Leading Article: Realism about Aids

WORLD Aids Day was, in this country at least, a low-key affair. There are two reasons for this. First, the more alarmist predictions of an Aids explosion have not come to pass and the condition has not, as yet, crossed over from high-risk to low-risk groups in large numbers. There is a firebreak over which it appears hard for the disease to jump.

Second, those who conducted the initial publicity campaigns tended to blur the distinction between the technically accurate assertion: 'We are all at risk' and the inaccurate impression that we are all somehow at equal risk. They did so partly because they did not wish to be accused of stigmatising male homosexuals and partly because they felt it necessary to use shock tactics to catch the attention of the general public. The approach was misguided. People resent being manipulated or patronised. When the official message does not square with anecdotal impressions, cynicism and complacency ensue.

There is a danger of just such a mood developing in Britain. Young people reportedly show a disinclination to use condoms in spite of the growing sophistication of sex education in schools and the Aids advertising to which they are exposed in the media. Heterosexuals are inclined to joke that it is rather more likely that they will be struck by lightning than that they will become HIV-positive as a result of 'normal' sex. Among homosexuals there has been a marked shift back to unsafe sexual intercourse.

These trends can best be resisted by a greater sense of realism in the campaigns conducted by the National Aids Trust, the Health Education Authority and similar bodies. An honest and therefore effective campaign would start from statistics published by the UK Communicable Disease Surveillance Centre. During the third quarter of this year 417 new cases of Aids were reported. This is the highest quarterly total to date. (The cumulative total of reported cases of Aids now stands at 6,555, of whom 4,061 have already died. Laboratory reports of newly diagnosed cases of HIV infection have reached 18,526.)

The sombre phrase 'this is the highest quarterly total to date' is repeated quarter after quarter. It is the clearest indication that the condition is spreading, in both high-risk and low-risk groups. Even so, in Britain, Aids remains a disproportionately homosexual condition. Male homosexuals make up perhaps 10 per cent of the population, but approximately three-quarters of those who have died of Aids were infected through unsafe homosexual practices.

Campaigners should differentiate more clearly between high-risk and low-risk groups. The former should be told that they are at particular risk. The latter should be told, frankly, that the danger they run is very small indeed - but that it is real and growing. If they are unlucky enough to become infected they will surely die of the disease. Those in low-risk groups should also be warned that once Aids has established a bridgehead in the heterosexual community it can spread with devastating effect. The example of Uganda and a number of other African states is often quoted. But if the African experience seems too remote, the example of San Francisco should not be. In San Francisco - where cross-over has occurred - some 10 per cent of the city budget is spent attempting to cope with the consequences.