Anatomy of an Epidemic

The AIDS Epidemic

edited by Kevin M. Cahill MD.
St. Martin’s, 173 pp., $12.95

How to Have Sex in an Epidemic: One Approach

by Richard Berkowitz, by Michael Callen, with editorial assistance by Richard Dworkin
News from the Front (New York), 40 pp., $3.00

Gay Men’s Health: A Guide to the AID Syndrome and Other Sexually Transmitted Diseases

by Jeanne Kassler MD.
Harper and Row, 166 pp., $7.95

Since it was first recognized in 1979 and until very recently, the incidence of the diseases grouped under the acronym AIDS (Acquired Immune Deficiency Syndrome) roughly doubled every six months, with about five cases being reported a day in the US (and about two a day in New York City). The overall national mortality rate has been 39 percent; half of all AIDS patients die before the end of the first year of the illness and nearly all before the end of the third year. According to a spokesman for the Centers for Disease Control (CDC), as of July 1, 1983, 1,737 people have been afflicted by the disease, and 678 of them have died.

The AIDS Epidemic presents a disturbing picture of the epidemiological, etiological, and clinical aspects of the disease as it is currently known, as well as discussion of a number of special problems, such as the protection of health workers, guidelines for blood donation, the direction of future AIDS research, and government funding for that research. The book is a collection of reports on various aspects of the illness presented at a symposium held at Lenox Hill Hospital in New York City last April. It is edited by the senior member of the New York City Board of Health and a specialist in tropical medicine, and among the authors are such distinguished authorities as Dr. William H. Foege, director of the CDC; Dr. Donald P. Francis, chief coordinator, AIDS Laboratory Activities, Center for Infectious Diseases at the CDC; Dr. Donald S. Fredrickson, former director of the National Institute of Health; Dr. David J. Sencer, New York City commissioner of health and former director of the CDC; Dr. R. Ben Dawson, director, Blood Transfusion Services and Research Laboratories, University of Maryland School of Medicine and Hospital; and Dr. Robert A. Good, former president and scientific director of the Memorial Sloan-Kettering Cancer Center.

As Dr. Foege explains in his account of the history of the disease in the US, most of its victims thus far have been homosexual men under fifty—the median age is thirty-six—who live in large cities on the East and West coasts. According to the latest CDC figures, 47.9 percent of these are from New York (and 44.5 percent from New York City), 9.5 percent from San Francisco, and 6 percent from Los Angeles. Cases have occurred in thirty-eight states, the District of Columbia, and Puerto Rico; and there have been 121 cases in twenty-one other nations.

While the disease was first diagnosed in promiscuous homosexual men with previous histories of sexually transmitted diseases, it was subsequently discovered among other groups—intravenous drug abusers, hemophiliacs, and Haitians recently arrived in the US who apparently had no history of either drug abuse or homosexuality. These account for some 94 percent of the cases. Of the remainder, who are not in these “high-risk” groups, in half of the cases information pertaining to risk factors is unknown or incomplete; the rest …

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Letters

An Exchange on AIDS October 13, 1983