PERSPECTIVE ON AIDS : This Flap Won’t Be ‘Marginalized’ : Shorthand accounts of a research report seem to write off people with HIV; the pain and anger won’t easily heal.

A report in early February by the prestigious National Research Council has ignited a firestorm among the nation’s top specialists in AIDS policy, damaging friendships and turning respected colleagues into intellectual adversaries.

Both sides agree that there was a failure of the communications process that filtered the complicated, 322-page report into news accounts. Typical of many news stories about the NRC report was this version from Associated Press, which appeared in many newspapers:

The council concluded that AIDS “will ‘disappear,’ not because, like smallpox, it will have been eliminated, but because those who continue to be affected by it are ‘socially invisible, beyond sight and attention of the majority population.’ ”

Headlines ranged from predicting “limited harm . . . “ to the nation from the HIV epidemic to “Little Effect on U.S.”

The members of the National Commission on AIDS, which was created by federal statute to advise Congress and the White House, were among the many people seriously disturbed by stories about the report, titled “The Social Impact of AIDS in the United States.”

A few days after its release, Dr. David E. Rogers, vice chairman of the national commission, left a meeting of more than 40 board members of the National Community AIDS Partnership in Washington both saddened and angered. NCAP includes foundation executives, blacks, Latinos, people with HIV and CEOs of major corporations.

“It was sobering to hear their concerns” about the report, Rogers wrote in an emotional letter to a colleague. “Their feelings: Those gains (of the last decade) have been tragically damaged by (the) high-minded but badly misunderstood report.

“The spin given (the) report has reinforced every miserable prejudice all of us have been trying to dispel. Thus, your many friends’ reactions vary from incredulity, to sadness, to despair,” he added.

The implication that AIDS was somehow disappearing, that only the “marginalized” (the report’s term) would be affected, even the hint that some people in our society count more than others, runs counter to the conclusions that the National Commission on AIDS has drawn from its intense analysis over the last three years.

As a communications problem in a media-intensive issue, it demonstrated the maxim that a little knowledge is a dangerous thing. Many AIDS experts saw the report unintentionally reinforcing denial of the epidemic’s scope, fanning prejudice against the infected and minimizing the need for more initiatives by government and society. It also blurred the great difference between behaviors that put one at risk of contracting HIV and membership in a racial, ethnic or socioeconomic group, which is no risk at all.

At Harvard University, Dr. Jonathan Mann estimated recently that 100 million people worldwide might be infected with HIV by the year 2000. The World Health Organization has issued an admittedly conservative estimate of 40 million. While U.S. projections are not as dramatic, the epidemic here is broadening, with heterosexuals the fastest-growing category of transmission.

That is hardly a “disappearing” epidemic or a “marginalized” impact. It echoes the national commission’s findings that AIDS is the defining health crisis of our times, that our basic institutions must change in profound ways if we are to withstand the virus, and that the risk of transmission, while varying among behavior groups, is widespread.

National Research Council officials, stung by the criticism from fellow researchers, public health and health policy experts, moved to limit the damage.

“I directed the study,” wrote Jeff Stryker of the NRC. “As a gay man working in San Francisco, I’m no stranger to the tragedy of AIDS. This reading of our message couldn’t be further off the mark. . . . The report repeatedly notes how AIDS has become another facet of a ‘synergy of plagues’ in which ‘poverty, poor health and lack of health care, inadequate education, joblessness, hopelessness and social disintegration converge to ravage personal and social life.’

“AIDS risks being tossed on the dust bin of seemingly intractable social problems. This is what the committee fears, not advocates,” Stryker said.

Is the report evidence of a chasm dividing the nation’s AIDS experts, or semantic differences exaggerated by the foreshortening of the news process?

The report, painful as its conclusions are about suffering and indifference, describes what is, not what should be. It is long on describing how many of our institutions have absorbed the impact of HIV with relative ease, but very short on commentary and recommendations. Some have interpreted this to imply that the status quo is acceptable; that the tens of millions of infections descending on humankind are business as usual.

The report needed to end with a moral exclamation point. The dispassion of its analysis left room for misinterpretation, or at least understatement of the massive demands that we must make on our society and its institutions because of the lives that will otherwise be claimed by this epidemic. The national discourse about AIDS cannot have language that allows room for denial. We must be absolutely clear about the moral imperatives, about the risks to each of us, about the responsibilities to one another.

Those who think that the world will never be the same as the result of the AIDS pandemic will wish that the National Research Council had used a different vocabulary.