AIDS: Profile of an epidemic

<v Speaker>Major funding for this program has been provided by a grant from Hoffman Laroche Inc. <v Speaker>A research-intensive health care company. <v Speaker>Additional funding has been provided by the National Institute of Allergy and Infectious <v Speaker>Diseases and the National Cancer Institute. <v Edward Asner>Acquired Immune Deficiency Syndrome, AIDS, is an epidemic of <v Edward Asner>staggering proportions. It has struck in more than 34 countries around the world. <v Edward Asner>In the United States, Gerald Borrell is a Haitian living in New York City. <v Edward Asner>Christopher Shahar, a gay man in Los Angeles. <v Edward Asner>Kenneth Brown, an intravenous drug abuser from Chicago. <v Edward Asner>David McKie, a hemophiliac living in rural Kentucky with his family. <v Edward Asner>Amar Hamilton, a six-year-old child in New York. <v Edward Asner>Five of the thousands struck by this disease, each without the natural immune <v Edward Asner>defenses to prevent deadly infections and rare forms of cancer, <v Edward Asner>all potentially fatal. <v Edward Asner>For the moment, AIDS is incurable. <v Edward Asner>The longer a patient has the disease, chances for survival dwindle dramatically

<v Edward Asner>in the absence of intensive media coverage. <v Edward Asner>Some might be led to believe that the disease is leveling off. <v Edward Asner>It is not. Many researchers would argue that the number of cases is actually <v Edward Asner>10 times higher than those reported by the Centers for Disease <v Edward Asner>Control. <v Edward Asner>When the AIDS alarm sounded four years ago, most people knew little or nothing about the <v Edward Asner>disease, much less knew anyone who had it. <v Edward Asner>Now as the number of cases doubles every six months. <v Edward Asner>That profile is changing and so is the profile of AIDS. <v Edward Asner>Research breakthroughs isolating the probable viral cause of the disease <v Edward Asner>give new leads to the scientific community, new information if not hope <v Edward Asner>for patients, loved ones and the growing number of people touched by <v Edward Asner>AIDS. I'm Edward Asner. <v Amar Hamilton's Grandmother>You know, they should just come out and tell people what, uh...

<v Amar Hamilton's Grandmother>What meaning light of day said through sexual intercourse or through <v Amar Hamilton's Grandmother>blood. But the way they're going on, they're figure if they touch a person they could <v Amar Hamilton's Grandmother>get AID. They all got everybody scared. <v Edward Asner>At first, the AIDS scare was identified with homosexuals. <v Edward Asner>The media called it the gay plague. <v Edward Asner>The homophobic point of view was that AIDS victims were getting what they deserved. <v Christopher Shahara>My initial reaction was that it's all over. <v Christopher Shahara>I mean, I'm gonna die. And that's cause the news media at that time was doing heavy <v Christopher Shahara>push on AIDS. It was just starting to. <v Christopher Shahara>And all you heard was the negative things that AIDS in statistics. <v Christopher Shahara>Nothing positive. And if you had AIDS, you are gonna die, and that was it. <v Christopher Shahara>If you lasted, or lived for another two years, you were really stretching it. <v Edward Asner>Tragic stories mount, family rejection, isolation, eviction, job <v Edward Asner>firing. Cops geared up as if ready to do battle. <v Edward Asner>Health care workers, ambulance drivers refusing to touch people with AIDS. <v Jeffrey Laurence, M.D.>In the very beginning, we had technicians that weren't interested in working with their

<v Jeffrey Laurence, M.D.>disease. There were stories in certain hospitals about physicians refusing <v Jeffrey Laurence, M.D.>to treat patients, about, um, technicians standing up and refusing to deal with <v Jeffrey Laurence, M.D.>blood samples. And because of all this, things became very difficult. <v Jeffrey Laurence, M.D.>And I think in the very beginning of this epidemic, uh, the full exerted effort <v Jeffrey Laurence, M.D.>of a real team couldn't happen because of all of the concerns of a lot of people <v Jeffrey Laurence, M.D.>working with this disease. <v Edward Asner>Even the Journal of the American Medical Association published an article speculating <v Edward Asner>that AIDS may be transmitted casually. <v Edward Asner>It is not. <v David McKee>There's just so many misconceptions about it. <v David McKee>And usually what makes the news is the worst, uh, the <v David McKee>most extreme cases. <v Edward Asner>In the United States some rare cases of AIDS in adults and children have been attributed <v Edward Asner>to blood transfusions. This heightens the threat. <v Edward Asner>Were the blood banks contaminated? <v Margaret Fischl, M.D.>Problems have been identified with blood transfusions and patients have come down with <v Margaret Fischl, M.D.>AIDS related to transfusions.

<v Margaret Fischl, M.D.>But the number of cases have been relatively small compared to the large <v Margaret Fischl, M.D.>number of blood transfusions that have been given in the U.S.. <v Edward Asner>Some people started to stockpile their own blood. <v Edward Asner>The federal government issued strong statements of reassurance, but the public was <v Edward Asner>not easily convinced. At the same time, the national blood supply <v Edward Asner>fell to dangerously low levels as potential donors refused to give. <v Cladd Stevens, M.D.> Because, uh, there is a needle stick involved in the actual <v Cladd Stevens, M.D.>blood donation itself. Many people have assumed that, well, maybe they could get AIDS <v Cladd Stevens, M.D.>from donating blood. <v Cladd Stevens, M.D.>The needles that are used, uh, in blood donors are actually sterile <v Cladd Stevens, M.D.>and are only used in one donor and then discarded. <v Cladd Stevens, M.D.>So, there is really no possibility of, uh, <v Cladd Stevens, M.D.>being exposed to an infectious agent, whether it be AIDS or any other agent through, uh, <v Cladd Stevens, M.D.>donation of blood. <v Edward Asner>In some cases, children acquire the disease from their mothers who have AIDS. <v Arye Rubinstein, M.D.>Most data points to an in utero transmission of the disease

<v Arye Rubinstein, M.D.>so that the baby acquire the disease. Eh... <v Arye Rubinstein, M.D.>As a fetus, we can say. <v Arye Rubinstein, M.D.>And was born already with the disease and then slowly evolved <v Arye Rubinstein, M.D.>and developed all the symptoms. <v Edward Asner>Amar Hamilton's mother is an I.V. drug abuser with AIDS. <v Edward Asner>Amar contracted AIDS from her. <v Edward Asner>He's in the custody of his grandmother. <v Amar Hamilton's Grandmother>She had been in my house until she moved in her house. <v Amar Hamilton's Grandmother>There, I used to make her eat. <v Amar Hamilton's Grandmother>But when she's by herself, she doesn't, you know, she doesn't have <v Amar Hamilton's Grandmother>the willpower to do nothing. <v Amar Hamilton's Grandmother>That's why I try to keep, you know, the kids away from as much as possible. <v Edward Asner>Amar struggles with one opportunistic infection after another and has lost most <v Edward Asner>of his hearing. Dr. Brian Novick is his treating physician. <v Brian Novick, M.D.>Amar is, uh, almost 6 years old now and really that, that <v Brian Novick, M.D.>makes him one of the oldest children that has AIDS.

<v Brian Novick, M.D.>One of the first children that was probably diagnosed [Amar coughs] with AIDS. <v Brian Novick, M.D.>Um, And in the first <v Brian Novick, M.D.>four years or so of his life, he had several [Amar coughs] severe infections, <v Brian Novick, M.D.>including meningitis. <v Brian Novick, M.D.>Uh, he's had several episodes of pneumonia and, um, he's had other infections <v Brian Novick, M.D.>which have really debilitated him. <v Edward Asner>Doctors are trying to strengthen Amar's immune system with a course of intravenous gamma <v Edward Asner>globulin. Some children respond to this therapy. <v Edward Asner>So far, adults have not. <v Brian Novick, M.D.>There is a difference between what we're seeing in adults with AIDS <v Brian Novick, M.D.>and children with AIDS. <v Brian Novick, M.D.>Um, really, the most obvious one is Amar, that Amar is 6 years old. <v Brian Novick, M.D.>Um, There are probably [Amar coughs] very few adults <v Brian Novick, M.D.>that have lived this long with AIDS, uh, whereas <v Brian Novick, M.D.>Amar is one of two or three children that are really around five and a half, six years <v Brian Novick, M.D.>that we're following who are still alive, um, and are <v Brian Novick, M.D.>clinically stable. This is much longer than many of the adults.

<v Arye Rubinstein, M.D.>The social issue is, uh, as bad in children as in adults. <v Arye Rubinstein, M.D.>If you, for example, have one child with AIDS in the family, with the other children, <v Arye Rubinstein, M.D.>it's often so that the other children are excluded from schooling because of their <v Arye Rubinstein, M.D.>contact with a sibling that has AIDS. <v Arye Rubinstein, M.D.>Uh, there are situations where families have to move- had to move from their apartments <v Arye Rubinstein, M.D.>because the neighbor's found out that they had a child with AIDS and they didn't want <v Arye Rubinstein, M.D.>their children to play with a child that has AIDS or with siblings of a child with AIDS. <v Amar Hamilton's Grandmother>But when the teacher teaches him for the deaf, they have to use their hands. <v Amar Hamilton's Grandmother>And other kids, they're set up to teach to you with their hand they figured that <v Amar Hamilton's Grandmother>something from him could, you know, all the kids would catch it. <v Amar Hamilton's Grandmother>So I told them, I told them that was foolish. <v Amar Hamilton's Grandmother>I said, because... <v Amar Hamilton's Grandmother>I said, the only way they could contract anything it have to be through sexual <v Amar Hamilton's Grandmother>intercourse or through blood. <v Amar Hamilton's Grandmother>And then they said to me, well, we elect Amar stay home <v Amar Hamilton's Grandmother>and, um, we'll send a tutor for him.

<v Arye Rubinstein, M.D.>Currently, as you know, we are studying and treating 40 children with AIDS or with <v Arye Rubinstein, M.D.>AIDS related complex. <v Arye Rubinstein, M.D.>We are studying all the members of the family of these children and especially the other <v Arye Rubinstein, M.D.>children in the family or in the foster family. <v Arye Rubinstein, M.D.>And so far, we could not document in any one of these families a second child <v Arye Rubinstein, M.D.>that acquired the disease from the index patient. <v Amar Hamilton's Grandmother>I raised four kids on my own, and I know there's certain precautions you have to take. <v Amar Hamilton's Grandmother>I know every [stammers] well, all I can do is I use <v Amar Hamilton's Grandmother>a lot of disinfect around the house. <v Amar Hamilton's Grandmother>And, uh, when a certaint time, I put on a glove. <v Amar Hamilton's Grandmother>You know, certain things I put on a glove, and I don't, I don't feel I'm <v Amar Hamilton's Grandmother>gon' get it. <v Arye Rubinstein, M.D.>The myth of the infectiousness of AIDS has also touched upon the children <v Arye Rubinstein, M.D.>in quite a... <v Arye Rubinstein, M.D.>Sad form. <v Arye Rubinstein, M.D.>Most of the children, as I told you before, coming from families with a mother, often <v Arye Rubinstein, M.D.>also the father are drug abusers.

<v Arye Rubinstein, M.D.>Most of these families are broken families where the parents don't live together and <v Arye Rubinstein, M.D.>cannot care for the child with AIDS. <v Arye Rubinstein, M.D.>Some of the parents abandoned those children in the hospital, uh, and we have been <v Arye Rubinstein, M.D.>involved for a long time. In many of these children in the search for foster parents. <v Amar Hamilton's Grandmother>?Eba? was taking care of this baby ever since he was born because I kept <v Amar Hamilton's Grandmother>him with me as he wasn't a well-baby and I didn't, you know, I wanted him to have the <v Amar Hamilton's Grandmother>best of care. And after I found out that he was sick, I <v Amar Hamilton's Grandmother>went for court. Now he is rewarded to me during court to make sure [Amar coughs] <v Amar Hamilton's Grandmother>that he gets his food the way he's supposed to get it. <v Amar Hamilton's Grandmother>And I know he is well taken care of. <v Edward Asner>From the moment of birth, the body is assaulted by a barrage of foreign invaders, <v Edward Asner>viruses, microbes, chemicals, particles and substances of every kind. <v Edward Asner>Most are blocked from entering the body's tissues. <v Edward Asner>Outside, the body's tough elastic skin acts as a resilient shield.

<v Edward Asner>Inside, the fluids of the digestive system consume or expel many of <v Edward Asner>these dangerous substances. <v Edward Asner>And the mucous linings of the respiratory system also trap and eject them. <v Edward Asner>Foreign invaders that do get in as here, through a cut in the skin, are called antigens. <v Edward Asner>The immune system evolved to prevent antigens from taking over. <v Edward Asner>Without natural immune defenses, the body would lose the constant battle against <v Edward Asner>the microbial world. <v Edward Asner>David, the boy in the bubble, lost that battle. <v Edward Asner>He was born without any components of immune defense at all. <v Edward Asner>He died of what is called severe combined immunodeficiency disease. <v Edward Asner>It is inherited. It is not contagious and it is even more profound <v Edward Asner>than AIDS. Children with this disease must live from birth in a totally <v Edward Asner>germ-free environment for them, contact with even the most common <v Edward Asner>germs and antigens can be fatal.

<v Edward Asner>Normally, a healthy immune system responds to them in a complex and <v Edward Asner>elegant way that science is just beginning to understand. <v Renslow Sherer, M.D.>And immunology is a very young science and it's grown <v Renslow Sherer, M.D.>exponentially since the, the first major discoveries of immunoglobulins <v Renslow Sherer, M.D.>and a cellular immune system. <v Renslow Sherer, M.D.>But in fact, it's still a very young science. <v Renslow Sherer, M.D.>And for that reason, really, the, uh, research and investigation of AIDS <v Renslow Sherer, M.D.>will parallel the growth of understanding of the human immune system. <v Edward Asner>This miracle of the human body has several remarkable characteristics. <v Edward Asner>When it is working properly, it is able to identify what is and what is not part of the <v Edward Asner>human body. It can combat infection and disease, and it can remember <v Edward Asner>how so that the next combat will be swifter and even more efficient. <v Edward Asner>When an immune system is not working properly, a wide range of diseases can <v Edward Asner>be unleashed. Allergies are an overreaction to a relatively harmless <v Edward Asner>invader, like a pollen.

<v Edward Asner>Rheumatoid arthritis, a more serious disorder, occurs when the body mistakes <v Edward Asner>its own tissues as foreign and attacks them. <v Edward Asner>The major organs of the immune system are stationed throughout the body. <v Edward Asner>Tonsils and adenoids, thymus, spleen, appendix, bone <v Edward Asner>marrow and lymph nodes laced along an elaborate network of lymph vessels <v Edward Asner>that merge with the bloodstream. <v Edward Asner>Strings of these bean-shaped structures can be found in the neck, armpits, <v Edward Asner>groin. The immune system deploys billions of immune cells. <v Edward Asner>Sharing combat duties, they patrol the body and are able to trap, kill <v Edward Asner>and remove invaders. <v Edward Asner>These lymphocyte immune cells play a major role in immune defense. <v Edward Asner>They are small white blood cells. <v Edward Asner>The T cell lymphocytes are the captains. <v Edward Asner>There are two types of T-cells, helpers and suppressors. <v Edward Asner>Together, these captains issue and revoke orders to their troops, <v Edward Asner>the B cell lymphocytes.

<v Edward Asner>When an invader is present, it is first identified by helper T cells. <v Edward Asner>Then these cells send out chemical alarms, drawing B cells to the invasion <v Edward Asner>site. B cells are chemical experts when ordered <v Edward Asner>into action by helper T cells. <v Edward Asner>They produce lethal antibodies to combat and kill the antigen invader. <v Edward Asner>Too much antibody can be harmful to the body. <v Edward Asner>That's why suppressor t cells are needed to regulate the battle. <v Edward Asner>Helper T cells issue orders for more antibody. <v Edward Asner>Suppressor T cells countermand those orders until the immune response is completely <v Edward Asner>shut down. When the battle is over, the immune system remembers. <v Edward Asner>The next time a similar antigen invades, defense can be faster and <v Edward Asner>more efficient. Here is the process once again. <v Edward Asner>Identification, alarm, antibody combat, <v Edward Asner>regulation, shut down.

<v Edward Asner>Normally, there are two helper t cells for every suppressor T cell. <v Edward Asner>The AIDS agent appears to be attacking helper T cells, reversing <v Edward Asner>the 2 to 1 ratio and preventing the body from combating <v Edward Asner>antigen invaders. <v Edward Asner>When a person has AIDS, the body becomes vulnerable to a range of cancers and <v Edward Asner>infections, which can be fatal. <v Edward Asner>People with healthy immune systems usually don't get AIDS diseases. <v Edward Asner>That's why these diseases are called opportunistic. <v Edward Asner>They take advantage of the weakened immune system. <v Edward Asner>The cancer, Kaposi's sarcoma and the parasitic infection pneumosystis <v Edward Asner>carinii pneumonia are the most common. <v Edward Asner>Opportunistic AIDS diseases like these can be treated with some success. <v Edward Asner>The earlier, the better. However, at present, the underlying immune suppression <v Edward Asner>of AIDS remains incurable. <v Joel Weisman, D.O.>I don't think we have a great deal to offer the, the patient in terms of,

<v Joel Weisman, D.O.>of magic medicines. There's no penicillin for AIDS. <v Joel Weisman, D.O.>I mean, there's no magic injection. <v Edward Asner>The Centers for Disease Control in Atlanta, a public health service of the federal <v Edward Asner>government, was among the first to document that something unusual was happening <v Edward Asner>on the east and West coasts. <v James Curran, M.D.>Back in, uh, early 1981, there were <v James Curran, M.D.>a few unusual requests for a drug called pentamidine diisethionate, <v James Curran, M.D.>the backup drug to treat this rare pneumonia, pneumocystis pneumonia. <v James Curran, M.D.>Uh, Some of these requests had come from New York City and there is an unusual group <v James Curran, M.D.>of three or four such requests from Los Angeles, from UCLA Medical Center. <v Michael Gottlieb, M.D.>In early 1981 at UCLA, we evaluated four patients with unexplained fevers <v Michael Gottlieb, M.D.>and marked weight loss. All four ultimately developed pneumocystis pneumonia, <v Michael Gottlieb, M.D.>an opportunistic infection which occurs only in individuals with compromised <v Michael Gottlieb, M.D.>immune systems. At this point, we thought we had discovered a new,

<v Michael Gottlieb, M.D.>previously undescribed, immune deficiency condition. <v Michael Gottlieb, M.D.>All four of our original patients were gay males and thus we considered the possibility <v Michael Gottlieb, M.D.>that this was a transmissible immune deficiency. <v Edward Asner>Following the pattern of many infectious diseases, AIDS gradually spread from the coastal <v Edward Asner>areas to the center of the country. <v Renslow Sherer, M.D.>The slow start apparently is because of the onset of the epidemic and the coasts. <v Renslow Sherer, M.D.>And Chicago was, uh, had our first case really I think in 1982. <v Renslow Sherer, M.D.>But since then, we really are equaling the epidemic in the rest of the country. <v Margaret Fischl, M.D.>Well, it's very possible that AIDS has been around for a long time, but clearly <v Margaret Fischl, M.D.>with just sporadic cases. <v Margaret Fischl, M.D.>When one looks back in the medical literature, one may find a case or two, <v Margaret Fischl, M.D.>10, maybe even 20 years ago, that might now be diagnosed as AIDS. <v Margaret Fischl, M.D.>But clearly, something happened in 1979, 1980 that <v Margaret Fischl, M.D.>caused this to really surface and which we now have a major epidemic.

<v Edward Asner>History is filled with accounts of diseases that wiped out masses of people. <v Edward Asner>They are often woven into myth. <v Edward Asner>The Bible tells fantastic stories of pestilence from the 14th century, <v Edward Asner>the bubonic plague, called the Black Death, killed 25 million Europeans <v Edward Asner>and left a lasting scar on the collective memory of that continent. <v Edward Asner>In the 1950s, polio was marked by the specter of the iron lung. <v Edward Asner>The March of Dimes burst upon the national scene and made its way door to door. <v Edward Asner>Funds collected by volunteers were used to track down the polio virus and develop <v Edward Asner>a vaccine. More recently, Legionnaires' disease was shrouded in an <v Edward Asner>aura of mystery. It wasn't until a new bacterium was discovered that <v Edward Asner>anyone knew what struck the Philadelphia conventioneers. <v Edward Asner>AIDS has its own myths. <v Edward Asner>The delays in finding the facts are attributed to prejudices against the groups AIDS <v Edward Asner>most often affects homosexuals, I.V.

<v Edward Asner>drug abusers, Haitians. <v Edward Asner>Candlelight marches across the country added the element of urgency. <v Edward Asner>They raised money for underfunded research and galvanized groups to respond with a <v Edward Asner>measure of sanity and concern. <v Patti Lupone>The purpose of this evening is support. <v Edward Asner>In April 1983, the New York Gay Men's Health Crisis filled Madison <v Edward Asner>Square Garden for a benefit performance of the Ringling Brothers Barnum and Bailey <v Edward Asner>Circus. In one night, they raised nearly $400,000. <v Edward Asner>Proceeds went to AIDS research and support programs. <v Edward Asner>As with all AIDS volunteer groups, the essential services and information they provide <v Edward Asner>are not limited to gay people, but to everyone touched by AIDS. <v Shirley Verrett>We don't really know where it's going to hit next. <v Shirley Verrett>So I think we all have to be very, very much involved in this. <v Patti Lupone>It's a disease that must be cured. <v Patti Lupone>Let us begin to find an end to acquired immunodeficiency <v Patti Lupone>syndrome. <v Margaret Fischl, M.D.>As far as the general public is concerned, I think they should realize that we are

<v Margaret Fischl, M.D.>dealing with a new disease. <v Margaret Fischl, M.D.>We don't have all the answers. <v Margaret Fischl, M.D.>And because of that, that doesn't mean there needs to be mass hysteria. <v Margaret Fischl, M.D.>This disease does not appear to be highly contagious. <v Joel Weisman, D.O.>Intimate contact diseases are, are transferred by blood <v Joel Weisman, D.O.>products and serum products, those containe d in semen and blood. <v Edward Asner>The exchange of body fluids during male to male sexual contact is suspected <v Edward Asner>to be the most common mode of transmitting AIDS in the United States. <v Paul Volberding, M.D.>This is a sexually transmitted disease, and that probably <v Paul Volberding, M.D.>rectal intercourse, the.. <v Paul Volberding, M.D.>The insemination of the rectum, is more likely to result <v Paul Volberding, M.D.>in trauma, which will open blood vessels for the <v Paul Volberding, M.D.>inoculation, direct inoculation, of, of the AIDS agent. <v Paul Volberding, M.D.>While vaginal intercourse is more protected structurally, <v Paul Volberding, M.D.>doesn't result in that trauma and probably doesn't result in the same inoculation <v Paul Volberding, M.D.>of, of infectious diseases.

<v Edward Asner>According to federal statistics, 72 percent of all people with AIDS <v Edward Asner>in the United States are homosexual or bisexual men. <v Edward Asner>No cases of AIDS in homosexual women have been reported so far. <v Christopher Shahara>And when the doctor did call me up and asked me to come in before office hours to have a <v Christopher Shahara>consultation, I assumed that it was something drastically wrong. <v Christopher Shahara>And when he said AIDS, my initial reaction was that it was nice knowing you. <v Christopher Shahara>That's what I said to the doctor. <v Edward Asner>Christopher Shahara's AIDS was confirmed when he was diagnosed with Kaposi's sarcoma <v Edward Asner>in November 1982. <v Edward Asner>So far, this cancer is mostly confined to gay men with AIDS. <v Christopher Shahara>I sensed that something is wrong for the previous year or so, I hadn't felt right and I <v Christopher Shahara>didn't know whether it was just exhaustion but my body didn't feel right. <v Christopher Shahara>When I first was diagnosed and started coming to the hospital, it used to be a really <v Christopher Shahara>terrifying experience. But now, after almost a year and a half, it seems like an everyday <v Christopher Shahara>occurrence. I can remember back the first time I was admitted as an inpatient <v Christopher Shahara>for my interferon treatments. I was put into the laminar flow room, which is basically <v Christopher Shahara>the room that they used in the movie like Boy with a glass bubble.

<v Christopher Shahara>And that was really terrifying. <v Christopher Shahara>I had no idea what was gonna be happening. <v Christopher Shahara>And here I was put in this clear plastic room. <v Christopher Shahara>And in order to do anything, I had to call the nurse. <v Christopher Shahara>I wasn't allowed out of the room. Everybody could see into the room, people would walk by <v Christopher Shahara>and kinda stop and look at you like what's wrong with him? <v Christopher Shahara>And it was really an awful experience. <v Edward Asner>Dr. Joel Weissman treats many AIDS patients in Los Angeles. <v Christopher Shahara>And by time you get into the second year of treatment, the <v Christopher Shahara>physical seems to be going smooth and the treatment is for the physical and then you have <v Christopher Shahara>the psychological like, where am I going? <v Christopher Shahara>How long is this going to take? <v Christopher Shahara>Am I better? Am I not better? <v Christopher Shahara>Um, Do I live? Or is death imminent? <v Christopher Shahara>I had a very close friend come over for dinner and my friend came in, he said. <v Christopher Shahara>Did you, you know? Can I catch it from the salad? <v Christopher Shahara>And I just started laughing and I kind of looked at him ready to throw him out, because I <v Christopher Shahara>didn't know whether he was serious or not. And he started laughing. <v Christopher Shahara>I said, it's funny because I just used gloves when I made the salad and he looked, did <v Christopher Shahara>you really? And yeah. I mean, it was just I mean, myself

<v Christopher Shahara>getting phobic about the whole situation, which I knew you're not going to catch AIDS <v Christopher Shahara>from tossing a salad, but yet at the same time I said, well, just in case I can't <v Christopher Shahara>live with the fact of knowing, or maybe it is. <v Christopher Shahara>I've gotten over that. <v Joel Weisman, D.O.>But the reality is that's, that's not a factor in that, that it's <v Joel Weisman, D.O.>if we've gotten anywhere with the disease, we're, we're dealing with the fact that it's <v Joel Weisman, D.O.>not transmitted casually. <v Joel Weisman, D.O.>And that it's an intimate contact disease. <v Joel Weisman, D.O.>Uh, I don't know w-what it would be like to go home and not, <v Joel Weisman, D.O.>and not be hugged. I mean, and that I can't <v Joel Weisman, D.O.>always answer those- those questions. <v Christopher Shahara>It's not a good feeling. <v Edward Asner>Christopher is an outpatient at the UCLA Medical Center. <v Edward Asner>Despite reduced levels of energy, he's still very active. <v Edward Asner>So far, his cancer is being controlled with interferon treatments. <v Christopher Shahara>I'm not sure whether I have a fear of travel or not, but I definitely stay close to home <v Christopher Shahara>and find that there's that security in being in the house, which is- a lot of it

<v Christopher Shahara>is very psychological or all of it is psychological. <v Christopher Shahara>There's no physical reason for staying in the house or within a mile radius of the <v Christopher Shahara>house. And it's very difficult to deal with waking up one day and being a great <v Christopher Shahara>mood and two days later, ready to slit your wrists, so to speak, <v Christopher Shahara>in a figurative sense and not knowing what's going to happen. <v Christopher Shahara>And for that, I do use- need lots of support and get lots of support from friends <v Christopher Shahara>and go to therapy once a week for the emotional support, which I feel is real, real <v Christopher Shahara>important. <v Edward Asner>Nancy Cole is on the board of directors of the AIDS Project Los Angeles. <v Edward Asner>She and Christopher met on a candlelight march and have become close friends. <v Nancy Cole>I hate AIDS. <v Nancy Cole>The syndrome. The disease. What it does to people. <v Nancy Cole>I'm not necessarily thinking that a person going into a transition <v Nancy Cole>of life to death. <v Nancy Cole>That's not it. I hate the disease. <v Nancy Cole>I hate AIDS. I hate the fact that it's- no one has been able to really get a grip on what

<v Nancy Cole>this is and how to stop it. <v Nancy Cole>I mean, we're learning and everything. <v Nancy Cole>But I think that people, even within <v Nancy Cole>the gay community, that they're segmented. <v Nancy Cole>A lot of the gay community, some of them think that- they blame it on certain lifestyles <v Nancy Cole>within the gay community. It's not that at all. <v Nancy Cole>Everybody. It's it's a disease that's affecting human beings and people. <v Nancy Cole>I think what I hate most about it is the prejudice that- it has created <v Nancy Cole>for no reason. <v Christopher Shahara>I've gotten calls from some people that were just diagnosed. <v Christopher Shahara>And their biggest fear, which never entered my mind, was that <v Christopher Shahara>AIDS is, to quote, like a sleazy disease. <v Christopher Shahara>I mean, you have to be promiscuous. You have to be out on the streets. <v Christopher Shahara>And that's why you get AIDS. And I mean, it's so off the wall. <v Nancy Cole>And you don't have to be promiscuous. <v Christopher Shahara>Not at all. <v Nancy Cole>it can be the one contact in a sexual act that <v Nancy Cole>is done with risk.

<v Nancy Cole>Russian roulette. <v Joel Weisman, D.O.>I talk in terms of risk reduction, not, uh, not celibacy. <v Joel Weisman, D.O.>Not having no sex. <v Joel Weisman, D.O.>I don't think for most people, whether straight or gay. <v Joel Weisman, D.O.>That that's a viable alternative. <v Joel Weisman, D.O.>And what we've developed with guidelines set up by many different <v Joel Weisman, D.O.>organizations as forms of risk reduction. <v Joel Weisman, D.O.>And basically they, they talk about decreasing the number of sexual <v Joel Weisman, D.O.>partners, uh, they talk about uh not transferring <v Joel Weisman, D.O.>body fluids generally in those terms talking <v Joel Weisman, D.O.>about semen or blood, possibly fecal matter which contains blood. <v Joel Weisman, D.O.>I don't think that that we worry in terms of saliva, because if <v Joel Weisman, D.O.>it was a saliva borne disease, we would probably be seeing a quite <v Joel Weisman, D.O.>different pattern than, than the pattern of intimate contact. <v Edward Asner>The New York Blood Center is studying the natural history of AIDS by tracking patterns <v Edward Asner>of 1000 gay men.

<v Edward Asner>Physical examinations, blood tests and elaborate questionnaires about sexual activities <v Edward Asner>are routine every three months for three years. <v Edward Asner>Dr. Cladd Stevens is in charge. <v Cladd Stevens, M.D.>When these men, uh, come into our clinic, we will, uh, <v Cladd Stevens, M.D.>examine them physically. <v Cladd Stevens, M.D.>And we'll take blood samples, which will be tested in our laboratories, uh, <v Cladd Stevens, M.D.>for evidence of infection with various viral agents, for example, <v Cladd Stevens, M.D.>and tests of their immune function as well. <v Edward Asner>Similar studies are underway in San Francisco, Los Angeles, Chicago, Pittsburgh <v Edward Asner>and Baltimore. It will take years before these studies reveal exactly who <v Edward Asner>gets AIDS. To what degree and why. <v Joel Weisman, D.O.>Many of the people who I've treated are people that I've been socially <v Joel Weisman, D.O.>friendly with and have known over the course of eight years. <v Joel Weisman, D.O.>And I've had to deal with the death and dying of, of my patients <v Joel Weisman, D.O.>and friends.

<v Joel Weisman, D.O.>And it's- it takes it's toll. And I don't think any physician who does this <v Joel Weisman, D.O.>can do without therapy himself. <v Joel Weisman, D.O.>And I- I've certainly sought out that form of therapy <v Joel Weisman, D.O.>in terms of dealing with the frustrations of, of, of the disease and not <v Joel Weisman, D.O.>having a cure and having to deal on a repetitive basis with the fact that <v Joel Weisman, D.O.>people are going to die from the disease. <v Margaret Fischl, M.D.>In essence, you, you know them quite well. <v Margaret Fischl, M.D.>You try to help them deal with their AIDS and then at the same time help them die. <v Margaret Fischl, M.D.>And it becomes a tremendous emotional burden for the physician. <v Margaret Fischl, M.D.>And I literally had to get away from it for a short time and just pull away, <v Margaret Fischl, M.D.>literally leave the country to sort of escape it all, and come <v Margaret Fischl, M.D.>back and deal with it again on a better level for myself and for my patients. <v Edward Asner>Doctors are convinced that exposure to the AIDS agent does not always lead to the full <v Edward Asner>blown, life threatening forms of AIDS.

<v Frederick P. Siegal, M.D.>Almost all infectious diseases are characterized by the fact that the majority <v Frederick P. Siegal, M.D.>of individuals exposed simply don't get sick. <v Frederick P. Siegal, M.D.>And one of the most fascinating problems in understanding infectious disease is <v Frederick P. Siegal, M.D.>understanding those things which determine who gets sick and who doesn't. <v Jeffrey Laurence, M.D.>Presumably, most people that are exposed to an AIDS agent actually don't <v Jeffrey Laurence, M.D.>get the disease itself. If there were, there wouldn't be a few thousand patients with <v Jeffrey Laurence, M.D.>AIDS. There would be tens of thousands of patients with AIDS. <v Jeffrey Laurence, M.D.>And that's important that there is probably something known as a herd immunity, that <v Jeffrey Laurence, M.D.>people are exposed to a low level of the agent. <v Jeffrey Laurence, M.D.>Just as with any virus, they develop an immunity, following that exposure, <v Jeffrey Laurence, M.D.>and aren't prone to going on and developing the devastating kinds of things that AIDS <v Jeffrey Laurence, M.D.>could be. <v Edward Asner>People who do come down with AIDS are infected long before they know anything is wrong. <v Edward Asner>At the onset of the disease, these early warning symptoms may appear. <v Edward Asner>Fever lasting longer than a week or so. <v Edward Asner>Steady weight loss not caused by dieting.

<v Edward Asner>Swollen lymph glands, especially in the neck, armpits, groin. <v Edward Asner>Fatigue that will not go away. <v Edward Asner>Shortness of breath or a dry cough for no apparent reason. <v Edward Asner>Drenching night sweats. Fever during sleep. <v Edward Asner>Sudden changes in mood or personality. <v Edward Asner>Unexplained or persistent diarrhea. <v Edward Asner>These symptoms may appear in any combination over time, but a word of caution. <v Edward Asner>Any of these symptoms can be confused with the symptoms of common illnesses colds, <v Edward Asner>flu. <v Joel Weisman, D.O.>A person just doesn't... <v Joel Weisman, D.O.>Get this disease by waking up in the middle of the night with 103 fever <v Joel Weisman, D.O.>and the next day has pneumocystis pneumonia. <v Joel Weisman, D.O.>Generally, you can trace back, uh, these other symptoms that have been <v Joel Weisman, D.O.>mild but progressive over a period of months. <v Joel Weisman, D.O.>It's not a disease that you snap your fingers and it happens the next day. <v Edward Asner>Kaposi's sarcoma, the AIDS disease most often associated with gay men <v Edward Asner>is marked by purple or red lesions.

<v Edward Asner>Sometimes these lesions are internal, as in the case of Christopher Shahar. <v Christopher Shahara>The first sign that I had something is wrong was the lymph nodes in my groin had swelled <v Christopher Shahara>and I had to go down and have them removed. <v Christopher Shahara>And when they were biopsied, they came out positive as having campuses. <v Gerald Borrell>I usually catch a- a flu, at least once a year <v Gerald Borrell>that lasts about a week or two. <v Gerald Borrell>But this time, in spite of all the medication and antibiotics <v Gerald Borrell>that I took, you know, I seem to be- you know, I just kept <v Gerald Borrell>getting worse. <v David McKee>My first symptoms was that, uh, I had started having <v David McKee>night sweats and, uh, weight loss. <v David McKee>And I had- I had my foot operated on and I'd been, uh, <v David McKee>down for about six weeks. And I just started <v David McKee>having trouble breathing and I felt I had a little touch of pneumonia. <v Kenneth Brown>Our first symptoms were these spots in my arms, back, chest, <v Kenneth Brown>legs. I didn't know what they were.

<v Edward Asner>17 percent of all people with AIDS in the United States or intravenous drug abusers. <v Edward Asner>Four men to every woman. <v Edward Asner>AIDS can be transmitted by sharing needles contaminated with infected blood. <v Edward Asner>The drugs themselves can be lethal health hazards. <v Edward Asner>Kenneth Brown is hospitalized with AIDS in Chicago. <v Kenneth Brown>Well, I got TB when I came to the hospital <v Kenneth Brown>and I didn't know that either but they did a bone marrow dust and found <v Kenneth Brown>out. <v Renslow Sherer, M.D.>Of all of the risk groups I'd say that they are the least, least informed <v Renslow Sherer, M.D.>on the whole subject. <v Renslow Sherer, M.D.>And, um, this is true and has been observed in our emergency <v Renslow Sherer, M.D.>room where commonly I.V. <v Renslow Sherer, M.D.>drug abusers will come for various minor complaints and really will have little <v Renslow Sherer, M.D.>idea when asked about AIDS and the implications of shooting <v Renslow Sherer, M.D.>drugs and the possibility of contracting AIDS. <v Kenneth Brown>I've been doing drugs since I was 14.

<v Kenneth Brown>I started shooting heroin when I was 18. <v Kenneth Brown>When I was shooting heroin it was everything in my life, I couldn't stop. <v Kenneth Brown>I've ?inaudible? <v Kenneth Brown>you steal. <v Kenneth Brown>Support my habit. <v Kenneth Brown>It was very hard for me to stop taking drugs. <v Kenneth Brown>I did it for most of my life. <v Kenneth Brown>I really don't care if my friends are sharing needles. <v Kenneth Brown>If they might get AIDS. <v Kenneth Brown>I have to worry about myself. <v Kenneth Brown>It didn't ever bother me that I'd get AIDS from shooting- from shooting heroin. <v Kenneth Brown>You just don't care. <v Kenneth Brown>You don't care. <v Edward Asner>When cholera broke out in 1832, it was attributed to decadence and immorality. <v Edward Asner>Society blamed recent immigrants for the disease. <v Edward Asner>In New York, this burden was shouldered by poor Irish people until someone figured

<v Edward Asner>out that the public water supply was contaminated. <v Edward Asner>People with AIDS have also been stigmatized. <v Renslow Sherer, M.D.>In this illness there's an extraordinary amount of victim blaming, um, which <v Renslow Sherer, M.D.>is a terrible thing in any illness, and it's particularly terrible <v Renslow Sherer, M.D.>in A.I.D.S. <v Renslow Sherer, M.D.>That's where people are simply blamed for their having the illness. <v Renslow Sherer, M.D.>There still is quite a bit of homophobia prevalent in this country. <v Renslow Sherer, M.D.>It's a group most people don't understand. <v Renslow Sherer, M.D.>Most people are either afraid of or, um. <v Renslow Sherer, M.D.>Much like the Moral Majority fear are somehow acting against <v Renslow Sherer, M.D.>God's will with their, their daily habits. <v Renslow Sherer, M.D.>IV drug users are the second most commonly affected group, and there again is a group <v Renslow Sherer, M.D.>that most people are fearful of, uh, have no understanding <v Renslow Sherer, M.D.>of. I.V. drug abuse as a problem that people would simply like to blame on <v Renslow Sherer, M.D.>isolated individuals who like to enjoy themselves by shooting <v Renslow Sherer, M.D.>drugs as opposed to seeing it as yet another disease of substance abuse.

<v Margaret Fischl, M.D.>Nurses will shun them, physicians will shun them. <v Margaret Fischl, M.D.>They'll put on masks, gloves, gear up as if they had the plague <v Margaret Fischl, M.D.>and it's difficult to deal with. <v Margaret Fischl, M.D.>And then at the same time, they have to deal with dying. <v Joel Weisman, D.O.>People respond to AIDS like people respond to the diagnosis of cancer. <v Joel Weisman, D.O.>I mean, especially the way people responded to cancer ten or fifteen years <v Joel Weisman, D.O.>ago when I first started practice. <v Joel Weisman, D.O.>They respond with fright, with denial, with hysteria. <v Joel Weisman, D.O.>It causes all kinds of crises for the, uh, for the homosexual <v Joel Weisman, D.O.>patient it brings about a crises that they can't separate <v Joel Weisman, D.O.>the disease, uh, from their dealing with their sexuality. <v Edward Asner>This gay man asked that his name be withheld in order to protect his legal action <v Edward Asner>against a former employer. <v Anonymous man>Six months ago, I was diagnosed with AIDS. <v Anonymous man>I had a job at that time, um, and as far as my <v Anonymous man>physicians are concerned, I am functioning as a normal individual and

<v Anonymous man>there is no reason for me not to work. <v Anonymous man>But the company physicians have, uh, rejected that <v Anonymous man>idea and I just want the opportunity to be, um, <v Anonymous man>productive again and to live a full <v Anonymous man>life. I do not accept the premise that I have to sit <v Anonymous man>home and wait to die. <v teacher>Do you read your English book every day Amis? <v Edward Asner> 4 percent of all AIDS cases in the United States are <v Edward Asner>Haitians. Men outnumber women 7 to 1. <v Margaret Fischl, M.D.>The Haitians are classified as a high risk group by the Center for Disease Control. <v Margaret Fischl, M.D.>And unfortunately, the publicity from this has really had major adverse <v Margaret Fischl, M.D.>effect on the Haitian population. <v Roger E. Biamby>The percentage of Haitian employment has plummeted, uh, <v Roger E. Biamby>over the past few months since this AIDS issue surfaced. <v Roger E. Biamby>It is unfortunate that this has happened because it has

<v Roger E. Biamby>severely affected the financial and social life of the Haitians <v Roger E. Biamby>here in Dade County and elsewhere. <v Roger E. Biamby>Uh, It is utterly ridiculous to, to classify <v Roger E. Biamby>a nationality as a high risk group. <v Roger E. Biamby>Haitians are being used as scapegoats. <v Robert Auguste, M.D.>Emotionally it is now very difficult for anyone <v Robert Auguste, M.D.>to be Haitian. <v Robert Auguste, M.D.>If a Haitian would like something <v Robert Auguste, M.D.>to be done because there is a deep sense <v Robert Auguste, M.D.>of anger, frustration, shame, embarrassment. <v Donna Mildvan, M.D.>We don't understand whether the Haitian population really is, <v Donna Mildvan, M.D.>is a member of a different risk group, but not acknowledging it or in <v Donna Mildvan, M.D.>fact represent a distinct risk group with distinct, uh, risk factors <v Donna Mildvan, M.D.>that we just don't understand.

<v Robert Auguste, M.D.>The medical advice I would give to Haitians is the same advice <v Robert Auguste, M.D.>I would ve- I would give to every patient. <v Robert Auguste, M.D.>One, don't be promiscuous in your sex <v Robert Auguste, M.D.>life. And number two, <v Robert Auguste, M.D.>if you are addicted <v Robert Auguste, M.D.>to substance, do <v Robert Auguste, M.D.>everything possible to get help because you playing <v Robert Auguste, M.D.>with your life. <v Gerald Borrell>I feel like myself, I wish I knew where I got it. <v Gerald Borrell>I have no idea. I'm not an I.V. user. <v Gerald Borrell>My only connection is that I'm Haitian. <v Gerald Borrell's doctor>Gerald had no exposures that we're aware of that would put him <v Gerald Borrell's doctor>at risk for AIDS. And so he's an enigma to us as, as have been all the other Haitian <v Gerald Borrell's doctor>patients. <v Edward Asner>Gerald Burrill had been in and out of Beth Israel Hospital in New York several times <v Edward Asner>before his AIDS was diagnosed with the onset of tuberculosis. <v Gerald Borrell>When I first found out what it was. It was after a series of, uh, intensive

<v Gerald Borrell>testing that they found other, I had a... <v Gerald Borrell>Pulmonary tuberculosis. <v Gerald Borrell>And a couple days later, the came in and told me that I was also <v Gerald Borrell>anemic and that I had developed a, you know, a case of AIDS. <v Gerald Borrell>At the time, it was my very first time that I heard of AIDS. <v Gerald Borrell>I had no idea what it was. <v Gerald Borrell>Each time that I've come here I've gotten weaker. <v Gerald Borrell>And that's my main worry right now. It's just slowly getting weaker <v Gerald Borrell>and weaker. I don't have any symptoms right now, everything is fine, but still is this, <v Gerald Borrell>you know, a weakness, you know, that frightens me. <v Gerald Borrell>Uh, I've known AIDS patients that have died. <v Gerald Borrell>As a matter of fact, I know three of them. <v Gerald Borrell>The one that died recently while I was here, he died of the ?KS?. <v Gerald Borrell>Another one died of, uh, I believe he had a... <v Gerald Borrell>He just kept getting smaller and smaller.

<v Gerald Borrell>You die of dehydration. <v Gerald Borrell>At first, I didn't believe it. The first time I was here, I didn't believe it. <v Gerald Borrell>I didn't accept it. I didn't wanna accept it. <v Gerald Borrell>And I was very angry, you know. <v Gerald Borrell>I- I've gotten so angry that now I can hardly get angry anymore. <v Gerald Borrell>I can hardly cry. I haven't been able to cry like I <v Gerald Borrell>did in the beginning. <v Gerald Borrell>I've been very sad, very fearful. <v Gerald Borrell>And I feel very lonely, you know. <v Gerald Borrell>I feel like, uh, I've been dealt a bad <v Gerald Borrell>hand here. I'm hoping my landlord doesn't see this because I know for sure that <v Gerald Borrell>he will kick me out if he finds out. <v Gerald Borrell>That's one of my biggest fears. <v Gerald Borrell>We're not at fault for having AIDS. <v Gerald Borrell>That is just a misfortune. You know, God didn't give it to us neither, it just <v Gerald Borrell>something- a freak of nature. <v Edward Asner>Controversial issues affecting people with AIDS will continue until epidemiologists

<v Edward Asner>better understand the origin and spread of the disease. <v Richard M. Krause, M.D.>The epidemiologist is the community's physician, and his <v Richard M. Krause, M.D.>or her job is to think about the disease as it spreads <v Richard M. Krause, M.D.>through the community, to count the number of cases, to count <v Richard M. Krause, M.D.>where the cases occur. To count the circumstances under which the cases occur. <v Richard M. Krause, M.D.>And by doing that, a pattern emerges, much as <v Richard M. Krause, M.D.>does the pattern emerge in a detective story. <v Edward Asner>Epidemiological detectives have turned to Central Africa. <v Edward Asner>There is an unusually high incidence of AIDS cases in Zaire, Burundi, <v Edward Asner>Rwanda and Chad. <v Edward Asner>And there was a growing consensus that this may be the point of origin of the epidemic. <v Edward Asner>At first, it appeared that AIDS was spread from major American cities to Europe <v Edward Asner>and Australia. <v Edward Asner>Then it appeared that AIDS was brought to this country from the Caribbean. <v Edward Asner>Now scientists speculate that AIDS may have spread first from Africa to

<v Edward Asner>Europe and to the Caribbean and then to the United States. <v Edward Asner>All these theories remain unproven. <v Edward Asner>New patterns emerge. <v Ronald K. St. John, M.D.>The, uh, United States model for high risk groups in AIDS <v Ronald K. St. John, M.D.>is not a, it's not- is not holding up in all countries. <v Ronald K. St. John, M.D.>It's quite- That model applies in any of the homosexual male, the drug addict, <v Ronald K. St. John, M.D.>the hemophiliac and so forth applies in place in some of the countries in Europe. <v Ronald K. St. John, M.D.>But it doesn't apply in a country like Haiti and it doesn't apply in Zaire, <v Ronald K. St. John, M.D.>where there are many more women diagnosed with the disease, whereas in the United States, <v Ronald K. St. John, M.D.>it's almost exclusively a disease of male homosexuals, in these countries many more women <v Ronald K. St. John, M.D.>have it-. <v Edward Asner>Some AIDS cases are linked to a contaminated batch of factor 8, a <v Edward Asner>substance used to prevent hemophiliacs from bleeding to death. <v Edward Asner>Less than 1 percent of all AIDS cases in the United States are people with hemophilia <v Edward Asner>a and inherited disorder confined to men.

<v David McKee>Well I'm, uh, 100 percent sure in my own mind, that that's why <v David McKee>I contacted that AIDS was from factor 8. <v Edward Asner>David McKee lives with his wife and two daughters in a remote corner of Kentucky. <v Edward Asner>Neighbors have been generous and supportive. <v Edward Asner>Many share his passion for racing dune buggies, a sport David pursued with success, <v Edward Asner>despite the risks involved with his hemophilia. <v David McKee>You know, it's something that I was borned with and, uh, <v David McKee>there's been a lot of limitations put on what I can do and what I can't. <v David McKee>And, uh. <v David McKee>As a rule, I stay in them limitations. <v David McKee>We talk about taking the factor eight and, uh... <v David McKee>uh. <v David McKee>Most people don't realize how that it's administered, that <v David McKee>it is intravenously and it puts the <v David McKee>clottin' factor back into my blood system. <v Edward Asner>Currently, Factor 8 is an expensive product derived from the blood of thousands

<v Edward Asner>of donors. <v Mrs. McKee>And we knew the risk. um, I had read up enough on AIDS that I knew he <v Mrs. McKee>was in a high risk group. <v Mrs. McKee>But the chances for him getting the AIDS from the factor was so low <v Mrs. McKee>that, you know, we didn't think it ever happen. <v Mrs. McKee>But no, I'm not angry. <v Mrs. McKee>You can't hate someone because maybe he's got a bad batch of blood <v Mrs. McKee>and you can hate someone because of that because maybe the donor didn't know <v Mrs. McKee>that he had AIDS at the time. <v Edward Asner>When David first showed signs of illness, the local hospital treated him for pneumonia, <v Edward Asner>not knowing that he had AIDS when his condition worsened. <v Edward Asner>He was referred to the University of Kentucky Medical Center nearly 100 miles away. <v David McKee>They had done a bronchostomy and took a biopsy of the lung and, <v David McKee>and found out that had pneumocystis and <v David McKee>well, pretty well the rest of the story.

<v David McKee>You know? You know- They knew the rest of the story when I had the, the pneumocystis <v David McKee>and, uh, so then they went head and done the <v David McKee>blood work. And two days later they diagnosed me as having <v David McKee>AIDS. <v David McKee>Oh, you know, I figured that at the time I went to Lexington that, uh, you know, as <v David McKee>bad a shape as I was in when I went on up there, that there wasn't much else left for it <v David McKee>to be. <v Edward Asner>Once his diagnosis was confirmed, David was treated for pneumocystis carinii <v Edward Asner>pneumonia. He has recovered from that episode of that opportunistic <v Edward Asner>infection. <v David McKee>But at the time that I was diagnosed, I- I- I <v David McKee>was so sick that I didn't really care. <v David McKee>And so then as I started feeling a little bit better, you know, and, and <v David McKee>really surveyed the situation and what was really taking place. <v David McKee>I had already learnt to accept it and deal with it. <v Edward Asner>David's 3 year old Jonah doesn't understand AIDS.

<v Edward Asner>Becky, who is 10, has her own definition of her father's condition. <v David McKee's daughter>Our ?pa? doesn't have any immune system. <v David McKee's daughter>And if you get around someone that has a cold or something, you'll catch the cold <v David McKee's daughter>and you could... die. <v Mrs. McKee>We knew that when I married David, that this hemophilia wasn't <v Mrs. McKee>curable. Uh, So they come up with the clotting factor, he <v Mrs. McKee>got along fine. <v Mrs. McKee>So now he has AIDS. <v Mrs. McKee>Uh, We hope that they will come up with a cure for the AIDS. <v David McKee>You know, I know that the morality rate on it is high, but, uh, <v David McKee>my main concern right now is, is if any of these <v David McKee>opportunistic diseases come along is deal with each one of <v David McKee>them individually. <v Mrs. McKee>The hardest thing for me is knowing that, uh, I would probably have to face

<v Mrs. McKee>the future with my children by myself. <v Mrs. McKee>Because with no cure, we know there's no cure <v Mrs. McKee>in the near future. <v Mrs. McKee>Um, as far as David getting these opportunit diseases, it could happen tomorrow. <v Mrs. McKee>You know, um, that's the hardest thing. <v Mrs. McKee>But again, I try not to think about tomorrow, because <v Mrs. McKee>we have David today and we hope we have <v Mrs. McKee>David tomorrow, you know? <v Edward Asner>In April 1984, the federal government announced that the probable cause of <v Edward Asner>AIDS had been found. <v Edward Asner>A variant of a known human cancer virus. <v Edward Asner>To tell us what this research means, I have with me Dr. Harold Jaffe, chief of <v Edward Asner>epidemiology for AIDS activity at the Centers for Disease Control. <v Edward Asner>And Dr. Jeffrey Laurence, assistant professor of medicine at New York Hospital, Cornell <v Edward Asner>Medical Center. Dr. Laurence, does this discovery of a probable cause

<v Edward Asner>of AIDS move us any closer to a cure? <v Jeffrey Laurence, M.D.>Brings us a lot closer. If we start looking at the history of viral epidemics in the <v Jeffrey Laurence, M.D.>United States and in the world, it's always been the ability to name the virus, <v Jeffrey Laurence, M.D.>the ability to grow that virus, either in the test tube, or in an animal in large <v Jeffrey Laurence, M.D.>quantities and then the ability to mount an effective vaccination program against <v Jeffrey Laurence, M.D.>it or develop an effective antibiotic that have led to cures. <v Jeffrey Laurence, M.D.>And that's what we're aiming for in this disease. <v Jeffrey Laurence, M.D.>There'll be problems with that. However, part of the problem will be that if it's a <v Jeffrey Laurence, M.D.>disease or a virus like polio, the most effective cure will be <v Jeffrey Laurence, M.D.>truly a vaccine, a preventative measure and compulsive vaccination of large populations. <v Jeffrey Laurence, M.D.>If it's more a, a virus, say, herpes virus, we have very effective antibiotics <v Jeffrey Laurence, M.D.>against some of the manifestations of herpes. <v Jeffrey Laurence, M.D.>So there are two ways now that scientific research is going to effectively try to combat <v Jeffrey Laurence, M.D.>this disease. <v Edward Asner>How much time to a vaccine are we talking about? <v Jeffrey Laurence, M.D.>If it's truly one virus and we have that to rely on with genetic

<v Jeffrey Laurence, M.D.>engineering methods today, we could probably have a vaccine within a year if there <v Jeffrey Laurence, M.D.>are variants of this virus. If as the flu, the virus changes the way <v Jeffrey Laurence, M.D.>that it looks to the body's immune system, it could take several more years than that. <v Edward Asner>Dr. Jaffe, what does the discovery of the probable cause of <v Edward Asner>AIDS mean for the national blood supply and the threat of <v Edward Asner>transfusion related AIDS? <v Harold Jaffe, M.D.>In the last three years, about 10 million Americans have received transfusions, yet <v Harold Jaffe, M.D.>only about 50 of them have had transfusion AIDS. <v Harold Jaffe, M.D.>So the risk is really quite small. <v Harold Jaffe, M.D.>In 1983, the Public Health Service and Blood Banks made recommendations <v Harold Jaffe, M.D.>on limitation of donation by so-called risk group members. <v Harold Jaffe, M.D.>And we assume that that made the risk even smaller. <v Harold Jaffe, M.D.>Now that it's going to be possible to screen donated blood for evidence of <v Harold Jaffe, M.D.>the AIDS virus, that risk should become, we hope, minuscule. <v Edward Asner>Is AIDS an automatic death sentence?

<v Harold Jaffe, M.D.>It's hard to generalize about the prognosis for AIDS because it takes probably several <v Harold Jaffe, M.D.>different forms. For example, patients with the severe forms of AIDS clearly <v Harold Jaffe, M.D.>don't do well. Patients diagnosed more than two years ago, at least <v Harold Jaffe, M.D.>80 percent have died. <v Harold Jaffe, M.D.>Presumably, that's because their immune systems are profoundly depressed <v Harold Jaffe, M.D.>and don't return to normal. And until there's a therapy available, we can assume <v Harold Jaffe, M.D.>they won't do well. Patients with milder forms of the disease, however, do <v Harold Jaffe, M.D.>seem to do well. How well people will do who've been exposed to the AIDS virus <v Harold Jaffe, M.D.>and are clinically well, we really don't know. <v Edward Asner>What can we expect from the epidemic in the future? <v Harold Jaffe, M.D.>I think we have to assume that the epidemic will not go away anytime soon. <v Harold Jaffe, M.D.>The number of cases continues to increase. <v Harold Jaffe, M.D.>The rate continues to increase. <v Harold Jaffe, M.D.>We do think that changes in behavior by certain risk group members can <v Harold Jaffe, M.D.>slow the epidemic. But the ultimate control will probably require a vaccine. <v Jeffrey Laurence, M.D.>Absolutely correct. We're working on two fronts now.

<v Jeffrey Laurence, M.D.>We need an effective vaccine for the people who are at risk. <v Jeffrey Laurence, M.D.>We need an effective therapy, a way to bolster the immune system in people who have <v Jeffrey Laurence, M.D.>the disease. We're going to learn a lot about the way that viruses cause cancer. <v Jeffrey Laurence, M.D.>The way the viruses cause various diseases in the immune system from this epidemic. <v Jeffrey Laurence, M.D.>And hopefully we're going to able to help people with the disease. <v Edward Asner>Doctors, let's lay it on the line. <v Edward Asner>Are we being overly optimistic? <v Jeffrey Laurence, M.D.>It's a real problem here because truly, we could say if we know the protein on the virus <v Jeffrey Laurence, M.D.>that we want to make a vaccine to, we can have one in a year by genetic engineering. <v Jeffrey Laurence, M.D.>We don't necessarily know that. We don't know that the virus isn't going to change. <v Jeffrey Laurence, M.D.>And no one has ever prepared an effective vaccine against a retrovirus before, <v Jeffrey Laurence, M.D.>a virus as the virus that causes AIDS. <v Edward Asner>Jaffe. <v Harold Jaffe, M.D.>I'd agree with Dr. Laurence. I think it's very difficult to predict when such a vaccine <v Harold Jaffe, M.D.>might be available. And then even when it is available, it has to be shown to be both <v Harold Jaffe, M.D.>safe and effective. And that could be quite difficult. <v Edward Asner>Thank you, Dr. Laurence. Dr. Jaffe.

<v Edward Asner>AIDS has forced people with the disease to grapple with a life and death situation, <v Edward Asner>shattering their lives, often leaving them abandoned, that present with slim hope of <v Edward Asner>recovery. Science has conquered the microbial world before. <v Edward Asner>That takes time. As we've just heard, AIDS research will continue to yield <v Edward Asner>secrets and puzzle scientists for years to come. <v Edward Asner>In the meantime, a warning. <v Edward Asner>The AIDS epidemic is not over. <v Edward Asner>If you are among the risk groups, heed the precautions, exercise <v Edward Asner>good judgment in matters of human intimacy, seek help if you are abusing <v Edward Asner>drugs, protect your life and the lives of others. <v Edward Asner>If you are family or friend or lover or neighbor of someone who does have AIDS. <v Edward Asner>Keep a clear perspective. <v Edward Asner>AIDS is not a casual contact disease, nor is it the wrath of God. <v Edward Asner>To complete the AIDS profile, it must be said that each of us has the responsibility <v Edward Asner>to suspend prejudice and exercise rational behavior

<v Edward Asner>and informed thought until the threat of AIDS is eliminated. <v Amar Hamilton's Grandmother>I guess my emotion strength came- come from God. <v Amar Hamilton's Grandmother>He gave it to me. <v Amar Hamilton's Grandmother>The strength to help to take care of this baby. <v Amar Hamilton's Grandmother>I don't mind doing that. <v Amar Hamilton's Grandmother>Because when I'm- when I'm doing- when I'm- what I'm doing for him. <v Amar Hamilton's Grandmother>I'm helping him, you know, because he is a sick child. <v Christopher Shahara>It's not time to give up. You know, There's hope out there for me and there's hope for <v Christopher Shahara>lots of other people. And you just have to keep a positive attitude. <v Christopher Shahara>Otherwise, you're not going to do well. <v Christopher Shahara>But with a positive attitude, at least it helps you to keep going. <v Christopher Shahara>And you never know. The cure might come tomorrow. <v Christopher Shahara>I want to be here tomorrow if the cure is here. <v Kenneth Brown>I got this disease from shooting heroin. <v Kenneth Brown>And everybody who does it is crazy. <v Gerald Borrell>The miracle... <v Gerald Borrell>Is just around the corner. All I have to do is hold on and be strong. <v David McKee>I'm still David McKeen. Except I've- uh, I've got AIDS now.

<v Speaker>As far as my physicians are concerned, I am functioning. <v Speaker>[voices overlapping] I do not accept the premise that I have to sit <v Speaker>home and wait to die. <v Speaker>[music plays] <v Edward Asner>This is Edward Asner at the time of broadcast the Centers for Disease report more than <v Edward Asner>five thousand diagnosed cases of AIDS. <v Edward Asner>More than two thousand ?for toddlers?.

<v Edward Asner>Young Amar Hamilton, Christopher Shahara in Los Angeles, and David McKee in Kentucky <v Edward Asner>are all reported to be in perfectly stable condition. Gerald Baril's condition is described as deteriorating by his physician in New York. Kenneth Brown from Chicago is deceased. <v Speaker>Major funding for this program was provided by a grant from Hoffman Laroche Inc. <v Speaker>A research intensive health care company. <v Speaker>Additional funding was provided by the National Institute of Allergy and Infectious <v Speaker>Diseases and the National Cancer Institute. <v Speaker>For information about a video cassette of this program, write AIDS <v Speaker>WNET. 356. West 58 Street. <v Speaker>New York, New York. 10019.

<v Speaker>For a transcript, send three dollars to the same address.