The Incredible Shrinking AIDS Epidemic
Fumento, Michael
in the February 5, 1988, issue of Science, noting the above donor and military figures, concluded, "These preliminary data suggest that the pro-portion of 'unexplained' heterosexual HIV...
...But the report's statement clearly contradicts Joseph's earlier statements...
...Writer Kristin Loomis, in the March 6, 1989, New York magazine, strongly implied that the reduction was a conspiracy on the part of the Health Department to make up for the lack of hospital beds...
...Cancer fund-ing, with the AIDS portion pulled out, comes to about $1.45 billion for next year...
...If one regards any man who has ever engaged in a sex act with another man as a homosexual, then the degree of seropositivity among homosexuals is probably quite low...
...Similar cau-tion should prevent us from offering a flat figure for the number of homosex-uals who are seropositive...
...In order to keep the homosex-ual level in New York at 250,000, the seropositivity level among New York homosexuals would have to be reduced from 50 percent to about 20 percent...
...One of the two retiring top NCI officials told the Post that NCI "is withering away...
...Could the long-assumed Kinsey "ten percent" be just a myth...
...Kinsey properly rated homosexuals on a continuum instead of making a flat calculation...
...It's time for the AIDS hysteria to end and for some rational thinking to begin...
...But with AIDS, using a conservative estimate for federal patient costs, federal research ex-penditures will be an almost incredible 230 percent greater than federal patient costs for AIDS patients this year...
...but CDC officials will tell you, as chief epidemiologist Harold Jaffe put it to me, "That's just stupid...
...Another argument used to support massive AIDS spending refers to federal spending for patient care: we should fund AIDS research now so we won't have to spend so much on AIDS patient care in the future...
...Heart disease kills even more people than cancer, over 750,000 Americans a year, yet its funding this fiscal year is only slightly more than $1 billion...
...In the Bush Administration's proposed budget for 1990, AIDS will surpass cancer at $1.6 billion...
...Whether for purposes of deciding who is represented by the NGLTF or who has HIV, the ten percent figure hardly seems a good indicator...
...Further, the new explanation—that it might not be that there are fewer homo-sexuals, just fewer infected homosexu-als—is an implicit rejection of the validity of San Francisco's seropositivity studies...
...But the fact is, Kinsey never gave any such ten percent figure...
...It isn't the present caseload...
...T hus the bitter reaction of the New York homosexual population to the new figure was a natural response to a double whammy...
...AIDS is a terrible disease Its newness makes it seem all the more so...
...According to Joseph, "Our previous estimates were based in part upon extrapolation from data published by Kinsey several de-cades ago, estimating that one out of ten men engaged in homosexual behav-ior . . ." The new estimate, he ex-plained, was based in part on more refined estimates of the number of homosexuals in San Francisco, which a telephone poll in 1984 indicated to be about 56,000, including bisexuals...
...Next, it denied that its lower estimate necessari-ly meant that there were fewer homo-sexuals in the city than previously believed...
...Is there any The new figures implied that New York's homosexual population might not be as large CDC projection and didn't peak until 1993, AIDS cases diagnosed that year will be but one-fourth of all 1993 cancer deaths...
...Fear and Loathing in New York Just as CDC has been forced to reduce its estimate of the number of sero-positives, so too has the City of New York...
...PHS at $1.3 billion (of which about $400 million goes to education, not research), now nearly matches cancer funding...
...It's the predictions of millions or tens of millions or hundreds of millions of future cases that has so many Americans rating AIDS as the number one health priority...
...was one of the rallying cries of the Gay Liberation Movement...
...He said he feared that the new estimate would be "used to give us less when we desperately need more" funds and ser-vices to treat current as well as future patients...
...This past July the New York Times ran an article quoting communi-ty leaders responding to the news that AIDS researchers were coming to a consensus that almost all seropositives would eventually fall ill...
...in the February 5, 1988, issue of Science, noting the above donor and military figures, concluded, "These preliminary data suggest that the pro-portion of 'unexplained' heterosexual HIV transmission is not much higher than predicted from analysis of re-ported cases of AIDS...
...The Ameri-can Heart Association, for its part, has begun running television ads showing the risk of getting AIDS versus that of getting heart disease in order to prompt more donations for heart research...
...Further, in last year's appropriations bill, Congress specifically called for hiring an additional 780 AIDS research-ers...
...Eleven ACT-UP members were arrested at a sit-in out-side his office...
...Last year, in a medical news-paper called the Scientist, two young psychiatric researchers spoke of having to resist the "seduction" of AIDS research money...
...With the 400,000 figure generating such dread, one might think that this revised, lower estimate would cause an outpouring of relief...
...Or forty-four heart disease deaths...
...If one regards this category as comprising...
...As the Washington Post recently reported, AIDS research has drained cancer research to a point where NCI's coming from...
...For heart disease it is about 2.9 percent...
...H. Hunter Handsfield, director of the Seattle-King County Department of Health, wrote: "Even when the pro-longed interval from HIV infection to overt AIDS is taken into account, it is likely that the classification of reported cases accurately reflects the actual pat-terns of transmission...
...Of course, a comparison of death counts is not the only appropriate factor in allocating funding and researchers...
...This is pretty much a zero-sum game...
...Unfortunately," they wrote, "many other young scientists may have no choice but to go into the field that offers the most easily ob-tained funding...
...As Acr-up is well aware, to challenge those predic-tions is to challenge the idea of pour-ing massive resources into the fight...
...They'll come from the same place they've been THE AMERICAN SPECTATOR MAY 1989...
...Nor did anyone quoted by the Times note that the 400,000 figure was incompatible with the extreme slowing of reported AIDS cases...
...They bled cancer to feed AIDS in terms of people's time," one of the doctors told the Post...
...Yes...
...Assuming the premise that government has a duty to fund the cur-ing of disease, why doesn't it have blood on its hands for the twenty-seven cancer deaths every half hour...
...If this happens, other areas of research important to the welfare of the U.S...
...harm done by "erring on the side of caution" by pumping funds, and attention in general, toward AIDS...
...Rumblings of Discontent But is there really anything wrong with exaggerating the epidemic...
...A slogan making the rounds on signs and bumper stickers reads, "The government has blood on its hands: One AIDS death every half hour...
...This will be true next year and the year after that, with no peaking or decline until scientists bring one about...
...Further, the first Kinsey report indicated that there are far fewer lesbians than male homo-sexuals...
...This time it covered itself in two ways...
...More recent figures from blood testing of all women giving birth in California during last October showed that out of 43,301 tested, only thirty-six proved positive...
...Dropping the "more or less" and the "three years" reduces to four percent the figure that Kinsey says applies to men who are ex-clusively homosexual throughout their lives...
...Joseph also used the new explanation to blast Buchanan, accusing him of advancing "an agenda of bigotry and divisive-ness," notwithstanding that the New York Times had come to the same ob-vious conclusion that Buchanan had...
...We live in a world of fmite re-sources...
...Originally, in 1987, its Depart-ment of Health estimated 500,000 in-fections in the city...
...CDC, in-cidentally, uses the four percent figure in its calculations...
...only those who engage in a fairly ac-tive homosexual life (what most of us regard as being homosexual), then the seropositive rate is probably quite high...
...And while its awesome fatality rate is a curse, its extremely inefficient transmission is a blessing...
...According to lore, Alfred Kinsey, in his landmark 1948 study, found that ten percent of all Americans are homosexual...
...Just before stepping down re-cently as director of the National Can-cer Institute (NCI), Dr...
...In other words, "Pay me now or pay me later...
...First, homosex-uals worried that reducing the estimate might reduce impetus to find a cure...
...there are still fourteen causes of death in America that are ahead of AIDS...
...In fact, of-ficials with both the New York Depart-ment of Health and CDC confirmed to me that CDC never proposed a range for New York nor any other city...
...Two top NCI doctors have recently left the agency, partly in frustration over this...
...Even if AIDS kept up with the ability to fund promising new pro-posals is more restricted than at any time in the past two decades...
...Instead, it stated that the lowered number of infected homosexuals could THE AMERICAN SPECTATOR MAY 1989 simply mean that the percentage of homosexuals infected was much smaller than previously believed...
...Instead, they were calculated from the projected caseload for the next three years, a mathematical extrapola-tion from the present caseload trend...
...A spokesman for the Gay Men's Health Crisis, a major private agency, said the projection was "numb-ing, absolutely numbing...
...Thus in the short run, AIDS researchers must come from—and in-deed have come from—other research areas, primarily but not exclusively cancer...
...And it indeed is possible that seropositivity levels are much lower than previously believed...
...In an editorial in the October 7, 1988, Journal of the American Medical Association, Dr...
...Mathilde Krim, the well-known AIDS fund-raiser, rounded the Department of Health figure up to half a million and accelerated the incubation rate by assuming they would all die within a decade, saying, "Half a million people are going to die here in the next ten years . . ." No one quoted by the article noted that the 400,000 figure was completely at odds with the CDC estimate of one million to 1.4 million infections in com-bination with the New York City Department of Health's estimate that 15 percent of those cases would be New Yorkers...
...They heckled him at public appearances, disrupted his private meetings, and demanded his resignation...
...It's time to take AIDS out of the realm of science fiction and put it within the wide spectrum of diseases and other problems -which continue to plague mankind and which, we may hope, will eventually themselves fall vic tim to man's increasing collective knowledge...
...Perhaps, as some have suggested, we could just trade funds earmarked for F-16s or MX missiles for AIDS re-search...
...mevertheless, as convoluted and 111 inconsistent as this new explana-tion was, it helped get the city off the hook with angry homosexuals...
...The New York Native, the city's leading homosexual news-paper, later depicted Joseph on its cover with a Cheshire Cat grin, spout-ing mumbo-jumbo about the number of seropositives in the city...
...Indeed, rumblings of discontent with our AIDS preoccupation are already be-ing heard...
...Having viewed the political pitfalls New York City encountered with its estimates, the New York State Depart ment of Health stuck its fmger into the political winds and was much more cir-cumspect...
...New York's Loomis, of course, also ignored the plateau, as indeed she would have to in order to write her terrifying article about how the city was grossly un-prepared for the tidal wave to come...
...San Francisco's seropositivity studies all indicate that about_50 percent of that city's homosexuals are infected...
...A number of commentators have inferred that our new estimate of infection strongly implies that the male gay/bisexual population . . . is much smaller than the 250,000-500,000 com-monly asserted," said the new report...
...Despite the far greater health threat posed by cancer, federal AIDS funding, allocated to...
...During fiscal year 1989, only 25 percent of cancer grant applications approved by review committees will receive funding...
...Such was the outcry at the new figures that New York City quickly came up with yet another estimate...
...It announced that it would not rely upon the new New York sero-positivity estimate, and, completely ig-noring the plateauing of actual cases in the city, in December New York State health officials extended their projec-tions to show an unabated increase in cases for the next five years...
...Already buffeted by AIDS, by the public scrutiny the epidemic has brought to the homosexual population and its sexual practices, and by the in-herent stigma in being identified with a particularly hideous disease, homo-sexual activists were naturally disin-clined to hear that the population they allegedly represent is much smaller than had been widely believed...
...But second, the new figures implied that New York's homosexual popula-tion might not be as large as previous-ly assumed, and any dramatic reduc-tion of the estimated size of the homo-sexual population seriously threatens their own power base...
...And for Alzheimer's disease— a cruel malady that, because people are living longer, will take an ever-higher yearly toll unless medical intervention becomes possible—federal research ex-penditures will equal less than one per-cent of federal patient costs...
...The adjustment also reflected a The press treats the CDC projections as sacrosanct...
...AIDS "has been an ex-traordinary drain on the energy of the scientific establishment," he said...
...Health released new numbers that sliced the old figures in half, estimating that there were in fact 200,000 total in-fections in the city...
...Joseph says he has also received hostile phone calls at home and at the office...
...As part of her evidence, she stated that "last fall the CDC pro-posed a range of 150,000 to 380,000 in-fections in New York City...
...For non-AIDS work, the National Institutes of Health has lost almost 1,100 employees since 1984...
...The importance of this 40-year-old statistical assumption to the cause of the acceptance of homo-sexuality in our society cannot be overstated...
...The resulting figure would be 142,000 to 210,000 infections...
...Money and attention devoted to one cause means resources pulled off another...
...There is a connection between the perception of AIDS as a national catastrophe and the willingness to fund the campaign against it...
...It's taken a lot of intellectual energy away from the cancer program...
...public will be neglected for years to come...
...But it is just a disease and not an Andromeda Strain, as the novelist Michael Crichton has taken pains to point out...
...What he said was that 10 percent of males are "more or less exclusively homosexual for at least three years between the ages of sixteen and fifty-five...
...As to the true level of seropositivity among homosexuals, the explanation for the lack of infected homosexuals is probably a combination of both fewer homosexuals and lowered levels of seropositivity...
...And the ratio of AIDS research and development spending to federal pa-tient costs is vastly out of proportion to other deadly diseases...
...q as previously assumed...
...First, it took a hint from CDC and set a range of seropositivity—from 149,000 to 229,000—effectively allowing its estimate to go even lower...
...Where will they come from...
...Members of an ac-tivist group called the AIDS Coalition to Unleash Power (ACT-UP), which promotes whatever will advance the curing and patient-care of those now suffering from HIV, besieged the direc-tor of the Department of Health, Stephen Joseph...
...Not a chance...
...Later, this figure was dropped to 400,000 when better in-formation on infection prevalence and the size of at-risk groups had been col-lected...
...Never-theless, it is the ten percent figure that New York had used earlier to arrive at its estimate that there were 400,000 homosexuals in the city...
...The 10-percent figure is also regularly employed as a lobbying tool by such groups as the Na-tional Gay and Lesbian Task Force, which claims to represent "23 million Gay and lesbian persons...
...Vincent DeVita bemoaned the loss of resources to the AIDS industry...
...It's the statistical cure of AIDS," said Dr...
...In any case, the myth of the Kinsey ten percent could prove to be yet another casualty of the AIDS epidemic...
...For some time . . . Health Department researchers have noted a disparity between the ratio of AIDS cases to the estimated number of gay men in New York City versus San Francisco: New York City, with a total population ten times that of San Francisco, has been estimated to have a population of gay men several times larger than San Fran-cisco's, yet its AIDS caseload of homosex-ual men is less than twice that [of San Francisco] .. . Assuming that the ratio of seropositive homosexual men with AIDS is about the same in the two cities, "that would produce," said Joseph, "an estimate of 50,000 HIV-infected gay men in New York City, rather than the previously estimated 200,000 to 250,000...
...But when the psychiatric researchers mentioned above made a comparison, they found that in terms of persons af-fected and patient costs, direct and in-direct, the toll caused by psychiatric disorders swamps that of AIDS...
...By rejecting the Kinsey figure (the myth-ical ten percent, that is) and accepting the San Francisco figures, there can be no other conclusion but that Joseph was saying New York had little more than twice as many homosexuals as San Francisco's 56,000, and that therefore New York's homosexual population is far below the alleged Kinsey ten percent...
...Said the chairman of New York State's AIDS Advisory Council: "I shudder to think what happens if we try to put 400,000 people into the system without better preparation than we have shown to date...
...Barry Leibowitz, president of the Doc-tors Council, a union representing physicians on the Health Department staff and at several hospitals...
...As usual, the line was that of maximum hype...
...Each year a million cases of cancer are diagnosed, almost half of which end in death...
...In any event, the lowered estimate wasn't a cure for anything except an earlier faulty estimate, and Joseph and reduction in the estimate of infected New York homosexuals in the city from 250,000 to 50,000...
...But even this wouldn't solve one major part of the problem, which is a drain on the number of researchers...
...The media greeted it with silence...
...During the 1970s, between 43 and 60 percent of such approved grants were funded...
...It takes up to a decade to put a high school graduate through medical school...
...Indeed, the columnist Patrick Buchanan picked up on the New York figures and made just that point in a column last September...
...Estimates of sero-positivity in New York are based on sampling at STD clinics which might well be unrepresentative of homosex-uals...
...For example, cancer research expenditures will equal about 4.5 percent of cancer patient costs...
...A new Kinsey report, conducted in 1970 but first released in the January 20 issue of Science, tends to confirm this four percent figure...
...Considering that this is the land of East Los Angeles, Watts, and Oakland, and that these women are by definition heterosexual, sexually active, and of the ages during which IV drug use is most common, a rate of 8.3 per 10,000 is wonderful news...
...We are everywhere...
...Dur-ing the same period, according to Science magazine, the number of employees engaged in AIDS work has increased by more than 400, to 580 workers or their full-time equivalents...
...Thus, it came as a shock when the following week the Department of his staff were quick to point out that the estimates upon which the city planned its medical services weren't based on the estimate of seropositivi-ty...
Vol. 22 • May 1989 • No. 5
