Prostitutes’ Role in Spread of AIDS Suspected

Prostitutes may be spreading acquired immune deficiency syndrome to the heterosexual population, according to health professionals who are just beginning to study this connection.

Three men outside the usual risk group for the disease--they were not homosexuals, intravenous drug users or hemophiliacs--recently were diagnosed at County-USC Medical Center as having AIDS. Their only apparent exposure to the AIDS virus was heterosexual contacts, including visits to street prostitutes in Los Angeles. Five other heterosexual men in Los Angeles who recently contracted AIDS also frequented street prostitutes, according to a spokeswoman for the county’s Health Services Department.

As a result, the USC School of Medicine initiated a study at Sybil Brand Institute and asked all women arrested for prostitution if they would submit to blood tests. Of the 78 women who agreed, six have been exposed to the AIDS virus, said Dr. Alexandra Levine, an associate professor of medicine at USC.

The test proved only that the women developed antibodies to the disease; they will not necessarily develop AIDS. Health professionals say, however, that it is still unclear how likely it is that a woman who has been exposed to AIDS will spread the disease through sexual contact with men.

‘Implications for Society’

“Someone who has the antibodies is potentially contagious,” Levine said. “There are implications for society as a whole, not just the homosexual community.”

Prostitutes who inject drugs are exposed to the AIDS virus through used needles, and four of the women who tested positive at Sybil Brand were intravenous drug users. Of 400 female drug users at the Orange County Jail, 10 prostitutes tested positive to the AIDS virus.

Several women from the Sybil Brand study still are working, even though they have been informed that they could be contagious. There is no way to legally detain them, Levine said.

“They told me they had to go back to the streets because they had no skills and no other way to support themselves,” said Scott Aguilar, AIDS clinical research coordinator for USC.

There are no national figures on the number of prostitutes who have been exposed to AIDS, said William Darrow, a researcher with the Centers for Disease Control in Atlanta. In some areas the figures are extremely high. At one AIDS screening clinic in Miami, 10 of 25 prostitutes tested were exposed to the disease; eight of the 10 were intravenous drug users. According to William Haseltine, an AIDS researcher at Harvard, one of every three prostitutes in New York has been exposed to the AIDS virus.

Research in 8 Cities

The disease control centers will sponsor research next year in eight cities into the link between prostitution and AIDS. The testing program at Sybil Brand will be expanded and included in the national study.

Some past studies that linked heterosexual men with AIDS and prostitutes may not be definitive, Darrow said. Some men with AIDS might be more inclined to claim that they “slipped a few years ago and saw a hooker” than to admit to homosexuality or intravenous drug use.

For this reason, a recent study that described nine military men with AIDS who visited prostitutes in the United States or abroad should be further scrutinized, some researchers said. Drug use or past homosexual encounters could lead to a dishonorable discharge.

Some prostitutes’ rights groups claim that street walkers are being used as scapegoats and that most of the women used condoms with customers. Many prostitutes recently interviewed in Los Angeles said, however, said that they eschewed condoms if the customers offered more money.

Male prostitution also has the potential for spreading AIDS to the heterosexual community, said Joel Schwartz of the Gay and Lesbian Community Services Center in Hollywood. Male prostitution is flourishing on Santa Monica Boulevard, and many of the customers are married, he said, adding that he knows of six male hustlers who contracted AIDS, three of whom continued to work after they were diagnosed.

“The spread of AIDS to the straight community by male hustlers is the greatest threat to the nation’s health,” he said. “A man gets AIDS from a hustler, then goes home to his wife or girlfriend. That’s how it will happen.”