By the end of this year, about 350,000 Californians will learn for the first time whether they have been exposed to the AIDS virus.
The results of the tests on these people, medical officials say, may herald a new phase in the epidemic of acquired immune deficiency syndrome, bringing home to the heterosexual community as never before that the risks of the fatal disease are shared by everyone.
The people receiving the test results will be those who have donated blood in California since last March, when a federal rule went into effect requiring a test for AIDS antibodies in prospective donors. Medical officials say that virtually all of these people are heterosexuals because the blood banks now turn away gays and other members of high risk groups.
Since the rule went into effect, a moratorium on the release of the test results has been observed by blood banks in this state. That moratorium is to expire at staggered dates--depending on the institution--over the next several months.
The number of people who have tested positive is difficult to estimate, but experts believe that 350 to 700 positive results have already accumulated and that the number is increasing daily.
A positive result does not mean that a person will necessarily develop the disease. It does indicate that the person has come into contact with the AIDS virus and has begun to produce antibodies to it. In most cases, according to studies, the antibodies will prevail and the person will never fall victim to the disease.
Those studies, which examined members of the so-called high-risk groups, also revealed that about 10% of people exposed to the virus will develop AIDS and that 20% will fall ill with AIDS-related diseases. Equally ominous, medical officials say, is that many of the remaining 70% will become carriers of the disease capable of spreading AIDS through sexual contact.
For some individuals, who are unaware that they have been exposed to the virus through sexual contact or blood transfusion, a positive test will come as numbing news. Although a high percentage of AIDS patients are, and possibly always will be, in the gay population, public health experts see AIDS as a sexually transmitted disease that can strike heterosexuals as well.
"Although 98% of the cases in San Francisco are homosexual or bisexual men, this is truly a disease which affects everyone--father, son, brother, friend," said Dr. Mervyn F. Silverman, former San Francisco health officer, at a meeting of the Los Angeles City/County AIDS Task Force in May.
Like other public health authorities, Silverman advocated greatly expanded health education programs for the general community as well as for high-risk groups. In the past these campaigns, which outline "safe" sex practices and discourage risky sexual behavior, have been aimed almost exclusively at gay people and intravenous drug users.
Education, the experts say, will not only help control the epidemic but will help to dispel myths that compound the fears of those who test positive.
Two weeks ago, a young wife and mother of two who had just been informed that her blood contains antibodies to the AIDS virus ran screaming for help into a Hollywood health facility for gays. Workers at the clinic managed to allay her hysteria and refer her to a crisis center, where the meaning of the test was explained.
The woman appeared to fit none of the categories of people usually considered to be at high risk of acquiring AIDS. Her response may be repeated in coming months as the test results are revealed to people who considered themselves exempt from the threat of the disease. Most positive results will involve those outside high-risk groups because those groups--gay people, intravenous drug users, hemophiliacs and Haitians--are turned away from blood banks.
Aware of the psychological trauma that news of a positive test can cause in donors, blood banks use two tests in order to eliminate as many false positive results as possible. Blood that initially tests positive is tested again. If the second test gives the same result, the sample is retested using a more specific method. Only then, if the result is positive, will the donor be notified, blood bank officials said.
The confidentiality of test records has become a major concern because of fear that the information could be used by employers or insurance companies to discriminate against people exposed to AIDS. Red Cross blood banks, according to Gerry Sohle, a spokeswoman for the Los Angeles-Orange County Regional Red Cross Blood Center, keep no records of positive results that are available to government or private agencies.
No Record of AIDS