The Panic Builds at AIDS Testing Centers : Health Professionals Urge Heterosexuals to ‘Calm Down’

The couple sat in a crowded room that bristled with edgy confusion, quietly waiting to be tested for exposure to the lethal AIDS virus. On the woman’s lap was Erica Jong’s 1973 tribute to casual sex: “Fear of Flying.”

The irony of her reading selection wasn’t lost on the 31-year-old waitress.

“It’s really sad, because sex is so fun . . . natural . . . enjoyable, free, tender . . .” she said, almost dreamily.

A Gentle Smile

The 28 year-old cement worker who had accompanied her to the center, a state-sponsored anonymous test site in Long Beach, gave her a gentle smile. “Now it’s just fear,” he said.

For about five years, gay communities have been terrorized by the spread of AIDS. Now, almost overnight it seems, AIDS anxiety is coursing through the collective consciousness of mainstream America.

“I feel a building momentum of panic,” said Richard Bank, a private practice gynecologist in Beverly Hills who reports “at least a dozen calls every day,” about testing from his largely heterosexual clientele.

“We’re overwhelmed,” said Tom Dougherty, a registered nurse and coordinator of the AIDS antibody testing program at the Long Beach Health Department, which has had to turn away “300-400” people who have called the two Long Beach test sites or lined up before the scheduled clinics to have their blood analyzed.

Suddenly some of the same health professionals who worked hard to let the world know that AIDS is not just a gay disease have another message for heterosexuals: “Calm down.”

The first major wave of national concern began to peak a month ago, with intensified media coverage of the heterosexual risk--including cover stories in Time and Newsweek. Nationally, clinics reported increases of up to 150% in the number of people seeking the AIDS antibody test--with 50% to 70% of those requests coming from heterosexuals--as opposed to 10%-20% inquiries initially.

Then on Tuesday, public health officials suggested that the 12-million Americans who have received blood transfusions between 1978 and 1985 undergo testing. Now many of those administering the tests fear the snowball of heterosexual inquiries will become an avalanche.

Although none are downplaying the seriousness of the disease, they warn that among other problems created by the current atmosphere, the growing numbers of low-risk heterosexuals clogging the test sites in Los Angeles County may be discouraging high-risk people from getting tested.

Blood Donations Screened

Many hospitals and private physicians give confidential AIDS tests at prices ranging from $50 to $150, but they cannot guarantee that the people tested will never be named, health officials say. All blood donations are now screened for the AIDS virus, but the Red Cross discourages donating blood as a way of getting tested. Because of increased workloads at existing test locations, the County Board of Supervisors Tuesday approved two new free test sites, which guarantee anonymity, scheduled to open by the end of April.

“It feels like hysteria to me. You see it in faces and hear it on the telephone when people call (about the test)” said Jackie Gelfand, a counselor at the Edmund D. Edelman Health Center in Hollywood--where it now takes a minimum of eight weeks to get an appointment for the test.

“They’re saying, I can’t wait! I can’t sleep at night! I have to come in now!”

In general, heterosexuals have not had contact with the deluge of information on AIDS that has saturated homosexual communities, and are not reassured when Gelfand tells them that a delay of eight weeks is not likely to change their test results. Nor are they encouraged by the low rate of positive tests among heterosexuals who do not fit into any of the identified “behavior risk” groups--gays, bisexuals, intervenous drug users, hemophiliacs, persons who’ve received blood transfusions between 1978-85, and those who have had sexual relations with someone in one of those groups (the risk level of multiple partner heterosexuals is still under debate).

“I think the degree to which there is a panic is unnecessary,” Gelfand said. But she does understand the fear. About 12,000 people have undergone testing at the Edelman clinic in Hollywood since October, 1985. Gelfand has counseled about a third of those.

Psychological Problems

Although testing positive for AIDS antibodies does not necessarily mean that the person will develop AIDS, the news of a positive test can be psychologically devastating, and mere anticipation of the test results can cause psychological problems, she said.

For that reason, people seeking the test are carefully counseled, said Hugh Rice, director of the center. “We just don’t fling open our doors and say ‘Come one come all and be tested.’ ”

In many cases, there is no good reason to know if one has the antibodies in his or her bloodstream, Rice said. “The usefulness of this piece of information varies from individual to individual.”

A woman who has been sexually active with multiple partners and is considering having a child has a valid reason for wanting to be tested, Rice said. “But let’s say we have an older woman who got one unit of blood for a gall bladder operation in 1975, is widowed and not sexually active. Is this piece of information really necessary? Might it not create more anxiety than necessary on the slim chance she tests positive?”

An hour before its scheduled 5 p.m. clinic Wednesday, there were already 20 people waiting at the Long Beach alternative test site said a 33-year-old construction worker as he sat on a couch in a room filled with people of every age, race, occupation and description--all of whom were waiting to be given the anonymous test.

A heterosexual, the man said he had tested before. He recalled the 10-day wait for the results (which were negative): “It was like being strapped in an electric chair waiting for someone to flip the switch.”

A 30-year-old student, also being tested for the second time, said she was “scared to death,” awaiting the results of her first test.

‘Who’d Want Me?’

“I was afraid it would turn out positive. I thought, I’ll never be in a relationship with a man again--who’d want me? I was thinking that I could never have children . . . It was a long 10 days.”

She had come back for a second test, she said, just to be certain. After all, she explained, her lover has bragged that he slept with 76 women in 1976 to celebrate the nation’s bicentennial--having fallen short of his goal of 200.

By all accounts, more heterosexual women than men are being tested, and several women who have taken or are going to take the test gave similar reasons and expressed similar concerns in phone conversations.

“I was tested for my own peace of mind as much as anything else. I didn’t consider myself a high risk particularly. But there aren’t any guarantees anymore,” said a 35-year-old systems analyst.

A 44-year-old businesswoman said she is going to the Red Cross to be tested--although she didn’t tell the blood bank that getting tested was her sole motivation for giving blood for the first time in her life.

Her concern, she said, “Is best exemplified by the (condom) commercial: “ ‘I enjoy love, but I’m not willing to die for it.’ ”

And 29-year-old Kristin Brown is so concerned about the spread of AIDS that she handed out condoms as Christmas presents last year. Although she is married and monogamous, she has tested twice in the past two years.

Tension and Stress

Each time, awaiting the results was painful, she said. “I had a bad stomach for a week. Tension and stress. That anxiety of wanting to know and not wanting to know and wanting to know and not wanting to know.”

Each time, she tested negative, and each time the relief was tremendous, she said.

But she doesn’t write off the threat. Brown’s brother Mike is the coordinator of AIDS services for the Center in Long Beach, so she feels she’s better informed than the general public on the subject.

“I’m surprised that heterosexuals aren’t more concerned than they are. I don’t know what it will take. That lackadaisical attitude really discourages me--although I’m sure I seem overly dramatic to some people.”

In fact, said her brother, 75% or 80% of the people seeking tests at the center now are heterosexual. Yet, “of the several hundred heterosexuals with no other risk factors (tested in the past several weeks) we have not had one positive (test result).”

But he is not dismissing the danger, either.

“We’re starting a whole new ballgame with the heterosexual population and running into the same problems that were there a few years ago with the gay community. . . . The more chances you take, the more likely you are to encounter the virus as it increases exponentially in the community. As I heard on the news the other night, ‘There’s no such things as safe sex, only safe partners.’ ”

Some health professionals, however, wonder if such “black and white” statements in the media aren’t responsible for stirring up an unfounded panic.

Calling the situation “very complex,” Dr. Thomas Prendergast, head of epidemiology for the Orange County Health Department, said that the media has blown the heterosexual danger out of proportion.

The “multiple sources” who have an interest in promoting this unrealistic view include people who “have tried to promote sexual education in the schools” as well as those who oppose sex education in the schools and see the AIDS era as an opportune time at which to promote “their very moralistic feelings that abstinence needs to be emphasized,” he said, adding that “people who have been concerned about violations of civil liberties for the gay community and for drug users,” also stand to gain.

“There’s a coalition of individuals who would be comfortable saying this is everyone’s disease. It’s not. It’s everyone’s concern, but not everyone’s disease. The risk of infection of groups that are not at risk is still exceedingly small. Not quite zero, but exceedingly small.”

How low is the risk?

“In February there was one positive” test result among heterosexuals who did not fall into any established risk group in Orange County said Penny Weismuller, Orange County AIDS coordinator. And counselors who re-interviewed that patient felt strongly that he may have concealed the truth about his level of risk, she said.

As further evidence, she explained that Orange County has tested between 1,100 and 1,200 prostitutes who also use intervenous drugs. Thirty of those have tested positive to the antibody test, she said. But of 180 men who admitted to using prostitutes and were subsequently tested, only one tested positive--”and (on the second interview) he admitted to having had anal sex with men on occasion when he didn’t have money for prostitutes.”

Weismuller believes that energy being spent testing and educating low-risk heterosexuals might better be spent where it’s needed--in the high-risk groups, where the disease is still wreaking havoc. Neither she nor Prendergast underestimate the seriousness of the disease, they said. They preach safe sex for those in high-risk groups and those with multiple partners, and say it won’t hurt even in the low-risk groups.

But, Weismuller said, “In terms of (AIDS) being a catastrophe like the bubonic plague of the Middle Ages, it’s not going to be that way . . . Our recommendations (to heterosexuals) go something like this: If you are really concerned, and are not sleeping at night because of worry, we’re here and the test is available to you. But we want people to logically look at what their risk may be.”

Not all medical professionals or policy makers share that viewpoint, however.

Wednesday, Rep. Dan Burton (R-Ind.) announced that he will propose legislation requiring every man, woman and child in the United States to undergo an annual test for the AIDS virus.

Mentioning a Harvard neurosurgeon and the president of a research corporation among his sources of information, Burton said in a telephone interview that “at the very least, 90% of the people who are infected with the AIDS virus don’t know they’re infected . . . You’ve got a forest fire that’s out of control and even the people who are spreading it don’t know it.”

Gelfand, a psychotherapist and the program manager of counseling at the Hollywood Clinic, however, is convinced that the current focus on heterosexual risk is fueling “unnecessary panic.”

“People need to know that this is not a gay disease,” she said. But the emphasis in combating AIDS needs to be in “telling people to make sure they’re practicing safe sex. Make sure you’re not exposing anyone else. Make sure no one is exposing you.”

She doesn’t see indiscriminate testing as a solution to the AIDS problem, and worries that some testing may cause more harm than good. “The two-week waiting period is very stressful. It’s not healthy for people to be putting themselves under that kind of stress.”

“Some (low risk) people are suddenly making AIDS the focus of all the problems in their lives,” she said. “It’s a way for them not to worry about other things. Five years ago, I’d have said the same thing about fear of a nuclear holocaust.

“That’s not to say there’s no real risk,” she said. “But this feels too intense to me, and maybe it doesn’t need to be.”