The Big City: In 80's, Fear Spread Faster Than AIDS

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In July of 1988, at the height of the AIDS epidemic, the estimated number of cases in New York City suddenly plummeted. The city health commissioner soon needed police protection.

Until that July, the city had estimated that 400,000 New Yorkers carried the AIDS virus. Then the commissioner, Dr. Stephen C. Joseph, reviewed the evidence and reduced the estimate to 200,000. He was promptly denounced by leaders of AIDS organizations and gay-rights groups, who accused him of lying to minimize the crisis.

Members of Act Up were arrested once for staging a sit-in at the Health Department, and again for occupying Dr. Joseph's office. Hecklers trailed him at public appearances, chanting, "Resign! Resign!" His home was picketed and spray-painted. There were death threats.

Now it turns out that Dr. Joseph's estimate was actually too high. It might have been twice the actual figure, according to a new report from the American Council on Science and Health, a science advocacy group. The total number of AIDS cases diagnosed in New York City from 1981 through early 2000 was less than 120,000, the A.C.S.H. report notes.

That toll still makes AIDS a horrific tragedy, of course, but the disease never caused the widespread plague prophesied by so many activists, journalists and researchers. In their zeal for attention and money, they didn't let facts interfere with fearmongering, and not many public officials had Dr. Joseph's courage to stand up to them.

The campaign began on the cover of Life magazine in 1985: "Now No One Is Safe From AIDS." Federal officials said that AIDS could be worse than the black plague, and they conducted national television, radio and direct-mail campaigns aimed at heterosexuals. The officials wildly overestimated the number of AIDS cases, although they were more conservative than Oprah Winfrey, who warned that a fifth of heterosexuals could be dead by 1990.

Masters and Johnson warned that AIDS could lurk on toilet seats. A sex therapist, Helen Singer Kaplan, wrote a book, "The Real Truth About Women and AIDS," warning that condoms weren't enough and that even kissing was a risk. Magic Johnson's illness in 1991 was presented as the proof that H.I.V., the virus that causes AIDS, was finally breaking out into the heterosexual population.

BUT by then there was abundant evidence that the heterosexual breakout was not going to happen in America. The evidence had appeared long before that in New York, thanks in large part to the efforts of city workers like Anastasia Lekatsas. I once called her America's most dogged street detective of AIDS, and no one disputed that label.

During the mid-1980's she investigated the Health Department's N.I.R. cases "no identified risk." If a man claimed to have gotten AIDS from a woman, she would visit him, revisit him, interview his family and friends and eventually she would almost always find that he'd been sharing needles or having sex with men.

While other cities were credulously reporting that the epidemic was spreading beyond gay men and drug users, in New York the heterosexual breakout did not show up in statistics. Among the first 15,000 cases in New York, there were only eight men listed as having gotten the virus through heterosexual sex, and even that number was probably too high. "I have doubts about seven of them," Ms. Lekatsas said, "but we couldn't prove anything."

That evidence made it into some publications, notably Discover magazine, which in 1985 debunked the heterosexual breakout with a cover declaring that AIDS would likely remain "largely the fatal price one can pay for anal intercourse." A journalist, Michael Fumento, gathered the evidence in a 1990 book, "The Myth of Heterosexual AIDS," which many bookstores and distributors refused to sell because of opposition from gay activists.

Today, surveys show that American heterosexuals still have unrealistic fears of AIDS, and the crisismongering goes on. It's often justified as the only way to focus attention on the disease. But the constituency for AIDS is so well organized that the disease is guaranteed to remain a high public priority. It already gets more attention than other diseases that kill more people.

"AIDS was a genuine crisis in the 1980's, but today it's no more a crisis than any other chronic disease suffered by New Yorkers," said Dr. Elizabeth M. Whelan, the president of A.C.S.H. "We need to put AIDS in context and give it the proportionate share of resources. It shouldn't be getting more than its share because we've been brainwashed into thinking the numbers are greater than they are."