Orange County public health officials are at odds with members of the gay community over the usefulness of a blood test licensed Saturday to detect evidence of the virus believed responsible for Acquired Immune Deficiency Syndrome (AIDS).
Although the new test shows only that a person has been exposed to the virus, Orange County public health officials believe it can be a valuable tool in tracking the spread of the disease. They are advocating extensive testing of sexually active gay or bisexual men at the county's Special Diseases Clinic in Santa Ana as soon as test kits are available.
Representatives of the AIDS Response Program in Garden Grove, however, say they refuse to endorse widespread testing of gays because the test, which they refer to as a "Pandora's box," is unreliable.
The test, which detects antigens to the Human T-Cell Leukemia Virus III (HTLV-III), is intended mainly to screen blood supplies to eliminate the risk of spreading the disease through transfusions. Of nearly 8,600 cases of AIDS diagnosed in the United States, 1.2% have been attributed to transfusion of contaminated blood or blood products.
Gay leaders argue that the test produces significant numbers of false reactions, and they fear that unreliable test results will not be kept confidential and could be obtained and misinterpreted by employers, insurance companies or homophobic groups.
Also, they point out, an infected person may not have developed antibodies to the virus at the time of testing.
"One big fear is that (gay) persons who test negatively, but actually have the virus, may take it as an all-clear sign to go back to unsafe sexual practices," said Randy Pesquiera, director of the AIDS Response Program, a state-funded educational outreach project operated by the Gay and Lesbian Community Services Center of Orange County.
"Besides, if a person does have a positive test, we have no way to tell them if they have had the disease and are over it, if they are carriers or if they are incubating the disease and will come down with it," said Dr. Sherman Williamson, a member of the county's AIDS Task Force and immediate past president of Southern California Physicians for Human Rights.
"I don't think it's fair to put the burden on a individual and let them think they are going to come down with the disease," Williamson said.
These same inaccuracies, meanwhile, have American Red Cross officials fearful that gay men and other high-risk donors will flock to donation centers just to be tested. They also are worried about what to tell low-risk donors when they test positive for the virus.
"We're working on that," said Dr. Benjamin Spindler, medical director of blood services for the American Red Cross in Orange County.
Since it first appeared in the United States in 1979, AIDS has been limited almost exclusively to sexually active gay or bisexual men, Haitians, intravenous drug users, hemophiliacs and others exposed to contaminated blood products.
As of Feb. 25, the mysterious and deadly disease that destroys the body's immune system had killed 4,145 of the 8,597 people diagnosed with AIDS in the United States since reporting began in 1981, according to the federal Centers for Disease Control in Atlanta.
In California, 791 of 1,950 people diagnosed with AIDS have died, CDC public affairs officer Charles Fallis said. All but nine of the California cases have been adults.
In Orange County as of Feb. 28, 49 of 92 people diagnosed with AIDS have died, county health officials said.
Of those who died, all were gay or bisexual men except four. One of those four was a woman who had been an intravenous drug user and two were transfusion-related cases. The fourth was the first reported Orange County AIDS death involving a child, an 18-month-old girl who died last December. Health officials have not determined how she contracted AIDS.
The AIDS virus is believed to attack and grow in the same infection-fighting white blood cells that are defective or missing in AIDS patients.
The most severe symptoms of the disease include a rare skin cancer, Kaposi's sarcoma, and a parasitic lung infection called Pneumocystis carinii.
The virus is believed to be spread through the exchange of blood and body fluids, primarily through intimate physical contact.
But with an increasing number of transfusion-related cases--104 such cases and 61 hemophiliac cases as of the CDC's Feb. 25 report--there has been a rush to develop a screening test for the viral agent to protect the nation's blood supplies.
At a news conference Saturday in Washington, D.C., Health and Human Services Secretary Margaret M. Heckler and Frank E. Young, commissioner of the Food and Drug Administration, announced that Abbott Laboratories of North Chicago, Ill., had been licensed to market the AIDS test.
Four other companies also have applied for FDA approval to produce the test. Heckler said two more producers may be licensed later this week.