Even as the number of AIDS cases approaches 100,000 nationwide, concern about the disease among the general public has peaked and is now declining, The Times Poll has found.
The drop in anxiety about AIDS, which has killed almost 60,000 Americans since 1981, is due largely to lower concern among whites and people over age 40 that they personally will be affected by the epidemic, the poll found.
As a result, the percentage of Americans reporting that they have made substantial changes in their life style because of AIDS has dropped, and more Americans now voice support for forceful measures to identify those infected with the human immunodeficiency virus (HIV)--even at the expense of civil rights.
"There is a solid indication that concern about AIDS has peaked among the general public," said Times Poll director I. A. Lewis. "There is a more hard-nosed attitude about AIDS as a public health problem than we have seen before. Concern about protecting the civil liberties of infected individuals seems to have fallen by the wayside."
Despite the drop in general concern, worry about AIDS remains high among blacks and Latinos and younger Americans--groups often identified by health officials as being at increased risk of contracting HIV. One in five adults ages 18 to 39, as well as about one-third of blacks and Latinos, say they have made "almost total" or "large" life style changes because of AIDS, the poll found.
The poll's findings reflect the changing nature of the AIDS epidemic, which first struck mostly homosexual men but since has spread disproportionately to blacks and Latinos through unsafe sexual practices and intravenous drug use. The virus is transmitted through unprotected sexual intercourse, through the sharing of AIDS-tainted needles and from mother to child in the womb.
AIDS education efforts generally urge people not to have sex with infected individuals, to use condoms during sex and to limit the number of their sexual partners to lower the risk of contracting the disease.
Dr. Gary R. Noble, director of AIDS programs at the Centers for Disease Control in Atlanta, said the poll results contained "good news and bad news."
He said he was encouraged by the high levels of concern voiced by blacks and Latinos because of "the disproportionate impact of AIDS on minority populations." But he said he was discouraged by the decline in the number of individuals who reported AIDS-related life style changes.
There may be "an element of boredom or apathy or feeling that it is not me at risk," Noble said. "It makes me concerned that people may be returning to risky behavior."
The Times Poll, a nationwide telephone survey of 3,583 Americans ages 18 and older, was conducted July 8 to 13. It repeated a number of questions asked in Times polls about AIDS in December, 1985, and July, 1987.
The sampling error of the latest poll was plus or minus 2 percentage points. This means that the results could vary by two percentage points in either direction if every adult in the country had been interviewed in the same way.
Although Americans remain worried about AIDS, the intensity of that concern has slackened appreciably, the latest poll found.
Cancer remains the disease Americans are "most afraid of getting," followed by AIDS and heart disease. But since the last poll in 1987, the percentage of respondents ranking AIDS as the most feared disease has dropped 11 points (to 19%) and cancer has risen 3 (to 43%).
Moreover, the percentage of Americans who said they were "concerned" about AIDS as "a problem for your own personal health" declined to 37% after peaking at 46% in 1987. In 1985, the figure was 42%.
A far different pattern was seen among blacks, Latinos and younger adults. Of those interviewed in the current survey, 70% of blacks, 60% of Latinos and 46% of younger adults said they were concerned about AIDS as a personal health problem.
AIDS was ranked ahead of cancer as the most feared disease by 48% of Latinos and 42% of blacks. It was ranked as the most feared disease by 30% of adults ages 18 to 39.
As concern about AIDS has diminished, so has the percentage of Americans reporting that AIDS has caused a significant change in their life style--falling from 18% in 1987 to 13% in the current poll. The percentage for those 40 and older peaked in 1987 at 15% and in the latest survey fell to 7%--roughly the same as in 1985.
As of June 30, the CDC reported 99,936 AIDS cases nationwide. That figure is six times the number of AIDS cases when the survey was conducted in 1985 and about three times what it was in 1987. According to the CDC, 58,014 Americans have died of AIDS.
The latest Times Poll found increased support for mandatory HIV testing of high-risk individuals, such as homosexual men and intravenous drug users--but declining support for additional federal spending to combat the disease.
Nearly four-fifths said public health officials should trace the sexual partners of people who have tested positive for HIV infection.
Nearly three-fifths of those interviewed favor mandatory testing of high-risk individuals--a highly charged issue of ethics and personal rights. When the same question was asked two years ago, Americans were sharply divided, with a nearly even percentage favoring mandatory and voluntary testing.
Most public health officials continue to favor voluntary AIDS testing because of fears that mandatory testing might lead to discrimination and breaches of confidentiality. But in recent months federal health officials have strongly encouraged at-risk individuals to be tested so that they can take steps to protect their sexual partners and benefit from medical advances against HIV infection.
There is also increasing support in the medical community for contact tracing measures of sexual partners similar to those already widely used for other sexually transmitted illnesses. The percentage of Americans supporting such tracing rose seven points to 77% since the 1987 poll.
The CDC's Noble said he was "bothered" by the public's increased support for mandatory testing because it may "represent a we/they mentality. . . . That bothers me, because clearly this is a problem for all our society."
Americans appear less resistant to sacrificing civil liberties to battle the disease. When asked in 1987 whether "some civil liberties must be suspended in the war on AIDS," 42% said yes, 38% said no and 20% were not sure. In the current poll, the percentage favoring a crackdown remained unchanged, but the percentage who said they were opposed decreased by 12 points. The percentage of those who were unsure rose by 10 points.
When given a list of important problems facing the country and asked which deserved more federal spending, AIDS came in third at 24%, behind drug abuse (33%) and the homeless (30%). It was ahead of overall health (20%), crime (16%), the environment (15%) and cancer (14%).
At the time of the 1987 poll, when federal AIDS spending totaled about $900 million a year, 46% of Americans favored spending more money to combat the disease. But this month, with federal AIDS spending at about $2.2 billion a year, only 25% favored greater expenditures. Forty-seven percent say the current level is the "right amount" and 12% advocate less spending.
Americans were also asked if research on AIDS is "taking money away from other important medical research--such as cancer and heart disease?" Of those interviewed, 39% said yes, 48% said no and 13% were not sure.
VIEWS ON AIDS These are results from a Los Angeles Times Poll of 3,583 residents nationwide between July 8 and July 13, as compared to the results of prior Times Polls on AIDS.
DEC.1985 JULY 1987 JULY 1989 AIDS deaths 8,002 22,548 58,014 Annual federal $207 million $899 million $2.2 billion AIDS spending
What disease are you most afraid of getting? In percent: Cancer Dec.1985: 56 July.1987: 40 July 1989: 43 AIDS Dec.1985: 12 July.1987: 30 July 1989: 19 Heart disease Dec.1985: 11 July.1987: 8 July 1989: 14 How much money do you think the federal government should spend on AIDS? In percent: Spending right amount Dec.1985: 47 July.1987: 40 July 1989: 47 Spend more Dec.1985: 32 July.1987: 46 July 1989: 25 Spend less Dec.1985: 12 July.1987: 7 July 1989: 12 How concerned are you about AIDS as a problem for your own personal health?
DEC.1985 JULY 1987 JULY 1989 Concerned 42% 46% 37% Not concerned 57% 53% 63%
How much of an effect would you say AIDS has had in your life style?
DEC. 1985 JULY 1987 JULY 1989 Total change or large impact 6% 18% 13% Small impact or no change 93% 81% 86%
SOURCE: Los Angeles Times Poll