitute. He is dead now and it can't hurt him, but who's to know?'

One thing she is convinced of is that the straight community has got to accept that it cannot ignore the Aids issue. The group counsels the carers of HIV and Aids patients and their own figures show that the majority appear to have contracted through drug use, though the dubiety raised by Bates and by Pollock's own son's situation remains.

She stresses: ``People are sitting out there saying you either have to be gay or a drug user, but that is not true. Every single one of us has to keep that in mind.''

Pollock is horrified that people still believe they can contract Aids from toilet seats and cups, let alone that it is a disease contracted only by gays. She says: ``I believe there are a lot of people contracting Aids through heterosexual sex who aren't aware of it and won't be until they become not well. People don't change their attitude until they are affected.''

Dr Dermott Kennedy is unequivocal. To call Aids a gay issue can only be described as ``dangerous rubbish'', he says. His conviction comes not only from the statistics which he says show 80% of the 12 million Aids patients worldwide to be heterosexual, but from his own work at Glasgow's Ruchill Hospital, where as a hands-on doctor seeing HIV and Aids patients daily, he encounters heterosexuals who are dying proof of the polemic.

Kennedy says the disease arrived in Scotland via the drug and gay communities. A ripple effect infected heterosexuals who had sexual contact with drug users or bi-sexuals. Haemophiliacs have also contracted the disease through infected blood. Today, heterosexuals are infecting each other, and Kennedy insists that this does not happen only through anal intercourse as has been suggested, but through straight sex.

``The opening address at the 1992 Berlin Aids Conference suggested that Scotland had more Aids cases occurring through the heterosexual route than any other,'' Kennedy says. ``That was not entirely accurate, but it was a significant statement. In the east of Scotland, drugs have been the engine of heterosexual transmission.'' He adds: ``I always put it down to behaviour and biology.''

As far as the biology is concerned, other sexual diseases have been important in the transmission of HIV. herpes, clamydia, and chancroid are conditions where lesions exists which may bleed. It is the blood contact which can infect a partner.

For the behaviour side of the equation, Kennedy says: ``We are seeing HIV in men who have been to Africa and had heterosexual intercourse with infected women, in young women who have a fling on holiday in Italy or Spain or southern France where a lot of students dabble in injecting drugs and so the local men are dangerous, let alone the other men, and in female partners of bi-sexual men. I have had girl patients who have died who had no anal intercourse. You don't need that to transmit the virus.''

Men, according to Kennedy, are more likely to transmit the disease because they ejaculate into the woman and the virus needs an infecting dose such as drug users get when a needle contains freshly drawn blood from an infected person.

Kennedy says: ``Heterosexuals don't think they are at risk, but if you have an incubation period of up to 10 years it takes a while before the evidence begins to come through. In Glasgow, 50% of cases have been gay men. That means 50% of cases are not gays.''

Dr David Goldberg of the Scottish Centre for Infection and Environmental Health, who next week will speak at the International Aids Conference in Vancouver, stresses that no-one in Scotland is saying that Aids is just a gay issue.

Transmissions of HIV among heterosexual men and women increased during the mid to late 1980s, but the figures in the 1990s, as with drug users, are now quite stable. Goldberg says that the great majority of young heterosexuals in Greater Glasgow who inject drugs do not have protected sex, and there is little information available on condom use in the heterosexual population in general in Scotland.

Goldberg says in a report on HIV and Aids Surveillance in Scotland that to prevent the further transmission of HIV into the heterosexual population, there should be improved initiatives designed to effect safer sexual practice, a targeting of prevention initiatives at travellers, particularly those who go between the UK and Africa or Asia where the epidemic is most virulent, and a maintaining of initiatives which have successfully controlled the spread of HIV among injectors in the community.

Most men and women in Scotland who have acquired the infection heterosexually have been the partners of injectors or those with sexual exposure abroad. Women like Zoe remain in the minority.

He says: ``The heterosexual spread is more difficult to understand, but the data we do have suggests there is no evidence of an increase in the early or even the mid 1990s. We seem to have put the brakes on the spread among homosexuals and drug users.''

However, Goldberg adds: ``Of all the risk groups, gay men are still most at risk. By and large the gay male community behaves responsibly, and the great majority do practice safe sex, but an appreciable minority have unprotected anal sex and that is of concern.''