Heterosexual AIDS Warning Issued : Americans Becoming Complacent, Head of Federal Panel Says

The chairman of the presidential commission on AIDS warned Monday that Americans may be becoming too complacent about the threat the deadly disease poses to the heterosexual population because public health officials have played down the dangers and because the number of cases is currently so low.

“Our problem is that we are a nation that tends to look at statistics,” Adm. James D. Watkins, chairman of the panel, said Monday. “We say that, on the basis of today’s photograph, tomorrow will be OK. But the statistics could be very misleading. Over the next 10 years, we may find that the heterosexual aspect of this disease is very serious.”

Low Heterosexual Rate

Currently, 1,920, or 4%, of the 48,574 AIDS cases in the nation were acquired through heterosexual transmission, according to the federal Centers for Disease Control, and public health officials have said repeatedly that AIDS does not appear to be “exploding” into the heterosexual population. In this country, AIDS has primarily afflicted homosexual and bisexual men and intravenous drug users and their sexual partners.

The admiral made his remarks during an interview with The Times, one of his first with a news organization since becoming chairman of the White House commission in October. The former chief of naval operations said that he has had no trouble making a distinction between the position the military has long taken against homosexuality and the public health issues he must confront as head of the panel.

“I can separate the two in my own mind with no difficulty at all,” he said. “On the outside, it is a different environment. In the military, the adverse effect on readiness would be quite severe. It’s a different world. A confined world. I don’t see the two positions as incompatible.”

Aware of Sensitive Issues

Nevertheless, Watkins appears to be well aware of the extreme sensitivity involved in all the issues he and his panel must confront. “There are some political concerns if you overplay the heterosexual issue,” he said, without elaborating.

The numbers, he said, “shouldn’t give us any encouragement that heterosexual (spread) is a non-issue--that we have confined this to certain communities and no one else. Heterosexual (spread) is not a non-issue.”

“Now is the time to get way ahead in prevention through education,” he added. “Supposing you overplay prevention and education? What’s the harm?”

Watkins called intravenous drug abuse the “key long-term dilemma” in dealing with the transmission of the disease among heterosexuals, as well as the increasing problem of AIDS in children. Further, he said, related issues such as poverty, “a (general) sense of hopelessness,” illiteracy, inadequate health care and teen-age pregnancy will have to be dealt with as well.

Serious Social Dilemma

“I’m beginning to think more and more that the whole issue of drug abuse is going to emerge as the long-term specter hanging over us,” he added. “It is the most serious of all our social dilemmas.”

Education programs initiated by the gay community have resulted in a “marked decline” in the incidence of AIDS infection in homosexual men, he said, proving that education has been effective as a public health tool. But, he added, educating the drug-abusing population is more complicated.

“I think that problem is the real challenge that faces us,” he said. “It is the heart of the most difficult and vexing of educational preventive programs we’re going to have to come up with. It doesn’t lend itself to the intellectual approach, to the simple publication of documents (and the assumption) that people will read them. It’s going to be a tough nut to crack.”

On the controversial issue of testing for AIDS infection, Watkins said that he opposes mandatory testing of all Americans and prefers the voluntary approach.

“I believe we’re seeing a more mature response evolve in the country regarding testing,” he said. “I think people are beginning to find the right balance between the public health and the (issues of) confidentiality and discrimination.”

Stronger Laws Urged

Public health officials and others have called for stronger laws to protect against stigmatization and the abuse of test result information. The Reagan Administration opposes the enactment of federal legislation, saying that such laws are the province of the states.

“I think sometimes the quick passage of a law can be a cop-out,” Watkins said. “It isn’t that easy.”

He said, however, that the AIDS panel will not ignore the discrimination issue. “We hear it from the grass roots,” he said. “I have yet to talk to a person with AIDS who doesn’t tell me a lengthy story of discrimination.”

Watkins said that the commission intends “to issue some very strong statements” to reassure Americans with clear facts about AIDS, saying that incidents such as the burning of the Florida home of three children infected with the AIDS virus are “appalling to all of us on the commission.”

Credibility and Impact

“What good will it do? I don’t know if it will help,” he said. “If the commission has credibility, it will have an impact. If we come off half-cocked with some moral statements, it will have no impact. Our charter doesn’t call for a new menu of moral values from the commission.”

He added: “If we can come up with something for the President and the American people that gives people hope, and calms otherwise stormy waters, we will have an impact--so that people can say: ‘There’s hope.’ Clearly, we don’t want to give up hope.”