Defusing Fear Still Problem : HIV: Mellman says he has intensified effort to educate the sports world as to the real and imagined risks of virus.

In the month since Magic Johnson walked away from basketball, the NBA has returned to the business of glorifying its product.

Perhaps only the Lakers are feeling the impact of Johnson’s absence. The rest of the league, it seems, has moved on . . . and away from the AIDS issue.

But for Michael Mellman, Johnson’s physician, the subject did not end when the Laker guard re-retired Nov. 4 in the wake of criticism from some players.

“Something’s wrong here. It just doesn’t sit right,” Mellman said. “I guess we just didn’t do a good enough job, or we weren’t convincing enough or we got our facts messed up. It’s so hard to know what is wrong.”

Much of Mellman’s frustration is borne from the fact that Johnson played in last February’s NBA All-Star game and last summer’s Olympic Games without the controversy that came a week before this NBA season began. Once Johnson said he would play a regular season of 50 to 60 games, fears were expressed from such sources as Karl Malone of the Utah Jazz and Jerry Colangelo, owner of the Phoenix Suns.

Johnson said the pressures of being an HIV-positive athlete became too great when he was introduced to the world of AIDS discrimination.

The rejection, Mellman said, is similar to what others with HIV experience.

“I don’t think anyone thinks it was intentional,” Mellman said.

But that only makes Mellman more resolved to counter those fears. Mellman, a team physician for the Dodgers, Kings and Lakers, has handled Johnson’s HIV treatment with David Ho, director of New York University’s Aaron Diamonds AIDS Research Center.

An internist with a private practice in Inglewood, Mellman informed Johnson in late 1991 that he had the human immunodeficiency virus. The results came after Johnson was screened as part of requirements for an insurance policy.

Since then, Mellman, 41, said he and Ho intensified their efforts to educate the sports world as to the real and imagined risks of the virus.

“In spite of our attempts to educate, the message is: ‘Watch out. There will be some form of discrimination that will occur,’ ” he said.

The doctors fear the next positive athlete might not be as forthright as Johnson, who has gone so far as to detail his heterosexual experiences to quell rumors that he contracted the virus through a homosexual encounter.

“There will be a next time,” Mellman said. “We still haven’t learned our lesson. The goal is not to alienate those who disagree, but to help them gain as full an understanding as they can because this isn’t going to go away.”

Experts say there is an infinitesimal chance of an infection being transmitted during an athletic event, such as a basketball game. Those statistics did not allay fears of some players who were concerned that Johnson’s infected blood could mix with theirs in an open wound if they collided.

After examining available AIDS data, Mellman concluded that--at least, statistically--more than one athlete should have HIV by now if the virus could be easily transmitted in such manner.

“If there was ready transmission of contact on the playing field, and you look at the size of contracts people are receiving and you look at the numbers of those contracts being insured, and thus the number of HIV tests being done, just on that basis, you really would expect more,” Mellman said.

“And we still only had one positive.”

Not long after Johnson announced that he was HIV-positive and retiring on Nov. 7, 1991, a letter in the British medical journal, Lancet, was cited in the U.S. press as documentation that transmission had occurred in sports.

According to the letter, a group of Italian doctors said they had documented the first case of an HIV transmission through contact during an athletic event, a claim that many U.S. experts believe has not been proved.

Donato Torre, a physician with the Division of Infectious Disease at the Regional Hospital in Varese, Italy, wrote in Lancet that a 25-year-old man collided with a drug abuser who was HIV-positive during a soccer match in December of 1989. He wrote that the collision caused a severe wound in the eyebrows, with copious bleeding from both players.

Torre wrote that the man who became infected had tested negative for HIV a year earlier. Two months after the collision, he was tested again and found to be carrying the virus. Torre wrote that the man said he had no homosexual contact, was not an intravenous drug user, had a stable four-year relationship with one woman, had not had a blood transfusion or dental work and did not visit Africa or the Caribbean, regions where the virus is most prevalent. In other words, the infected man claimed he was not involved in high-risk behavior.

When reached by phone, Torre said the soccer match was a game between drug addicts and volunteer workers and aides at a rehabilitation center. He said he did not follow up with either patient and did not know where they were.

Torre said he believed the transmission was caused by the contact, but he did not offer proof by comparing particles of the patients’ blood to see if they matched.

“You have to get the viruses in each patient and make sure the ‘fingerprints’ are the same,” Ho, an infectious disease specialist, said earlier this year. “If they are identical or extremely close to one another, then you could say these two cases are linked by that transmission.”

The fact that the Italian doctors failed to monitor the patients was cause for skepticism, experts said.

“Any doctor would realize this is the very first case that is transmitted that way, (and that it) should be followed and evaluated,” Ho said. “It is somewhat irresponsible to let it go like that.”

Mellman said even if contact on the soccer field resulted in a transmission, it would be the only documented case in 10 years of the virus.

“If there was transmission, it should have occurred elsewhere,” Mellman said. “We should have picked it up. We’re 10 years into this thing. We’ve got a million HIV-positive people (in the United States). Even if there are others out there who are undisclosed, there must be very few.”

No matter how many studies and statistics Mellman cites, he said some are unbending because experts cannot say for certain that it will not happen.

Mellman said the only area where documentation has been closely monitored is in the health-care field, where employees are motivated to report infections because of worker’s compensation claims.

Still, the parallels are few. Medical practitioners usually handle patients who are sick and have high levels of the virus present in their blood. Experts believe transmission occurs when high levels of HIV are present.

Those competing in athletics would more than likely be healthy, and carrying low levels of the virus. Thus, chances of transmission greatly decrease.

Furthermore, physicians are prone to puncture wounds with the type of instruments they use. Those types of wounds with the amount of infected blood they handle put them into a much higher risk category than those playing against an infected athlete.

“Look at the way transmission occurs,” Mellman said. “Rarely is it a skin splash, which is what we’re talking about in sports.

“It’s time for rational thought. It’s really an invitation for people to show why this isn’t true. If my thinking is wrong, show me how it is. I’ll accept that, and I’ll retract everything I’ve said.”

Times staff writer William D. Montalbano in Rome contributed to this story.