Letter: How Aids is spreading: the dangers of cynicism, apathy and myth

Sir: In today's leading article 'Realism about Aids' (2 December), you correctly suggest that when the official message fails to square up with anecdotal impressions, then cynicism and complacency ensues. You are also right that there is a danger of such a mood developing in Britain. But this is the very danger reinforced by your article, which irresponsibly perpetuates the myth of 'high-risk groups' and, correspondingly, of the low risk of HIV infection among sexually active heterosexual people in this country.

At the official launch of World Aids Day, Baroness Cumberlege, the Minister for Health with responsibility for HIV/Aids, drew attention to the danger of assuming that, because there has not yet been a massive heterosexual epidemic in this country, this is a group not at risk. She suggested that the relatively low prevalence levels in this group (compared, for example, with France where prevention work has been patchy and prevalence in all groups higher), may be a consequence of the success of our prevention campaigns.

Official figures confirm that a third of all new cases of HIV in the United Kingdom are in the heterosexual population. Globally, the World Health Organisation reminds us that at the present rate, we shall be dealing with 30-100 million people with HIV/Aids by the end of the century, and that someone, somewhere, is infected every 15-20 seconds. The overwhelming majority of these infections will continue to be the result of heterosexual intercourse.

Far from being low key as you suggest, World Aids Day was marked by more than 300 events across the country. All of these reinforced the official message that there are neither high-risk groups nor high-risk places. HIV infection is spread by high-risk activity.

All sexually active people, from whatever group, are at risk of HIV if they practice unsafe sex. Because of the long incubation period, and the low level of testing within the asymptomatic heterosexual population, there are unknown numbers of infected people who are unaware of their HIV status.

While clear thought needs to be given to the means by which each population group is educated, realism about Aids is a matter of understanding and communicating these simple facts without equivocation. It is also a matter of saving lives.

Yours faithfully,

CHRISTOPHER SPENCE

Director

London Lighthouse

London, W11

2 December