The Political Uses of an Epidemic

August 08, 1988  ·  Michael Fumento  ·  The New Republic  ·  Aids

In the tragedy of AIDS, some conservatives believe they have found a shiny weapon with which to restore traditional sexual morality. They wish to recapture their vision of a better world — one where homosexuality is pushed back into the closet (or further), where chastity, monogamy, and sexual morality are revered, and where sexual behavior is once again within the domain of law.

But in order to do so, they have been forced to distort the true nature of the epidemic. They will find, however, that the epidemic will not change to fit their wishes. Whatever short-term gains they make through disinformation will eventually disappear and leave their causes worse off than before. They have already victimized the sufferers of the disease. Another victim may be American conservatism itself.

At the root of conservative confusion over AIDS policy is confusion over the AIDS virus itself. There are essentially three theories of transmissibility.

  • Theory One assumes that in addition to being blood-borne, the contagion can be transmitted casually, that it can be passed through mere close proximity as well as sexual intercourse.
  • Theory Two assumes that HIV (the AIDS virus) is transmitted efficiently through both homosexual and heterosexual sex.
  • Theory Three is that because HIV is blood-borne, it will continue to plague those who exchange fluids through anal sex and needles, but will pose far less of a threat to the general heterosexual population.

As a matter of logic, all three of these theories can’t be right. Either AIDS is a "gay plague" or it’s not. Either it is just a fluke that AIDS emerged in the gay community first or it is confined primarily to homosexuals (and drug users) by its very nature. Similarly, either AIDS is casually transmitted and hence no more a behavioral contagion than tuberculosis or influenza, or it’s not. Yet conservatives frequently combine all three models depending on their state of confusion — and depending on their agenda.

Theory three is correct. Ten years after the first heterosexual AIDS cases began showing up in New York City, AIDS remains confined almost exclusively to homosexuals, intravenous (i.v.) drug abusers, recipients of blood products prior to 1986, and their steady sexual partners.

Only about two percent of all diagnosed AIDS cases in this country have been attributed to heterosexual transmission in native-born Americans, a figure that has held steady for several years now. In New York City only eight males have been identified as having gotten AIDS from heterosexual sex.

If other health departments interviewed patients as carefully as New York and could thus screen out those who claim sex with women as their only risk when in fact they’ve had sex with men or shared needles, it’s quite possible that they’d find fewer than a score of such heterosexual men in the country. Blood tests for HIV infection among military applicants, blood donors, and hospital patients also indicate that the problem remains tightly confined to a few groups.

Gary Bauer

Most conservative leaders and writers have remained impervious to these facts. While writers such as George Will and Norman Podhoretz have insisted on Theory Three (the correct one), Theory Two (easy heterosexual transmission) holds sway with the Reagan administration. Secretary of Education William Bennett and White House Director of Policy Development Gary Bauer have thrown in their lot with Theory Two, as to some extent has President Reagan, who has declared that "AIDS is surreptitiously spreading throughout our population."

The president is advised in these matters by Bauer and assistant for domestic policy Kenneth Cribb. These conservatives, advised often by the kookiest of scientists, have used the theory to push programs from mandatory premarital testing to chastity-based sex education in schools, all to combat a virus that, according to the theory, spreads about as efficiently as syphilis.

In fact, syphilis is so infectious that you can get it on the back of your hand. The infection rate of this microbe during coitus is about 20 percent to 50 percent, depending on which sex it is being transmitted to (sexually transmitted diseases are transmitted more easily from male to female).

HIV has an infection rate estimated by Centers for Disease Control epidemiologist Dr. Thomas Peterman at less than 0.1 percent going from male to female and less than 0.05 percent going from female to male. Thus, for males syphilis appears to be 400 times more infectious than AIDS; for females 500 times. Yet syphilis is the Reagan administration’s favored analogy.

Republican presidential candidates Jack Kemp, Pierre du Pont, Alexander Haig, and Pat Robertson all supported mandatory premarital testing, on the syphilis prevention model. Two states have complied, and many others have such legislation pending. Senator Jesse Helms and Representative William Dannemeyer, both normally fierce champions of federalism, have introduced legislation to penalize states that refuse to mandate premarital testing. (Dannemeyer has deluged Congress with AIDS legislation, all of which remains bottled up in committee.)

We now have some evidence of how such strategies work. Couples preparing for marriage, by virtue of that fact, are in an extremely low-risk group for HIV infection. Some may be drug abusers or bisexuals, but few will be homosexuals.

Thus in Illinois, by the end of May, of an estimated 60,000 tested marriage applicants, only six were HIV-positive. The price of these tests vary, but they average over $100 for each individual. Thus it costs an average of more than $1 million per AIDS case detected. Testing clinics are doing handsomely, but it’s hard to see what benefit accrues to the people of Illinois.

Detecting cases doesn’t necessarily prevent even one case of AIDS. Testing premaritals simply because they have to get a licence is like the drunk who looked for his lost keys under the street lamp because the light was better there.

The Education Department, under Bennett, distributes AIDS information materials to government and private institutions; included is a thick package detailing the syphilis control measures instituted under President Franklin D. Roosevelt. The department urges that similar measures be taken against AIDS. Bennett, the administration member most active in promoting monogamy and abstinence as a method of preventing AIDS, has also predictably taken the lead in criticizing the use of condoms. He publicized the term "condomania."

Disguising moral indignation behind the shield of practicality, Bennett has tried to impeach the value of condoms in preventing AIDS. Studies have been dragged out demonstrating condom usage failure rates. Most frequently cited are the Planned Parenthood survey showing a ten percent failure rate for condoms as contraceptives and a University of Miami study showing a 17 percent failure rate in preventing transmission of the virus in partners of men infected with HIV.

A booklet circulated by Education Department staffers warns in all capitals: "DON’T ENGAGE IN INTIMATE CONTACT AT ALL. IF YOU HAVE HAD THAT KIND OF CONTACT IN THE PAST, STOP NOW. THAT IS THE ONLY ’SAFE SEX.’ IF YOU ENGAGE IN CLOSE SEXUAL CONDUCT, YOU ARE PLAYING RUSSIAN ROULETTE WITH YOUR LIFE." The book also declares: "The Black Plague was a disease that during the 14th century killed one-third or more of the people who live in Europe.... Unlike AIDS the plague killed only one out of every four people who caught it."

Apart from the fatuousness of comparing an insect-borne disease with a blood-borne one, the mathematics are impossible.

Bennett and his allies replace "safe sex" with the phrase "safer sex," because, after all, one can never be 100 percent sure that one’s partner is uninfected, nor 100 percent sure that a condom will be an effective barrier. Bennett et al. favor the term "Russian roulette." The only truly safe behavior is described as chastity until marriage, and then monogamy. One difficulty is immediately apparent.

Urging homosexuals to remain chaste until marriage is obviously problematic. Because heterosexual transmission of AIDS is so rare, emphasizing chastity and monogamy as AIDS preventatives is clearly misfocused.

Even for that two percent who get AIDS heterosexually, Bennett’s advice is problematic.

First, since most of these two percent are female partners of drug users and probably tend to share the addict’s penchant for instant gratification, the chastity message is unlikely to affect them.

Second, strange as it may seem in light of the campaign against promiscuity, the overwhelming number of heterosexually transmitted AIDS cases occur not in people engaging in "casual sex" but as a result of monogamous or near-monogamous relationships with i.v. drug users or, much less commonly, with bisexuals. This is because in a population with a low percentage of infected individuals and where transmission is highly difficult, only a regular relationship can expose one frequently to infection.

It follows that the same arguments conservative moralists use against condoms also apply to monogamy. There is no such thing as "safe" monogamy, because there is no way to know for certain that one’s partner is neither cheating nor shooting up. Studies done in recent decades estimate extramarital infidelity rates upward from 21 percent for females and 26 percent for males. Those who tell us not to place our faith in "one thin sheet of latex" might better trust latex than a spouse.

Monogamy may be no more effective than condoms in preventing AIDS among heterosexuals. Both have their place, and that place is limited. Jack Kemp pointed out in an address that there’s no need, moral concerns aside, for condom education for third-graders.

But there’s also no need, moral concerns aside, for impressing upon third-graders the importance of chastity, at least in order to prevent AIDS, for the same reason: AIDS is not being transmitted between third-graders. When engaged in properly, both condom usage and monogamy can reduce what is for most heterosexuals virtually no risk to absolutely no risk.

The director of a company that produces chastity-urging videos for schools (which don’t even mention homosexuality but do warn against the terrors of deep kissing) is undaunted by the astronomical odds against acquiring HIV through intercourse with other drug-free heterosexuals. "If there is one chance in ten million that a kid will catch AIDS, he shouldn’t take it."

Of course, to avoid such odds with everything that could kill us would end life as we know it. This year, more than one in 5,000 Americans will die in automobile accidents, or about 2,000 in ten million. About 500 in ten million will die in accidental falls, while over 200 in ten million will die from accidental drowning. Are we thus to conclude that there is no such thing as "safe driving" or "safe walking" or "safe swimming," or even "safer driving" or "safer walking" or "safer swimming"?

What the video producer is saying is that, to him, extramarital sex has zero utility. Unfortunately, he doesn’t have the honesty to come out and say so. It is dishonesty that underlies the entire moralistic scheme to exaggerate the heterosexual AIDS problem.

Frustrated with the failure of the message "Sex will cost you your soul," the moralists have cynically replaced it with "Sex will cost you your life." Moral suasion is replaced by mortal terror.

One prominent conservative columnist, while acknowledging the low risk of AIDS to heterosexual, nevertheless confided to me that he saw nothing wrong with the "chastity or death" message. He saw the end as being so important as to justify a "whatever works" approach. Yet such an approach is fraught with danger.

At some point, sexually active heterosexuals are going to wake up and find they’re still alive. Their chaste-out-of-fear brethren will see the same. What then? If the moral position is abandoned for a pragmatic one, how can the moral one be reclaimed once the reason for pragmatism is gone?

Conservatives have to a great extent ignored the i.v.-drug aspect of AIDS, presumably because i.v.-drug use has nothing to do with syphilis or chastity. Given the overemphasis on heterosexual AIDS cases, this is rather amazing. Almost 60 percent of i.v.-drug abusers with AIDS are exclusively heterosexual.

Even in heterosexuals who acquired the disease through intercourse rather than through needle-sharing, drug use is the overwhelming cause. About 85 percent of heterosexually transmitted cases occur in the partners of i.v.-drug abusers. Virtually 100 percent of males infected through heterosexual intercourse were the partners of i.v.-drug abusers. Yet no conservative member of Congress has introduced legislation dealing directly with the AIDS/i.v.-drug connection, and none has on to bill introduced by Representative Charles Rangel that does deal with it.

Mention of the AIDS/i.v.-drug abuse connection is almost absent from the speeches of Bennett and Bauer. Bennett’s booklet, "AIDS and the Education of Our Children," was put out last October. Almost two million copies have been printed. In this booklet, 15 sentences concern drugs only, 13 concern both sex and drugs, three sentences concern exclusively homosexual intercourse, and two exclusively heterosexual intercourse.

By contrast, a whopping 79 sentences make reference to sex in general, without mentioning drugs and without differentiating between homosexual and heterosexual sex. (Of these, 18 are devoted to disparaging condom usage.) Nowhere is anal sex mentioned. What can be said of a man who complains bitterly that the surgeon general’s report was incomplete because it did not mention condom failure when his report fails to mention that over 95 percent of sexually transmitted AIDS cases occur from anal sex?

Nowhere is the reader told that AIDS is virtually nonexistent in heterosexual men whose partners do not inject drugs. The silence is all the more amazing given the Reagan adminstration’s usual habit of using any evidence to inveigh against the "epidemic" of drug use in the United States.

According to Chicago Tribune reporter John Crewdson, at an October meeting at which White House officials and officials from CDC were present, Bennett confronted CDC Director James Mason. Bennett said, "You mean this thing is not exploding into the heterosexual community?" Dr. Mason replied, "No, it’s not." Whereupon Bennett said, "Well, why have you been telling everybody that it is?"

Why indeed? But why did Bennett then proceed with the mailing of his booklet, with a reprinting several months later?

As unfounded as the syphilis theory is, the casual contact theory is nothing short of bizarre. And unlike the syphilis theory, it appears to be almost the sole domain of the right.

Because responsible public officials and reporters will not credit the casual contagion model, its proponents are prone to conspiracy theories. The guru of the casual contagion theory is John Seale. Although he is a medical doctor, he gains most respectability from being a member of Britain’s Parliament. He has testified before a committee of the California General Assembly at the behest of conservative Republican legislators, and also at the behest of New York Governor Mario Cuomo.

Seale submitted a report to the House of Commons in May 1987, in which he admitted — indeed, trumpeted — that the material therein was completely in conflict with the reports in British and American medical journals. Among Seale’s claims was that "male homosexual contact of the finger, penis, or tongue with the rectal wall of another man transmits the virus very easily....Moderately efficient means of transmission include mouth-to-mouth and genital contact and oral salivary contact between small children."

Such a kook would be only amusing if he weren’t taken so seriously on the mainstream American right. His influence extends beyond fringe publications such as Reed Irvine’s "Accuracy in Media" newsletter and the Washington Inquirer, which have made much play of Seale.

Wayne Lutton, writing a scathing critique of "The Surgeon General’s Report on AIDS" in National Review, quoted Seale as saying that "the genetic information contained in AIDS’ tiny strip of RNA has all that is needed to render the human race extinct within 50 years." He mentioned none of Seale’s quirks. Lutton reprinted Seale’s California testimony in a book he co-authored on AIDS, again without disclaimer.

Last December presidential candidate Pat Robertson, in an interview with New Hampshire’s Concord Monitor, declared that "if say, we’re in a room with 25 people with AIDS and they’re breathing various things into the atmosphere, the chance of somebody catching it has become quite strong." Robertson’s source, according to a spokesman, was Dr. John Seale.

Other conservatives, such as nationally syndicated columnist Gregory Fossedal, don’t even feel the need to cite a physician or theorist like Seale to push the casual transmission line.

Fossedal wrote in one column: Polls show that a majority of Americans think they are being lied to about the disease, and they’re right, as the provocative book The AIDS Cover-up? suggests. They can tell that doctors are telling the truth but not the whole truth when they say there’s no evidence AIDS can be spread through casual contact. (There’s nothing proving it can’t, and common sense suggests erring on caution’s side.)

Fossedal merely states the logical proposition that one can’t prove a negative. That AIDS is not casually transmitted is demonstrated in the same way as so many other negatives we accept are, by lack of evidence on the other side. AIDS has been recognized as an epidemic for seven years now. During that time there has yet to be identified a single case of casual transmission.

The book cited by Fossedal, The AIDS Cover-up?, was written by Gene Antonio, a heretofore unknown former minister, and published by the Catholic Ignatius Press. It has become a cult classic, with over 200,000 copies sold. It makes no bones about its purpose being to terrify, and it succeeds.

"I got a copy of it from my dentist," related a friend of mine. After which she, a virgin until her marriage a year earlier, promptly got an HIV test. The AIDS Cover-up? has been offered as a selection of the Conservative Book Club, a popular book-of-the-month organization for conservatives. Copies of the text are displayed prominently on conservatives’ bookshelves and desks throughout Washington.

If you are a conservative journalist who writes about AIDS, like me, you are constantly plagued with the question: "Have you read Gene Antonio’s book?" Antonio has written updates that are circulated by the Department of Education. He has spoken at meetings of Phyllis Schlafly’s Eagle Forum. His agenda is also stridently anti-homosexual, portraying gay people as agents of human destruction.

The AIDS Cover-up? cites Seale 13 times. But Antonio is fully capable of apocalyptics himself. He uses the average doubling time of AIDS cases (12 months at that time, now thought to be at least 15) and extrapolates that as many as eight million Americans would be infected by the end of 1987 and 64 million by the end of 1990.

Antonio appears ignorant of the standard epidemiological curve, which indicates that as a new infection spreads, it curve, which indicates that as a new infection spreads, it slows down as the most vulnerable potential victims are struck and only harder targets are left. Eventually the rate peaks, drops, and levels off, as with syphilis or gonorrhea, or drops almost to a point of nonexistence, as with bubonic plague and influenza epidemics. (In the most AIDS-afflicted city in the United States, New York, the rate of new cases among homosexuals has already leveled off.)

Antonio has also peddled an absurd comparison between AIDS and a completely unrelated lentivirus in sheep that can be transmitted through coughing.

One source quoted in The AIDS Cover-Up? probably the most egregious AIDS scare article printed in the mainstream conservative press. The March 1986 American Spectator featured an article claiming that 30 percent of all men patronize prostitues, that cow’s milk could transmit the virus (even were this true, the heat of pasteurization would kill HIV), and that AIDS can be transmitted by coughing. After summarizing the various categories of persons at risk, the article concludes ominously, "Who will be left?" To which the apparent answer is "nobody."

Later, the Spectator ran an article by a former special adviser to Margaret Thatcher calling for compulsory universal testing with isolation for the infected. A half year later, though, when the authors proposed a follow-up, the magazine was more wary. "I was beginning to notice no one was dying," managing editor Wladyslaw Pleszczynski told me.

The Wall Street Journal, with the most prestigious conservative op-ed page in the country, has run two pieces advocating the heterosexual AIDS breakout theme. One was an anti-prostitution article in which the author, asserting that prostitution was no longer "victimless," claimed without citing any source that "between 1,000 and 10,000 men will become infected with the AIDS virus this year by having sex with female prostitutes."

A year later in New York City, which has more heterosexual AIDS cases and probably more prostitutes than any city in the country, a total of eight men have been identified as having acquired AIDS sexually from women, prostitutes or otherwise. Another Journal op-ed was written by Katie Leishman, pushing the theory that AIDS is really syphilis.

In an editorial just last year, the Journal also stated, "An African-style epidemic is certainly possible, especially with a mutation of the virus." (In fact, no virus known has ever mutated so greatly as to change its mode of transmission.) The Journal’s op-ed page has yet to publish a piece of challenging the heterosexual epidemic myth.

The mainstream journal Conservative Digest is also not above using fanciful statistics. It reported that 1.5 million homosexual and bisexual men in the United States were infected with HIV and that 20 percent of these men were married and had passed the virus on to their wives.

In fact, the official CDC estimate released nine months later indicated 625,000 to 1.1 million homosexual and bisexual men infected, a figure that many believe to be too high. As to their 300,000 infected wives, while CDC has no estimate of this, as of July only 1,500 full-blown AIDS cases were reported to have been infected through heterosexual intercourse. Of those, about 15 percent, or 225, appeared to have been infected by a bisexual.

The Rev. Jerry Falwell has employed all three AIDS transmission theories, calling for "immediate action or AIDS will prove to be the final epidemic — with millions dying each year — including your loved ones."

Falwell makes no bones that the virus is being spread by evil practices of perverted sodomites. So is he saying that our loved ones are homosexuals? Or is he adopting Theory Two, in which case he must be saying our loved ones are humping like bunnies — not a very nice thing to say to someone on the Moral Majority direct mail list. Or is he saying the virus is casually transmitted, in which case why is the solution abstinence and monogamous marriages?

The honorary national chairman of the AIDS Prevention Institute, a chastity-pushing organization, is singer Pat Boone. The newsletter contains such admonitions as: "Save sex for marriage! You owe it to your future children!" Authorities such as Miss America 1988 are cited as calling for mandatory testing. A story in the newsletter tells the story of a heterosexually promiscuous young man whose glands remain swollen for more than a week. He sweats through an AIDS test that after an agonizing wait comes back negative. "Never again!" proclaims the prodigal youth.

The newsletter terrifies heterosexuals into thinking they may be infected, then uses accounts of those needlessly terrified heterosexuals to needlessly terrify more heterosexuals.

Conservatives are not alone in exaggerating the terrors of the AIDS epidemic. Liberals have pushed the AIDS-doesn’t-discriminate line in order to advance their pre-epidemic causes, such as sex education in schools, and to generate more research funds and reduce the stigma of homosexuals. The difference is that liberals are winning, and conservatives will lose. And ironically, conservatives will lose because they’ve failed to act like conservatives.

The AIDS crisis called for what used to be thought of as conservative virtues: caution before all the evidence is in and dispassion when weighing public policy. Instead, conservatives have reacted as hysterically as their radical adversaries. In the process, they also lost two old battles. They conceded that sex education in schools was necessary in order to promote their own moral agenda. (They will have trouble now arguing that it should not occur at all.) And by ignoring the drug connection while grossly over-emphasizing heterosexual sex, they also passed up a key over-emphasizing heterosexual sex, they also passed up a key opportunity to talk about the immorality of drug abuse.

When the American Spectator ran its first hysterical AIDS story, assistant managing editor Andrew Ferguson wrote this dissent. It stands in stark contrast with the attitude of the American conservative leadership: This grotesque but recently voguish hysteria is ludicrous on its face, or anyway it should seem so to someone who prizes the principles on which conservatism is supposed to be based — limited government, prudence, and individual responsibility, to name a few. It is simply the latest version of the totalitarian flimflam that is forever drawing believers from the ranks of the weak-minded and the perpetually alarmed. The conservatism of which he writes is that not of a Bennett or a Bauer, but of a Burke.

Some of today’s conservatives seem to have forgotten that it is a liberal precept that "in the long run, we shall all be dead." After the long run of AIDS, the vast majority of us will still be alive. What short-term victories could the conservatives gain that, come the morning after, could possibly be worth what they will lose?