I believe it is important for the well being of gay men to be tested for antibody against Human T-cel1 Lymphotrophic Virus III (HTLV-III). Infection with the HTLV-lll is the necessary component in developing AIDS. It is very possible that in order for full blown, life threatening AIDS to develop a person needs to have an already compromised immune system. Nonetheless, the “AIDS virus” (HTLV-III) must still be present or AIDS will not occur. Other “co-factors” probably play a role in compromising the immune system also but more will be said about them later.
One of the most frustrating aspects of dealing with AIDS and its intrusion into our lives has been the element of the unknown. It is very difficult to defend oneself from the unknown. We now know with virtual certainty that it is a virus that so damages our immune system that we fall prey to cancer and opportunistic infections. This virus is present in blood, semen, and saliva (with the highest concentration of virus found in blood.) The nature of some sexual acts facilitates the sharing of blood and semen between partners. Passive anal intercourse without the use of a condom by the active partner is a very efficient (but by no means the only) way to expose oneself to this virus. Infection with the virus is common in the gay male community and is found in 30% to 65% of a broad representation of gay men in major metropolitan areas who have been sexually active in the past five years.
Much of the anxiety that has gnawed at us as individuals and as a community has been generated and fueled by the uncertainty of the situation. The lack of concrete information about our risk for developing AIDS has also fed our ability to rationalize the seriousness of the AIDS epidemic. How many times have we all said or heard others say, “If I’m going to get it I’m going to get it” or “If I haven’t gotten it by now I’m not going to get it”?
Information presented at the international AIDS conference held in Atlanta, Georgia during April of this year showed rather dramatically that to be positive for antibody means that one most likely also has the virus in their system currently and is therefore presumed to be infectious to others. Other data presented at the conference showed the estimated incubation period (time from infection to development of AIDS) to be 2 to 5 years! Many medical authorities speculate that 5% to 20% of those individuals testing positive for antibody will go on to develop AIDS.
This is a very frightening situation, but not one that we are powerless against. I believe that knowledge enhances our power to control the situation. What benefit does knowing your antibody status provide? Plenty!
If you are found to be positive for antibody against HTLV-III (AIDS virus) and this result is then confirmed again on a repeat test you can be quite certain you have been infected by HTLV-III and not merely exposed! This does not tell you that you are going on to develop AIDS. As mentioned previously, many experts feel that 5% to 20% of those testing positive for antibody will develop AIDS. I do not believe that having the knowledge that one is positive will create incapacitating anxiety. Quite the contrary, I believe it will provide the impetus for changing life-style behaviors that will significantly reduce the chances of developing AIDS. It is my opinion that various other co-factors are necessary to impair the immune system before the AIDS virus can do its irreparable damage. (See New York Native; May 6-19, 1985; “Co-Factors and AIDS” by Richard Pearce, Ph.D) These co-factors may include: poor nutrition; infection with other viruses that can be sexually transmitted including cyto-megalovirus, hepatitis-B and Epstein-Barr virus; drug (including poppers) and alcohol abuse; intestinal parasite infections; and stress. Good nutrition, plenty of rest, conscientious safe sex practices and limited or no use of alcohol and and recreational drugs are imperative to maintain a strong immune system! Periodic check-ups by a health care provider knowledgeable about AIDS also is wise.
At this stage of our knowledge about AIDS we must assume that if we are positive for antibody we are infectious to others and therefore must avoid sharing bodily secretions. This virus is not spread through casual contact! If two individuals in a relationship are both positive a knowledgeable health care provider should be consulted about what precautions, if any, should be taken. If only one partner of a couple is positive conscientious safe-sex guidelines are recommended, but the sexual history could be important and again a knowledgeable third party should be consulted for advice. Members of the Colorado AIDS Project (CAP) are receiving extensive in-service training in counseling individuals who test either positive or negative for the antibody. Use this valuable community resource (837-0166) or call the local public health department or see a knowledgeable physician.
A negative test result can also provide you with valuable information. However, there are some qualifications to interpreting a negative test. It is important to understand that it takes the body a certain amount of time after infection with a virus to develop a level of antibody high enough to be detected. Therefore, a series of tests over time may be necessary. This test is not economically prohibitive, and in fact, it’s cheap! Your personal sexual history is vital to being able to interpret the meaning of a negative test and whether or not further testing is needed in the future. There are many possible scenarios. For example, if you have been in a mutually monogomous relationship for the past year and both partners test negative you can be sure you are not infected. If you have been abstinent for the past year you can be sure a negative test means good news. If you had un-safe sex the night before the test (or several weeks/months before the test) you may not have produced enough antibody to be detected but you are, in fact, infected with the virus. If you are currently having un-safe sex (outside a mutually monogamous relationship) – stop now! If your first test is negative a repeat test several months down the road will most likely be recommended.
By known ing you’re negative, you can assume you have not been infected, and then by practicing safe sex or having a strictly monogamous relationship with a partner who is also negative, you then protect yourself from becoming infected and risking the chance of becoming a carrier or developing AIDS. Furthermore, at some time in the future, a vaccine will be developed, and seronegative (not seropositive) gay men will be candidates for the vaccine.
HTLV-III antibody testing will be available free (all positive samples will be tested a second time using the same method) at various alternate testing sites. The testing centers are being set up with federal monies and will provide counseling/information sharing both before and after the test is done.
The issue of confidentiality of test results has been raised quite vociferously across the country. One should not confuse confidentiality with anonimity. While I believe it is a concern the issue of confidentiality has been distorted. We are living in a very reactionary time and the possibility of a quarantine of gay men (or something worse) to “prevent the spread of AIDS to the heterosexual population” is a real possibility. I do not believe, however, that HTLV-III antibody testing will make this any more a possibility than it already is. It is public knowledge that this virus is common in the gay male community and it’s killing us in large numbers. Most gay men already have medical information in their health records indicating the possibility of homosexual lifestyle – hepatitis; rectal gonorrhea; anal warts; syphilis; and, repeated bouts with intestinal parasite infections.
Should we deny ourselves a piece of valuable medical information (HTLV-III antibody status) that can very well be pertinent to our very survival because of our fear of homophobic oppression? To do so really rubs me the wrong way! The issue is control over our own health and well being. We are not as powerless as we may think, but in order to decrease our vulnerability we must move aggressively in several areas. Gay input into all health issues affecting us, not just HTLV-III antibody testing, is imperative. We need to take care of each other as much as possible. The women’s health movement in this country can teach us a lot – we cannot turn our bodies over to a straight health care system. Also, we can only hope to prevent further erosion of our civil liberties around the AIDS issue by developing straight allies. We are outnumbered ten to one -remember? The only effective way to develop these allies is to present ourselves as real human beings and this cannot be done from the closet. A closeted lifestyle in this very threatening time is indefensible. The first step is to look realistically at how bad things already are and it will become obvious that no such thing as a “safe closet” exists for anyone any more.
We must be very vigilant and confrontive of any anti-gay behavior we encounter as individuals and as a community. We will experience a quarantine or other much worse measures only if we allow them to happen.
We now have the knowledge and ability to control the spread of the AIDS virus in our community. We must seize the initiative or someone else may do it for us.