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373 lines
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<20><><EFBFBD> <20><><EFBFBD><EFBFBD><EFBFBD> <20><><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD> <20><><EFBFBD><EFBFBD> <20><><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD> <20><><EFBFBD><EFBFBD> <20><><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD>
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<20><><EFBFBD><EFBFBD><EFBFBD> <20><><EFBFBD><EFBFBD><EFBFBD> <20><><EFBFBD><EFBFBD><EFBFBD> <20><><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD>
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ARRoGANT CoURiERS WiTH ESSaYS
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Grade Level: Type of Work Subject/Topic is on:
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[ ]6-8 [ ]Class Notes [Essay on Aids ]
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[ ]9-10 [ ]Cliff Notes [ ]
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[x]11-12 [ ]Essay/Report [ ]
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[ ]College [ ]Misc [ ]
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Dizzed: 10/94 # of Words:3423 School: ? State: ?
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<EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD>><3E><><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD>><3E><><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD>>Chop Here><3E><><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD>><3E><><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD>><3E><><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD>><3E><><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD><EFBFBD>
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AIDS and YOU (May 1987)
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By Martin H. Goodman MD
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(this essay is in the public domain)
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Introduction:
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AIDS is a life and death issue. To have the AIDS disease is at present a
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sentence of slow but inevitable death. I've already lost one friend to
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AIDS. I may soon lose others. My own sexual behavior and that of many of my
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friends has been profoundly altered by it. In my part of the country, one
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man in 10 may already be carrying the AIDS virus. While the figures may
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currently be less in much of the rest of the country, this is changing
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rapidly. There currently is neither a cure, nor even an effective
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treatment, and no vaccine either. But there are things that have been
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PROVEN immensely effective in slowing the spread of this hideously lethal
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disease. In this essay I hope to present this information. History and
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Overview:
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AIDS stands for Acquired Immune Defficiency Disease. It is caused by a virus.
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The disease originated somewhere in Africa about 20 years ago. There it
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first appeared as a mysterious ailment afflicting primarily heterosexuals
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of both sexes. It probably was spread especially fast by primarily female
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prostitutes there. AIDS has already become a crisis of STAGGERING
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proportions in parts of Africa. In Zaire, it is estimated that over twenty
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percent of the adults currently carry the virus. That figure is increasing.
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And what occurred there will, if no cure is found, most likely occur here
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among heterosexual folks.
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AIDS was first seen as a disease of gay males in this country. This was
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a result of the fact that gay males in this culture in the days before AIDS
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had an average of 200 to 400 new sexual contacts per year. This figure was
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much higher than common practice among heterosexual (straight) men or
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women. In addition, it turned out that rectal sex was a particularly
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effective way to transmit the disease, and rectal sex is a common practice
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among gay males. For these reasons, the disease spread in the gay male
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population of this country immensely more quickly than in other
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populations. It became to be thought of as a "gay disease". Because the
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disease is spread primarily by exposure of ones blood to infected blood or
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semen, I.V. drug addicts who shared needles also soon were identified as an
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affected group. As the AIDS epidemic began to affect increasingly large
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fractions of those two populations (gay males and IV drug abusers), many of
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the rest of this society looked on smugly, for both populations tended to
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be despised by the "mainstream" of society here.
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But AIDS is also spread by heterosexual sex. In addition, it is spread
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by blood transfusions. New born babies can acquire the disease from
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infected mothers during pregnancy. Gradually more and more "mainstream"
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folks got the disease. Most recently, a member of congress died of the
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disease. Finally, even the national news media began to join in the task of
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educating the public to the notion that AIDS can affect everyone.
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Basic medical research began to provide a few bits of information, and
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some help. The virus causing the disease was isolated and identified. The
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AIDS virus turned out to be a very unusual sort of virus. Its genetic
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material was not DNA, but RNA. When it infected human cells, it had its RNA
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direct the synthesis of viral DNA. While RNA viruses are not that uncommon,
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very few RNA viruses reproduce by setting up the flow of information from
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RNA to DNA. Such reverse or "retro" flow of information does not occur at
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all in any DNA virus or any other living things. Hence, the virus was said
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to belong to the rare group of virues called "Retro Viruses". Research
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provided the means to test donated blood for the presence of the antibodies
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to the virus, astronomically reducing the chance of ones getting AIDS from
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a blood transfusion. This was one of the first real breakthroughs. The same
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discoveries that allowed us to make our blood bank blood supply far safer
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also allowed us to be able to tell (in most cases) whether one has been
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exposed to the AIDS virus using a simple blood test.
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The Types of AIDS Infection:
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When the AIDS virus gets into a person's body, the results can be broken
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down into three general types of situations: AIDS disease, ARC, and
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asymptomatic seropositive condition.
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The AIDS disease is characterized by having one's immune system
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devastated by the AIDS virus. One is said to have the *disease* if one
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contracts particular varieties (Pneumocystis, for example) of pneumonia, or
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one of several particular varieties of otherwise rare cancers (Kaposi's
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Sarcoma, for example). This *disease* is inevitably fatal. Death occurs
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often after many weeks or months of expensive and painful hospital care.
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Most folks with the disease can transmit it to others by sexual contact or
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other exposure of an uninfected person's blood to the blood or semen of the
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infected person.
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There is also a condition referred to as ARC ("Aids Related Complex").
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In this situation, one is infected with the AIDS virus and one's immune
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system is compromised, but not so much so that one gets the (ultimately
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lethal) cancers or pneumonias of the AIDS disease. One tends to be plagued
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by frequent colds, enlarged lymph nodes, and the like. This condition can
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go on for years. One is likely to be able to infect others if one has ARC.
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Unfortunately, all those with ARC are currently felt to eventually progress
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to getting the full blown AIDS disease.
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There are, however, many folks who have NO obvious signs of disease what
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so ever, but when their blood serum is tested they show positive evidence
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of having been exposed to the virus. This is on the basis of the fact that
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antibodies to the AIDS virus are found in their blood. Such "asymptomatic
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but seropositive" folks may or may not carry enough virus to be infectious.
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Most sadly, though, current research and experience with the disease would
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seem to indicate that EVENTUALLY nearly all folks who are seropostive will
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develop the full blown AIDS disease. There is one ray of hope here: It may
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in some cases take up to 15 years or more between one's becoming
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seropositive for the AIDS virus and one's developing the disease. Thus, all
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those millions (soon to be tens and hundreds of millions) who are now
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seropositive for AIDS are under a sentence of death, but a sentence that
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may not be carried out for one or two decades in a significan fraction of
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cases. Medical research holds the possibility of commuting that sentence,
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or reversing it.
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There is one other fact that needs to be mentioned here because it is
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highly significant in determining recommendations for safe sexual conduct
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which will be discussed below: Currently, it is felt that after exposure to
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the virus, most folks will turn seropositive for it (develop a positive
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blood test for it) within four months. It is currently felt that if you are
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sexually exposed to a person with AIDS and do not become seropositive
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within six months after that exposure, you will never become seropositive
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as a result of that exposure.
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Just to confuse the issue a little, there are a few folks whose blood
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shows NO antibodies to the virus, but from whom live virus has been
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cultured. Thus, if one is seronegative, it is not absolute proof one is not
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exposed to the virus. This category of folks is very hard to test for, and
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currently felt to be quite rare. Some even speculate that such folks may be
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rare examples of those who are immune to the effects of the virus, but this
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remains speculation. It is not known if such folks can also transmit the
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virus.
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Transmission of AIDS:
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The AIDS virus is extremely fragile, and is killed by exposure to mild
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detergents or to chlorox, among other things. AIDS itself may be
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transmitted by actual virus particles, or by the transmission of living
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human CELLS that contain AIDS viral DNA already grafted onto the human DNA.
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Or both. Which of these two mechanisms is the main one is not known as I
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write this essay. But the fact remains that it is VERY hard to catch AIDS
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unless one engages in certain specific activities.
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What will NOT transmit AIDS?
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Casual contact (shaking hands, hugging, sharing tools) cannot transmit
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AIDS. Although live virus has been recovered from saliva of AIDS patients,
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the techniques used to do this involved concentrating the virus to extents
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many thousands of times greater than occurs in normal human contact, such
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as kissing (including "deep" or "French" kissing). Thus, there remains no
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solid evidence that even "deep" kissing can transmit AIDS. Similarly, there
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is no evidence that sharing food or eating utensils with an AIDS patient
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can transmit the virus. The same is true for transmission by sneezing or
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coughing. There just is no current evidence that the disease can be
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transmitted that way.The same may be true even for BITING,though here there
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may be some increased (though still remote) chance of transmitting the
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disease.
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The above is very important. It means that there is NO medical reason
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WHAT SO EVER to recommend that AIDS suffers or AIDS antibody positive folks
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be quarrantined. Such recommendations are motivated either by ignorance or
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by sinister desires to set up concentration camps. Combined with the fact
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that the disease is already well established in this country, the above
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also means that there is no rational medical basis for immigration laws
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preventing visits by AIDS suffers or antibody positive persons.
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The above also means that friends and family and coworkers of AIDS
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patients and seropostive persons have nothing to fear from such casual
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contact. There is no reason to not show your love or concern for a friend
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with AIDS by embracing the person. Indeed, there appears still to be NO
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rational basis for excluding AIDS suffers from food preparation activity.
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Even if an AIDS suffer cuts his or her finger and bleeds into the salad or
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soup, most of the cells and virus will die, in most cases, before the food
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is consumed. In addition, it is extremely difficult to get successfully
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attacked by AIDS via stuff you eat.
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AIDS cannot be transmitted by the act of GIVING blood to a blood bank.
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All equipment used for such blood donation is sterile, and is used just
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once, and then discarded.
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How is AIDS transmitted?
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Sexual activity is one of the primary ways AIDS is transmitted. AIDS is
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transmitted particulary by the transmission of blood or semen of an
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infected person into contact with the blood of an uninfected person. Sex
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involving penetration of the penis into either the vagina of a woman or the
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rectum of either a woman or a man has a very high risk of transmitting the
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disease. It is felt to be about four times MORE likely for an infected male
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to transmit AIDS to an uninfected woman in the course of vaginal sex than
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it is likely for an infected woman to transmit AIDS to an uninfected male.
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This probably relates to the greater area of moist tissue in a woman's
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vagina, and to the relative liklihood of microscopic tears to occur in that
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tissue during sex. But the bottom line is that AIDS can be transmitted in
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EITHER direction in the case of heterosexual sex. Transmission among
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lesbians (homosexual females) is rare.
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Oral sex is an extremely common form of sexual activity among both gay
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and straight folks. Such activity involves contact of infected semen or
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vaginal secretions with the mouth, esophagus (the tube that connects the
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mouth with the stomach) and the stomach. AIDS virus and infected cells most
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certainly cannot survive the acid environment of the stomach. Yet, it is
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still felt that there is a chance of catching the disease by having oral
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sex with an infected person. The chance is probably a lot smaller than in
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the case of vaginal or rectal sex, but is still felt to be significant.
|
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|
|
|
|||
|
|
As mentioned above, AIDS is also transmitted among intravenous drug
|
|||
|
|
users by the sharing of needles. Self righteous attitudes by the political
|
|||
|
|
"leaders" of this country at local, state, and national levels have
|
|||
|
|
repeatedly prevented the very rational approach of providing free access to
|
|||
|
|
sterile intravenous equipment for IV drug users. This measure, when taken
|
|||
|
|
promptly in Amsterdam, was proven to greatly and SIGNIFICANTLY slow the
|
|||
|
|
spread of the virus in that population. The best that rational medical
|
|||
|
|
workers have succeeded in doing here in San Francisco is distribute
|
|||
|
|
educational leaflets and cartoons to the I.V. drug abusing population
|
|||
|
|
instructing them in the necessity of their rinsing their "works" with
|
|||
|
|
chlorox before reusing the same needle in another person. Note that even if
|
|||
|
|
you don't care what happens to I.V. drug abusers, the increase in the
|
|||
|
|
number of folks carrying the virus ultimately endangers ALL living persons.
|
|||
|
|
Thus, the issue is NOT what you morally think of I.V. drug addicts, but one
|
|||
|
|
of what is the most rational way to slow the spread of AIDS in all
|
|||
|
|
populations.
|
|||
|
|
|
|||
|
|
Testing of donated blood for AIDS has massivly reduced the chance of
|
|||
|
|
catching AIDS from blood transfusions. But a very small risk still remains.
|
|||
|
|
To further reduce that risk, efforts have been made to use
|
|||
|
|
"autotransfusions" in cases of "elective surgery" (surgery that can be
|
|||
|
|
planned months in advance). Autotransfusion involves the patient storing
|
|||
|
|
their own blood a couple of weeks prior to their own surgery, to be used
|
|||
|
|
during the surgery if needed. Similary, setting up donations of blood from
|
|||
|
|
friends and family known to be antibody negative and at low risk for AIDS
|
|||
|
|
prior to schedualed surgery further can decrease the already small risks
|
|||
|
|
from transfusion.
|
|||
|
|
|
|||
|
|
|
|||
|
|
AIDS and SEX: What are the rational options?
|
|||
|
|
|
|||
|
|
The "sexual revolution" of the 1960's has been stopped dead in its
|
|||
|
|
tracks by the AIDS epidemic. The danger of contracting AIDS is so real now
|
|||
|
|
that it has massively affected the behavior of both gay and straight folks
|
|||
|
|
who formerly had elected to lead an active sexual life that included
|
|||
|
|
numerous new sexual contacts.
|
|||
|
|
|
|||
|
|
|
|||
|
|
Abstinence
|
|||
|
|
|
|||
|
|
The safest option regarding AIDS and sex is total abstinence from all
|
|||
|
|
sexual contact. For those who prefer to indulge in sexual contact, this is
|
|||
|
|
often far too great a sacrifice. But it IS an option to be considered.
|
|||
|
|
|
|||
|
|
|
|||
|
|
Safe Sex
|
|||
|
|
|
|||
|
|
For those who wish to have sexual contact with folks on a relatively
|
|||
|
|
casual basis, there have been devised rules for "safe sex". These rules are
|
|||
|
|
very strict, and will be found quite objectionable by most of us who have
|
|||
|
|
previously enjoyed unrestricted sex. But to violate these rules is to risk
|
|||
|
|
unusually horrible death. Once one gets used to them, tho, the rule for
|
|||
|
|
"safe sex" do allow for quite acceptable sexual enjoyment in most cases.
|
|||
|
|
|
|||
|
|
For those who wish to indulge in pentration of the vagina or rectum by a
|
|||
|
|
penis: The penis MUST be sheathed in a condom or "rubber". This must be
|
|||
|
|
done "religiously", and NO exceptions are allowed. A condom must be used by
|
|||
|
|
a man even when he is receiving oral sex. Cunnilingus (oral stimulation of
|
|||
|
|
a womans gentitals by the mouth of a lover) is NOT considerd to be safe
|
|||
|
|
sex. Safe sex includes mutual masturbation, and the stimultion of one
|
|||
|
|
genitals by another's hand (provided there are no cuts in the skin on that
|
|||
|
|
hand). But manual stimulation of another's genitals is NOT safe if one has
|
|||
|
|
cuts on one's hands, unless one is wearing a glove.
|
|||
|
|
|
|||
|
|
Note that even when one is conscientiously following the recommendations
|
|||
|
|
for safe sex, accidents can happen. Condoms can break. One may have small
|
|||
|
|
cuts or tears in ones skin that one is unaware of. Thus, following rules
|
|||
|
|
for "safe sex" does NOT guarantee that one will not get AIDS. It does,
|
|||
|
|
however, greatly reduce the chances. There are many examples of sexaully
|
|||
|
|
active couples where one member has AIDS disease and the other remains
|
|||
|
|
seronegative even after many months of safe sex with the diseased person.
|
|||
|
|
It is particularly encouraging to note that, due to education programs
|
|||
|
|
among San Francisco gay males, the incidence of new cases of AIDS infection
|
|||
|
|
among that high risk group has dropped massively. Between practice of safe
|
|||
|
|
sex and a significant reduction in the number of casual sexual contacts,
|
|||
|
|
the spread of AIDS is being massively slowed in that group. Similar
|
|||
|
|
responsible action MUST be taken by straight folks to further slow the
|
|||
|
|
spread of AIDS, to give our researchers time to find the means to fight it.
|
|||
|
|
|
|||
|
|
|
|||
|
|
Monogamy
|
|||
|
|
|
|||
|
|
For those who would have sexual activity, the safest approach in this
|
|||
|
|
age of AIDS is monogamous sex. Specifically, both parties in a couple must
|
|||
|
|
commit themselves to not having sex with anyone else. At that time they
|
|||
|
|
should take AIDS antibody tests. If the tests are negative for both, they
|
|||
|
|
must practice safe sex until both members of the couple have been greater
|
|||
|
|
than six months since sexual contact with anyone else. At that time the
|
|||
|
|
AIDS blood test is repeated. If both tests remain negative six months after
|
|||
|
|
one's last sexual contact with any other party, current feeling is that it
|
|||
|
|
is now safe to have "unprotected" sex. Note that this approach is
|
|||
|
|
recommended especially for those who wish to have children, to prevent the
|
|||
|
|
chance of having a child be born infected with AIDS, getting it from an
|
|||
|
|
infected mother. Note also that this approach can be used by groups of
|
|||
|
|
three or more people, but it must be adhered to VERY strictly.
|
|||
|
|
|
|||
|
|
|
|||
|
|
What to AVOID:
|
|||
|
|
|
|||
|
|
Unscrupulous folks have begun to sell the idea that one should pay to
|
|||
|
|
take an AIDS antibody test, then carry an ID card that certifies one as
|
|||
|
|
AIDS antibody negative, as a ticket to being acceptable in a singles bar.
|
|||
|
|
This is criminal greed and stupidity. First, one can turn antibody positive
|
|||
|
|
at any time. Even WEEKLY testing will not pick this change up soon enough
|
|||
|
|
to prevent folks certified as "negative" from turning positive between
|
|||
|
|
tests. Much worse, such cards are either directly or implicitly promoted as
|
|||
|
|
a SUBSTITUTE for "safe sex" practices. This can only hasten the spread of
|
|||
|
|
the disease.
|
|||
|
|
|
|||
|
|
If you want to learn your antibody status, be sure to do so ANONYMOUSLY.
|
|||
|
|
Do NOT get the test done by any agency that requires your real name,
|
|||
|
|
address, or any other identifying information. Fortunately, in San
|
|||
|
|
Francisco, there is a public place to get AIDS antibody testing where you
|
|||
|
|
may identify yourself only as a number. Tho that place has a three month
|
|||
|
|
long waiting list for testing, there are other private clinics where one
|
|||
|
|
may have the test done for cash, and may leave any false name one wishes.
|
|||
|
|
The reason I suggest this is that currently there are some very
|
|||
|
|
inappropriate reactions by government and business to folks known to be
|
|||
|
|
antibody positive. Protect yourself from such potential persection by
|
|||
|
|
preventing your antibody status from being a matter of record. That
|
|||
|
|
information is for you, your lover(s), and (if need be) your physician. And
|
|||
|
|
for NO one else.
|
|||
|
|
|
|||
|
|
There currently is NO treatment for AIDS (this includes AZT) that shows
|
|||
|
|
significant promise.
|
|||
|
|
|
|||
|
|
In Conclusion:
|
|||
|
|
|
|||
|
|
It is my own strongly held view, and that of the medical and research
|
|||
|
|
community world wide, that the AIDS epidemic is a serious problem, with the
|
|||
|
|
potential to become the worst plague this species has ever known. This is
|
|||
|
|
SERIOUS business. VASTLY greater sums should be spent on searching for
|
|||
|
|
treatments and vaccines. On the other hand, we feel strongly that this is
|
|||
|
|
"merely" a disease, not an act by a supernatural power. And while it does
|
|||
|
|
not seem likely we will find either a cure or a vaccine in the forseeable
|
|||
|
|
future, it may be that truly effective treatments that can indefinitely
|
|||
|
|
prolong the life of AIDS victims may be found in the next few years. When
|
|||
|
|
science and technology do finally fully conquer AIDS, we can go back to
|
|||
|
|
deciding what sort and how much sex to have with who ever we choose on the
|
|||
|
|
basis of our own personal choice, and not by the coercion of a speck of
|
|||
|
|
proteins and RNA. May that time come soon. In the mean time, we must all do
|
|||
|
|
what we can to slow the spread of this killer. This article is intended to
|
|||
|
|
help accomplish that. Please circulate it as widely as possible.
|