AIDS: A Growing Threat

By Claudia Wallis

A hospital, any hospital, is a grim place, full of the smells of sickness and antiseptic, stale air, pale faces, hushed voices and old people. Lots of old people. Recently, however, at hospitals like Harbor-UCLA Medical Center near Los Angeles, a new group of patients has appeared. They are men in their 20s and 30s, wan and fragile, short of breath and just barely clinging to life.

"I'm very scared to die such a young man. I'd like a little more time," says a 28-year-old patient. He is waiting for the results of tests that will determine if his recent exhaustion, bouts of fever and severe headaches are what he and his doctors fear it is: acquired immunodeficiency syndrome, or AIDS. The man is not gay. He is married and the father of two children. But he readily admits to a life of promiscuity and a history of many liaisons with prostitutes. "I lived in the fast lane," he confesses. "If only God will give me a break . . ."

Three floors down, another, even younger man goes through the same interminable wait. Jorge, 23, a homosexual, was told by doctors that he probably does have AIDS; then he was informed that the test results were ambiguous. "My mind has been going 200 miles an hour," he says. His eyes illustrate his point, darting around the room; his hands fly in all directions. "When you are close to knowing you are going to die, even a glass of water is very meaningful. I always want to remember how it felt. I am trying to understand why we die. Trying to get used to the idea and accept it."

Scenes such as these, eerie and unnatural though they may seem, are being played out in hospitals around the country as some 6,000 people--most of them young and, until recently, healthy--struggle with the idea and the painful reality of dying of AIDS. During the past four years, an equal number of AIDS victims have already succumbed.

By early this year, most Americans had become aware of AIDS, conscious of a trickle of news about a disease that was threatening homosexuals and drug addicts. AIDS, the experts said, was spreading rapidly. The number of cases was increasing geometrically, doubling every ten months, and the threat to heterosexuals appeared to be growing. But it was the shocking news two weeks ago of Actor Rock Hudson's illness that finally catapulted AIDS out of the closet, transforming it overnight from someone else's problem, a "gay plague," to a cause of international alarm. AIDS was suddenly a front-page disease, the lead item on the evening news and a frequent topic on TV talk shows. There seemed no end to the reports:

Rock Hudson was flown home to Los Angeles from France early last Tuesday and transferred on a stretcher to a waiting helicopter, which took him to UCLA Medical Center in Westwood for further medical treatment. Lester Maddox, former Governor of Georgia, was undergoing tests out of fear that he might have received the virus that causes AIDS from contaminated blood serum prescribed by a controversial cancer clinic in the Bahamas. At a New York City television station, technicians announced that they would not work in the studio during a scheduled live interview with an AIDS patient. The interview was dropped. Federal scientists announced that screening tests being used at blood banks around the country have been "highly successful" in eliminating the AIDS virus from the nation's blood supply. In Kokomo, Ind., a 13-year-old hemophiliac was denied permission to attend the local middle school because he has AIDS.

Irrational fear, paranoia and apocalyptic statements have abounded. More than one normally understated scientist has termed AIDS "the disease of the century." Others have, in the tradition of divine justification, viewed it as God's revenge on sodomites and junkies. There have been far more pervasive epidemics, certainly. In 1918 and '19, Spanish flu killed more than 500,000 Americans and ultimately 20 million worldwide. A million Russians may have died of cholera in 1848 alone. But during these scourges there were always the possibility and hope that the fever would lift, strength would return, and life would go on. With AIDS, says Dr. Michael Gottlieb, the UCLA immunologist who is overseeing Hudson's care, "the word cure is not yet in the vocabulary."

It is the virtual certainty of death from AIDS, once the syndrome has fully developed, that makes the disease so frightening, along with the uncertainty of nearly everything else about it. Despite the progress in medical research so far, huge questions remain about its origin and fundamental nature. In trying to understand AIDS, says Dr. William Haseltine, a leading investigator at Harvard's Dana-Farber Cancer Institute, "we have moved from being explorers in a canoe to explorers with a small sail on the vast sea of what we do not know."

Since the first cases were identified in the U.S. more than four years ago, AIDS has baffled the experts. UCLA's Gottlieb was among the first physicians in the country to notice that something strange was going on in the winter of 1981. In the space of just three months, he treated four patients with an unusual lung infection called Pneumocystis carinii pneumonia. PCP is what doctors term an "opportunistic infection," one that strikes people when their immune response is weakened. Typical victims are frail cancer patients and transplant recipients. Gottlieb's four patients departed strikingly from this pattern. Though tests showed their immune systems were severely depressed, all four were young men around 30 who had previously enjoyed excellent health. All were also avowed homosexuals, three of them with a history of many partners.

"The third case cinched the realization that what I was seeing was something new," Gottlieb recalls. Then, when another case turned up so quickly, he says, "I knew I was witnessing medical history, but I had no comprehension of what this illness would become." He notified federal health authorities of the four cases, and in June 1981, Atlanta's Centers for Disease Control published what was to be the first report on the strange new ailment.

No sooner did the report appear than the CDC began hearing from doctors in San Francisco and New York City, who were also seeing PCP in young homosexual men. And that was not all they were seeing. Many of the patients bore the purplish lesions of Kaposi's sarcoma, a rare skin cancer that in this country is usually found only in elderly men of Mediterranean extraction. They had other infections as well: Candida albicans, a fungus that cakes the mouth and throat, making it difficult and painful to speak or eat; herpes, not just the garden variety of sores, but ulcerating infections of the mouth, genitals or anus that raged for months. The patients fell prey to exotic bugs seen more often in animals than humans, like Toxoplasma gondii and Cryptosporidium, which causes diarrhea. Doctors were appalled. Says Dr. Paul Volberding, 36, who heads the AIDS clinic at San Francisco General Hospital: "You see someone your own age dying of such a gruesome disease that you can't do anything to stop."

By late August, less than three months after its initial report, the CDC knew of more than 100 cases of what was already being called the gay plague (despite the fact that at least six patients said they were heterosexuals and one was a woman). What they had in common was something Gottlieb observed in the first four cases, "a near wipe-out" of helper T cells, a class of white blood cells that plays a central role in orchestrating the body's immune defenses (see chart).

As the mystery deepened and the number of cases rose, the CDC intensified its investigation into the causes of the syndrome. Disease detectives interviewed scores of homosexuals about their sexual practices to test the hypothesis that AIDS was somehow tied to the gay life-style. They briefly considered and then discarded a theory linking AIDS to the use of "poppers" (liquid inhalants like amyl nitrite and butyl nitrite), which are said to enhance sexual pleasure and which had been used by many of the victims. Another theory held that repeated anal intercourse introduced sperm into the blood-stream and that this could cause profound immune suppression. Then there was the "immune-overload theory," which was based on the fact that many early AIDS patients were extremely active sexually, with hundreds of partners over the course of their lifetimes and long histories of venereal diseases and infections. Under the accumulated burden of so many infections, the overload theory suggested, their immune systems had simply given up.

But most of these explanations were abandoned as evidence grew that AIDS was caused by an infectious agent that could be passed from one person to another through sexual contact or in body fluids. The evidence included a "cluster" of nine patients in and around Los Angeles; each had had sex with people who later developed AIDS-related diseases. It was bolstered by the growing number of intravenous drug users infected by the disease. Addicts share germs when they share needles. Then came the clincher: cases of AIDS in hemophiliacs and later in recipients of donor blood. The pattern resembled that of hepatitis B, a blood-borne and sexually transmissible virus that is common among drug addicts, blood recipients and gay men. AIDS cases among Haitian men and women remained a puzzle until it was discovered that many of the men, though not homosexually inclined, had warded off destitution by serving as prostitutes to gay men. Earlier this year, Haitians were dropped by the CDC as a separate risk category for AIDS.

The discovery of the AIDS virus came much sooner than anyone could have expected. "We have never made such rapid progress with any disease in the past," says Margaret Heckler, Secretary of Health and Human Services. It was in May 1983 that a French team led by Dr. Luc Montagnier of the Pasteur Institute in Paris first published evidence of a new virus that appeared to play a role in the disease. The following spring, Dr. Robert Gallo of the National Cancer Institute in Bethesda, Md., announced that he had conclusively identified the AIDS virus and produced it in large quantities. At a press conference that many scientists felt undercut the important contribution of the French, Heckler hailed Gallo's achievement: "Today we add another miracle to the long honor roll of American medicine and science." Her fulsome statement added fuel to a smoldering rivalry over who deserves credit for the discovery.

Though AIDS sufferers have yet to benefit from the Franco-American "miracle," research on the virus has shed considerable light on the nature of their disease and why it so devastates the immune system. The virus launches a direct attack on helper T cells (or T lymphocytes, as they are also known), invading them in much the same way that the hepatitis virus homes in on cells in the liver. Once ensconced in the T cell, explains Dr. Clifford Lane of the National Institutes of Health, the AIDS virus prevents this vital cell from doing its job as "the initiator of all the immune-system response." Says Lane: "It turns the T cell off from being a lymphocyte and on to being an AIDS-virus factory."

The factory is extraordinarily efficient. Research conducted by Harvard's Haseltine and published in the July issue of the journal Cell reveals that the virus has a unique genetic component that allows it to reproduce itself a thousand times as fast as any other kind of virus. The mechanism for this reproduction "is one of the biggest effects I've seen in biology," says Haseltine. "It helps explain why AIDS is such a devastating disease and why it can spread so fast." In the process of rampant replication, the AIDS virus destroys its home, the T cell. Thus it is a peculiar feature of this disease that as it progresses, the helper T cells disappear and so does the virus. By then, however, the patient is invariably beyond recovery.

But not everyone infected with the AIDS virus develops the deadly syndrome. Most develop a seemingly peaceful coexistence with the virus, says Dr. James Curran, who heads the CDC task force on AIDS. "They have no symptoms at all or very minimal symptoms, but they have persistent infection and are probably persistently infectious to others." Another group suffers a mild version of immune-system depression, with symptoms and signs that include malaise, weight loss, fevers and swollen lymph nodes. This syndrome, called AIDS-related complex, or ARC, sometimes but not always develops into full-blown AIDS.

Curran estimates that for each of the 12,000 cases of AIDS reported so far in the U.S., there are at least five to ten cases of ARC. Sample studies based on blood tests suggest that an additional 500,000 to 1 million Americans are symptomless carriers of the virus. What will happen to this group is the object of much speculation and study. "That's the million-dollar question," says Dr. Michael Lange of St. Luke's-Roosevelt Hospital in New York City. The guess is that 5% to 10% of people who do not have symptoms but do have antibodies to the virus (meaning they have been exposed) will develop AIDS within five years. There is no way to tell which ones will get it. "It's like Russian roulette with one bullet and ten chambers," says Ronald Sanders of the Los Angeles health department. For people with ARC, the odds of developing AIDS within three years may approach 20%, or two bullets.

Researchers are hunting for clues to why one person develops the disease while others merely harbor the virus. Some investigators suspect that additional viral infections may play a role as accomplices or triggers. The main suspects: Epstein-Barr virus and cytomegalovirus (both members of the herpes family) and the virus that causes hepatitis B. The difficulty, says Lange, comes in determining whether such viruses are in fact co-agents of AIDS or merely tagalong infections.

Scientists are also trying to learn more about how and when the disease is spread. Are there, for example, certain periods of time when a person is more infectious than others? Many answers will be found within the next year or so, predicts Curran. "We'll know the risk of a pregnant mother in delivering a healthy infant vs. an ill one or a stillborn. We'll be able to quantify those kinds of things."

Just how immediate a threat AIDS poses to heterosexuals is much debated. The fact is, nobody knows. "There is nothing about the biology of the virus to lead us to think anyone is immune solely on the basis of the type of sexual partner," says Volberding of San Francisco General. "Heterosexuals are clearly at risk of acquiring the disease from sexual contact." The Burk family of Cresson, Pa., is a sad case in point. Patrick, 27, a hemophiliac, contracted AIDS from a contaminated batch of blood-clotting factor, which he requires to control his condition. His wife Lauren, 24, has since developed ARC and apparently passed the virus on to their 15-month-old son Dwight, most likely during her pregnancy. Daughter Nicole, 4, is the only one in the family left untouched by the disease.

The CDC has learned of at least 118 cases of transmission between heterosexual partners. Most heterosexual transmission seen to date has been from men to women, rather than from women to men, suggesting the possibility that women may be less efficient transmitters of the infection. However, at least 14 men have been infected by women, according to Mathilde Krim, a research biologist at the Memorial Sloan-Kettering Cancer Center in Manhattan, and health authorities are concerned about the possible role of prostitutes in spreading the epidemic. Curran thinks it may prove significant that "about 15% of the men whose cases remain unexplained have a history of sexual contact with prostitutes." The U.S. Army is also concerned about this risk, according to Dr. Robert Redfield of Walter Reed Army Medical Center. Soldiers, he says, "are largely in the 18-to-30 age group, a time of being most sexually active."

AIDS appears to be almost entirely a heterosexual disease in the central African countries of Zaire, Rwanda and Burundi, where it affects women and men in equal numbers. According to a Canadian researcher working in East Africa, "Prostitution seems to have played a key role in African AIDS." Many of the affected males, he notes, are "heterosexuals who have a large number of sexual partners." Virologist Myron Essex of the Harvard school of public health thinks that as many as one out of every 20 people is infected (though not necessarily ill) in Africa's "AIDS belt," which also includes parts of Kenya, Uganda and Tanzania. Some researchers see this as "a foretaste" of what will occur in the U.S., but many disagree. They point to Third World conditions that may promote the disease. Among them: the presence of feces in drinking water, the use and reuse of unsterilized needles in many small clinics and, possibly, even local rituals that involve scarification and the exchange of blood.

Squalid conditions, poverty and a semitropical environment may also play a role in the high rate of AIDS in Haiti and, oddly enough, in parts of southeastern Florida. Belle Glade (pop. 19,000), Fla., with 46 cases, has the highest incidence in the U.S. "There is raw sewage on the ground and rats running all around," says Dr. Mark Whiteside of Miami's Tropical Medicine Clinic. Filth, insects and a high rate of tuberculosis, he suggests, might contribute to the epidemic.

The prevalence of the AIDS virus in central Africa has led researchers to speculate that the disease originated on that continent. Harvard's Essex believes the scourge got its start in monkeys, specifically the African green monkey. In sampling the blood of 200 greens from this region, Essex found that 70% of them were infected with a virus similar to the one that causes AIDS in humans. Curiously, the virus does not seem to harm the monkeys, a fact that might hold important clues for future research. Essex suspects that in the past 20 to 40 years, the virus spread from monkeys to man. Other viruses have made this leap--notably jungle yellow fever virus--and, he notes, the greens often live in close association with people and frequently bite them. How the disease might have traveled from Africa to the U.S. and Haiti is anybody's guess. One "intriguing" clue, says Dr. Peter Piot of the Institute for Tropical Medicine in Antwerp, Belgium, is that several thousand Haitians lived in Kinshasa, Zaire, from the early 1960s to the mid-'70s, and most of them, he says, have since moved to North America and Europe. As another researcher put it, the virus "didn't just fall out of the sky."

There has so far been just one remark able success in the otherwise losing battle to contain the spread of AIDS. That is the rapid development of tests to detect signs of the virus in donor blood. About 2% of AIDS cases in the U.S. have occurred as a result of the contamination of blood used in transfusions or in blood products like the clotting factor needed by hemophiliacs. The toll includes infants, children, even a 66-year-old nun.

In April of last year, when the identification and mass production of the AIDS virus was announced in Washington, Health Secretary Heckler vowed that blood-screening tests would be available in record time. Medical scientists made good on that promise within nine months. Still, the fact that the test kits, manufactured by Abbott Laboratories, Electro-Nucleonics and Litton Bionetics, were produced in crash programs prompted many fears about the reliability and precision of the tests. Of particular concern was the chance that too many blood samples would register an incorrect positive reading, falsely suggesting the presence of AIDS antibodies. Last week, an NIH conference on the blood tests brought reassuring news: in the first three months of use around the country, the tests have proved 99.8% accurate. Screeners have found that most of the false positive results could be eliminated simply by repeating the test. Says Curran: "We've pretty much solved the problems of transfusion-related AIDS."

However, the tests have created a few problems of their own. Because they merely detect the presence of antibodies to AIDS (which proves only that exposure has occurred), they cannot determine if a person currently has the live virus, is capable of spreading it or is likely to develop the disease. Nonetheless, the perception persists that the tests can be used for diagnosis. Health officials fear that homosexuals and other high-risk individuals will volunteer to give blood simply to get themselves tested. This would increase the chances that AIDS-contaminated blood could enter the donor supply through a slipup or a faulty test reading.

To keep tainted blood away from the donor centers, the CDC is setting up alternative sites where people at high risk for AIDS can take the test with assurance that the results will remain confidential. Whether tests are administered there or at donor centers, one dilemma remains: how to relate the frightening news to someone whose blood has tested positive, and to interpret that finding for him.

Homosexuals and other high-risk groups have further concerns about the AIDS tests: that the results may fall into the wrong hands and be used to discriminate in hiring or insurance decisions. Some of those fears were realized in April, when the city of Hollywood, Fla., announced that it would use the AIDS test as a routine part of screening job applicants. "Candidly, we're not looking to hire somebody who may have an adverse impact on our health insurance," said Herbert Chernov, Hollywood's personnel director. "To consciously hire someone who may be dying would be foolish from a financial point of view." The city backed down when its plan was criticized by newspapers, doctors and gay leaders.

AIDS victims and people associated with them experience widespread discrimination, some of it heartless, some of it phobic. In New York City, Dr. Joseph Sonnabend was served with an eviction notice by the co-op board in the building where he practiced. "I treated people with AIDS," he explained. "People in the building didn't like AIDS patients walking through the lobby." In New Orleans, Johnny Greene, a writer, was fired from an editing job with McDermott International Inc. after writing an article for PEOPLE magazine about his own suspected case of AIDS. "They just walked in and said, 'Get the hell out,' " he recalls. "I hope they were acting out of panic or confusion, not belligerence or homophobia."

After months of battling AIDS-related illness, Ryan White, the Kokomo school boy with hemophilia, was eager to get back to Western Middle School and his friends this fall. Unfortunately, school officials do not want the seventh-grader in class. Though doctors believe that AIDS is not communicated through casual contact, School Superintendent J.O. Smith fears that Ryan poses too much of a risk to other students. He points to warnings from the Indiana board of health about the risks of exposure to AIDS-infected saliva and body fluids. "What are you going to do about someone chewing pencils or sneezing or swimming in the pool?" he asks.

The issue of whether or not AIDS can be transmitted through saliva remains medically unresolved and a focus of fear. Firemen around the country have refused to give mouth-to-mouth resuscitation to AIDS patients and often to gay men in general. In New York City and Los Angeles County, fire departments are providing special mouthpieces and other equipment to permit rescue without oral contact. New York State's department of corrections is providing bite-proof, scratch-proof suits to officers guarding infected inmates.

AIDS victims are treated like lepers even by some in the medical community. Ambulance workers in several cities have refused to transport desperately ill patients to hospitals. Hospital orderlies are reluctant to clean their rooms. Nurses are wary. When a friend visiting an AIDS patient in a Los Angeles hospital stepped out into the corridor to fill a water pitcher for him, he was shouted at by a nurse. "That pitcher should never leave that damn room!" she screamed. "How dare you jeopardize us all?"

Even in death the AIDS victim is shunned. In St. Louis and New York, undertakers have refused to embalm the remains of patients. In Los Angeles, a funeral parlor was asked to handle the body of three-year-old Sammy Kushnick, who had died from AIDS contracted through a blood transfusion. Until a rabbi intervened, they refused to dress the boy in the clothes and prayer shawl his parents had selected for his burial.

Despite their physical ordeal, many AIDS sufferers say that the worst aspect of their condition is the sense of isolation and personal rejection. "It's like wearing the scarlet letter," says a 35-year-old Harvard-educated lawyer who was forced out of a job at a top Texas law firm. "When people do find out," he says, "there is a shading, a variation in how they treat me. There is less familiarity. A lot less." Sometimes the changes are far from subtle, according to Mark Senak, a lawyer at the Gay Men's Health Crisis, a volunteer organization that helps AIDS patients in New York. "They'll come out of the hospital, and their roommate has thrown them out--I mean literally," he says. "Their clothes will be on the street." Rejection of this sort is not unique to gay men. Senak cites the case of a heterosexual woman with AIDS whose husband and family refused to take her back home from the hospital.

To help AIDS patients cope, volunteer organizations like GMHC have popped up around the country, most of them organized by gay-community leaders. GMHC, founded in 1982, provides various services, including crisis intervention, a hot line that answers 3,000 calls a month, group-therapy sessions for patients and their survivors, and financial and legal services. Most successful of all, and widely emulated, is GMHC's buddy program, which assigns a volunteer to befriend an AIDS patient, helping him to shop, cook, clean his apartment and to feel less forgotten and shunned.

In Los Angeles, Carol Archer, 40, was assigned by the Shanti Foundation, another AIDS support group, to attend to the needs of a dying 31-year-old patient. He was alone; family and friends had withdrawn from him as lesions spread over most of his body. When Archer helped him with his will and funeral arrangements, he began to sob. She reached out, hugged him and rocked him in her arms. "He cried all the harder," she recalls, "then he looked up at me and said, 'No one's touched me in so long.' "

The volunteer groups have also taken a leading role in educating the public and, especially, high-risk populations about AIDS and how to avoid it. They have issued a blizzard of pamphlets on "safe sex," advising gays to refrain from anonymous contacts and to avoid the exchange of body fluids. On the West Coast, AIDS Project Los Angeles has published a comprehensive guide to the disease titled "Living with AIDS." The project has also launched a billboard campaign and distributed posters with gentle reminders to "Play Safely."

Slowly, in many cases too slowly, state and local health officials around the country are taking a cue from the volunteer organizations and mounting their own efforts to deal with the epidemic. During the past two years New York State, where more than a third of the U.S. cases have been reported, has funneled $13 million into research, education and service programs. California has taken the lead in protecting the rights of patients with laws forbidding the misuse of blood tests for the purpose of discrimination.

Local governments are also beginning to put resources directly into the care of AIDS patients, many of whom no longer have medical insurance. In New York City, a day-care program, staffed with doctors, nurses and social workers, is being set up for infants and children with AIDS. Because many AIDS patients are evicted from their homes and have no place to go, the city is providing funds for shelters.

Although the Federal Government has put $200 million into AIDS research in the past four years, it has been criticized in many quarters for moving much too slowly. "When President Reagan called Rock Hudson in Paris, it was the first contact he has made with AIDS," says Larry Kramer, a novelist and playwright whose latest dramatic work, The Normal Heart, depicts the politics of AIDS. Sloan-Kettering's Krim charges that Washington has treated AIDS like a "ghetto disease. They didn't think the public would be too concerned or caring."

Responding to the criticism, Secretary Heckler last month announced a request for a 47% increase in research funds. She insists that "the important research into education, treatment and vaccines is being funded," but Congressman Henry Waxman of California disagrees. "The new request for more money is helpful, but very inadequate," he says. "The Administration should be putting together a Manhattan Project to push research as fast as possible."

Experts think that the Federal Government will inevitably have to take a more active role. As the AIDS toll mounts, the sheer cost of caring for patients, ranging from $50,000 to $150,000 each, will overwhelm local resources. By this time next year there will be twice as many cases of AIDS as there are now, says Lange of New York City's St. Luke's-Roosevelt, and "I can already see the whole hospital system coming apart at the edges." Some doctors believe that special medical centers similar to cancer centers may have to be established to care for AIDS and ARC patients. Public health experts are calling for wide-reaching educational programs to teach Americans about the disease and how to avoid exposure.

Meanwhile, clinical and molecular researchers are launching a biological attack on the virus. Their objective: the development of vaccines to prevent its spread and drugs to treat those already infected. But the AIDS virus is a formidable adversary. Because it can reproduce so rapidly, says Harvard's Haseltine, it can mutate frequently, changing its outer coat (the essential ingredient in making a vaccine) 100 to 1,000 times as fast as quick-changing flu viruses. As a result, he says, "trying to develop a vaccine for AIDS is like trying to hit a rapidly moving target." Scientists are now searching for segments of the coat that seem to resist change, hoping to use them to create a vaccine that would remain effective against more than one strain of AIDS. But even the most optimistic experts think that an effective vaccine is still five years off.

Progress in the treatment of AIDS has also been frustratingly slow. "We are no more effective today in prolonging survival than we were four years ago," says San Francisco's Volberding. Some potent antiviral substances are being tested, and several seem to stop or slow the reproduction of the AIDS virus at least temporarily. But they produce debilitating side effects, like kidney damage, which make them unsuitable for prolonged treatment. Among these drugs are HPA-23, a compound developed at the Pasteur Institute in Paris, where Rock Hudson sought treatment; Suramin, originally used to treat such parasitic disorders as African sleeping sickness; and Foscarnet, a drug being tested in Sweden and Canada.

For AIDS victims, the still unproven antiviral drugs represent the only chance, a reminder that the battle for their lives is not yet over. "So many people accept the diagnosis as a death sentence," says one 33-year-old patient. "They just don't want to fight anymore." The chance of being admitted to an experimental drug program, he says, "gives me a little extra hope. Hope is something I don't want to lose." --By Claudia Wallis. Reported by Patricia Delaney/Washington, Joyce Leviton/Atlanta and Melissa Ludtke/Los Angeles AIDS PATIENTS

[This article contains a table. Please see hardcopy of magazine or PDF.]

Males

Females

Children (under 13)

Homosexuals or Bisexuals

8,716 (78%)

0 (0%)

0 (0%)

Intravenous Drug Users

1,633 (15)

418 (53)

0 (0)

Transfusion Recipients

106 (1)

75 (9)

21 (14)

Hemophiliacs

70 (1)

4 (1)

8 (5)

Heterosexuals[*]

14 (0)

104 (13)

0 (0)

Children of Parents with AIDS

0 (0)

0 (0)

104 (70)

Others[**]

593 (5)

186 (24)

15 (10)

Total

11,132

787

148

[*] Contact with an AIDS-infected person

[**] Includes 332 born in places where AIDS is endemic, e.g., Africa and Haiti, and those with medical records inadequate to determine source of infection

Source: Centers for Disease Control. Numbers are for U.S. as of end July 1985.

TIME Chart

With reporting by Reported by Patricia Delaney/Washington, Joyce Leviton/Atlanta, Melissa Ludtke/Los Angeles