AIDS: Cool Reception

The federal Centers for Disease Control, seeking to accelerate AIDS-prevention programs, especially in minority populations, came to town with an innovative new program the other day, but the response raised danger signs for Los Angeles. A small number of agencies accepted invitations to a day-long briefing, and many of those that did attend demonstrated extremely limited knowledge of the pandemic.

This is a serious, critically serious, matter. The greatest risk of the rapid spread of the human immunodeficiency virus, which causes AIDS, is among intravenous drug users and in the black and Latino communities. But it is in those populations that public-health officials are finding the greatest resistance to the kind of behavior modification that can slow the spread of the disease. Los Angeles, unlike New York and New Jersey, has until now been spared an uncontrolled spread of the disease--a situation that will not last, according to epidemiologists, but a circumstance that offers a rare opportunity for preventive action.

Under the new program, the CDC is offering this year $9.7 million in grants of $20,000 to $225,000 directly to minority and other community-based organizations to sponsor HIV-prevention projects, with most of the money reserved for projects focused on minority groups. That is appropriate, for both blacks and Latinos have been hit by the disease out of proportion to their populations. Furthermore, both communities are showing the most rapid growth of the disease among women, children and heterosexuals. The largest infected group in the nation is still made up of white male homosexuals, but the infection rate in that group, at least in urban areas, has leveled off as a result of the widespread adoption of safer sex practices. The CDC has five teams traveling to major metropolitan centers of infection to inform community groups of the new program and encourage them to apply for federal grants. A team came to downtown Los Angeles, rented a ballroom at the Biltmore Hotel with places for as many as 1,000, but fewer than 100 came.

“I’m sorry to see so few of you here,” Dr. Peter Kerndt, epidemiologist in the county AIDS program office, commented. The reason for disappointment was evident in the stark figures that state and county officials shared with the audience.

Programs to help? “There aren’t enough of them,” Robert E. Frangenberg, head of the county AIDS program office, acknowledged. “Additional programs are needed desperately,” according to Irma Strantz, head of the county drug-abuse program office. Addicts still must wait for months to enter residential treatment programs, crucial to slowing the spread of the disease among intravenous drug users. Education? The level of knowledge about the disease remains low among Latinos, according to Marilyn Schuyler, with no correlation between education and behavior change. Particularly among blacks, even with a level of knowledge about AIDS of the highest order, high-risk behavior continues unabated.

“In contrast to the East Coast, we have a tremendous opportunity,” Kerndt emphasized.”It is not a question of if the disease will spread into the black and Hispanic minorities, but when .”

Perhaps the CDC challenge will evoke a strong response and imaginative, innovative programs from those who did take time for the briefing. If not, the consequences for Los Angeles couldbe bleak. There will be stiff competition for the grants. No alternative funds are now in sight.