OUR BODIES, OUR MINDS.

by

Harvey Thompson, M.D. "Twenty Questions: And Answers That Could Save Your Life"

1. What is the full name for the abbreviation, AIDS? Acquired Immuno Deficiency Syndrome. Memorize the name. A creative nurse wrote "Autoimmune Disease Syndrome" on a patient's chart last week.

2. Can you explain that, word by word? First, it's acquired. It's not congenital or a disease that you'd get on a desert island. Second, the immune system is deficient; there are decreased numbers of "helper" T-cells, the good guys of the immune system. Third, it's a syndrome, a group of illnesses that together characterize AIDS. Another syndrome is "Gay bowel syndrome", a collection of bowel infections that have different causes but similar manifestations (diarrhea, cramps, etc.) AIDS is a bit different in that its manifestations may differ, (kinds of infection or even cancer), but the cause is the same: decreased immunity.

3. What's an immune system? The surveillance system of the body that protects against invasions by disease-carrying micro-organisms and cancer cells.

4. What is it made up of? Many kind of cells. Lymphocytes are the major part, but other elements include phagocytic cells, complement, and antibody.

5. Where is it located in my body? All over. It has to be mobile to protect all your body territory, so lymphocytes produced in the bone marrow move about in the blood, along with other protective phagocytes, antibodies and complement. 6. What causes AIDS? No one Knows. Viruses are suspect because they are known to suppress lymphocytes. Cytomegalovirus, a yet-undiscovered agent, or other viruses in combination such as herpes, hepatitis, etc., are all possible.

7. How common is AIDS? Again, no one

knows. It depends on how liberal your definition is. Very seldom is, there a clear, concise definition in most of the written. material. 8. What is the medical definition of AIDS? The broadest definition may indicate that nearly every sexually active Gay male may have AIDS. A study from New York showed that 83% of nearly 100 healthy sexually active Gay men had decreased and deficient immune systems as measured by the "T-cell ratio". However, a stricter definition of AIDS comes from Dr. Donald Armstrong of the Sloan-Kettering Cancer Center:

A. Opportunistic infection by any of the following in a patient without recognized predisposing factors;

Disseminated Myobaterium aviumintracellularae

Fungus, more widespread than normal (for example in the esophagus) Parasites, such as p. carinii pneumonia or disseminated toxoplasmosis.

Viruses, such as CMV syndrome or severe persistent herpes.

B. Any two of the following: Myobacterium TB

Cryptococcus neoformans, cryptosporidiosis, isopora belli Disseminated Histoplasma capsulatum

Prolonged or dissemeninated herpes zoster.

C. Lymphadenopathy: nodes larger than 1cm in more than two regions for at least three months, with nondiagnostic biopsy and tests showing decreased immunological function.

D. A wasting illness of no apparent cause, often accompanied by diarhhea, fever, and lymphademopathy with weight loss.

E. Kaposi's Sarcoma under age 60 without immunosuppresion therapy. F. Unexplained autoimmune phenomena such as hemolytic anemia, plus one of the above infections.

9. Can I tell if I have AIDS? You can't make the diagnosis yourself. Symptoms may include weight loss, diarhhea, enlarged lymph nodes, low-

grade fever, or signs of the opportunistic infections listed above. But be careful of the label "AIDS". Diagnosing the condition requires a complicated workup and can depend on who makes the diagnosis. Educate yourself and ask questions.

10. What's an "opportunistic infection?" An infection that "seizes the opportunity." All of us have herpes, chicken pox virus, yeast, and probably even cancer cells occasionally in our bodies. But if the immune surveillance system is impaired, they have the opportunity to increase with less resistance. The local herpes infection then becomes generalized, or the single Kaposi's sarcoma cell multiplies into purple bumps all over, inside and out. 11. Is it contagious? The opportunistic infections are not; we have them around our bodies, but held in check. Only when the immune system is impaired can they advance. But AIDS looks as if it may be contagious. There are clusters of cases in groups of people known to exchange body fluids: intravenous drug abusers, recipients of blood products, and Gays.

12. What about the Haitians with AIDS? Not understood. Haitians do suffer from a great number of endemic dieases that might suppress immunity; then again, they may be, a source of an "Andromeda strain."

13. What's the "T-cell ratio?" There are two kinds of lymphocytes in the cellular portion of the immune system, helper and suppressor. In AIDS, the number of "helper" cells is decreased; their ratio to suppressor cells is lower. Help is not there to control opportunistic infeetion.

14. What is the treatment for AIDS? There's no easy way to repair a damaged immune system. At worst, there may be no treatment for a permanently damaged one. However, many viruses cause temporary immune suppression, and if immune insults and repeated viral exposures are eliminated, the system may rebound to normal.

15. What are my chances of catching AIDS? No one knows. It's the alarming rate of increase in cases that's Frighting, and the fact that incubation tim from contact to appearance may be as long as one year. The increase in cases is not linear, but doubles every six months apparently with no end in sight.

16. Can I decrease my chances? Perhaps by decreasing exposure to different partners. The most consistent finding in AIDS is that victims are promiscuous, averaging over a partner a week. Also, avoid seman exchange, both oral and anal. Sperm and it's fluids are rich environs for viruses such as cytomegalovirus.

17. Is it OK to have sex? Absolutely! In fact, in these hard times, you may want to do more. But do it with the same healthy person or persons, NOT with a new person each time. And hope that your partner(s) do the same thing.

18. Do animals get AIDS? Perhaps. There's a rumor that will soon hit the press that primates at the Vet school at UC Davis have AIDS. If so, an animal model would be invaluable. Experimental treatments could be tested, epidemiology determined, and the disease studied more easily. 19. Are there political repercussions to AIDS? Yes! Fundamentalists already talk about AIDS as the "wages of sin". AIDS has appeared among hemophiliacs and newborns receiveing transfusions traced to possibly Gay donors, a politically dangerous proposition, and a bad press that implies that we infect helpless kids.

20. What can I do to help? Contribute to the AIDS or Kaposi's Sarcoma Foundation in your area, or organize one. Set up a P.0. Box for donations and a storefront distribution point for pamphlets and a telephone hotline.

Above all, maintain your respect for yourself and your Gay friends. AIDS has no sex life; this is not "our" diease. The majority of healthy Gay people should band together to help the unfortunate minority, not stand back in an attitude of fear, alarm, or "moral" superiority. Stonewall Features Syndicate, 1983.