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More Than a Health Dilemma : Candidates Forced to Deal With AIDS Issue

November 02, 1987|MARLENE CIMONS | Times Staff Writer

WASHINGTON — Former Arizona Gov. Bruce Babbitt remembers the recent day when his fifth-grade son came home from school with an assignment to write an essay about AIDS.

"He turned to me and he said, 'Daddy, what's a condom?' " Babbitt recalled. "It's lucky he came to me and not the President. Otherwise he'd still be waiting to find out."

Babbitt's quip, amusing as it may seem, reflects a universal feeling among Democratic presidential candidates, who strongly criticize the way the Reagan Administration has handled this virulent and lethal epidemic.

AIDS, with its unique political and social ramifications, is forcing candidates to deal directly and publicly with sensitive and divisive issues that most might prefer to keep out of the political arena.

"The kinds of issues raised by AIDS are very different" from those associated with any other medical catastrophe in history, said Dr. Sheldon M. Wolff, physician-in-chief of the New England Medical Center and co-chairman of the highly regarded Institute of Medicine panel on AIDS.

"I don't think anything in our lifetime has had the same kinds of overtones," Wolff said. "AIDS is a disease that afflicts people outside the midstream of America: the gay population, minorities, intravenous drug users. You can't separate that from the equation. If we were able to look at things purely from a medical standpoint--accepting that the disease happens to occur in these people--it would be pretty simple. But nobody takes that attitude."

Thus, the AIDS epidemic has created much more than just a public health dilemma. In the six years since the first cases appeared in this country, AIDS has become a catalyst for a public forum on a host of explosive issues, including homosexual rights, sexual behavior, morality, sex education and privacy.

"Even if you look at the epidemic only in terms of dollars and cents, the impact on the health care system will have an impact on everybody," Wolff said. "It's a sad commentary that this has come into the political arena in any way, shape or form--other than to try to do something about it."

Republican candidates generally took a more hard-line approach in dealing with the epidemic than Democrats, favoring more mandatory testing as one means of combatting the epidemic with less emphasis on civil rights concerns. They generally seemed to think that any AIDS sex education should include--even stress--moral as well as medical issues. Democrats favored increased education as the most effective tool against the epidemic, supporting increased funding for that effort.

AIDS, or acquired immune deficiency syndrome, is caused by a virus that attacks the body's immune system, rendering it helpless against rare, opportunistic infections and cancers. The virus can also invade the central nervous system, causing severe neurological problems. It is commonly transmitted by anal and vaginal sexual intercourse, the sharing of unsterilized hypodermic needles and by woman to fetus during pregnancy. As of Oct. 26, the disease had struck 44,395 Americans, of whom 25,368 had died.

The AIDS antibody test, which was introduced in 1985 to screen the nation's blood supply, has been used increasingly for diagnostic purposes to determine if an individual has been infected by the virus and is infectious to others. Since there is neither a cure for AIDS nor a vaccine to prevent infection, education has been promoted by medical experts as the most effective way of curtailing the epidemic.

Valuable Education Tool

Thus, public health officials believe that the test, if used appropriately, can be a valuable education tool. They believe that individuals who engage in activities that put them at risk of AIDS should be tested. If they test negative, health officials believe, they will be motivated to remain that way by practicing safer behavior; if they are positive, they will act responsibly and avoid transmitting the virus to others.

At the same time, however, the test has become extremely controversial. Civil rights and homosexual rights groups and others have feared that the disclosure of test information would bring stigma and discrimination in employment, housing, education and insurance to infected individuals.

The issue of AIDS education, particularly for children, also has been the subject of intense argument with those who advocate early and explicit instruction about sex--including homosexual behavior and information about the use of condoms--pitted against those who believe that school programs should emphasize fidelity in marriage or abstinence as the only ways to protect against AIDS.

AIDS Education Supported

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