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

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Sir: Your leading article 'Realism about Aids' (2 December), apart from the fact that it ignored the substantial diferences in risk groups between Scotland and the rest of the United Kingdom, missed one very important point. The patients who are today being diagnosed as having Aids are the products of events that happened five to ten years ago. For one reason or another, these patients were never tested until they became ill.

In Edinburgh we see two to three new cases per week, but they are virtually all people whose immune system is typical of somebody who has been infected with HIV for seven to eight years. They belong to the first wave of infection, which took place in Edinburgh in 1984-5. We do not know how much the virus is spreading into the heterosexual population, because there is no systematic screening of this group. With things as they are, we will only know the extent to which HIV is spreading in 1992 in eight to ten years.

Therefore, while I agree that the educational material could be better targeted, is it not better to err on the side of overkill than to risk what is happening in urban areas of Thailand and India, where, as a result of apathy and denial, the infection has risen from being practically unknown to proportions of about 50 per cent in high- risk groups in five years?

Anybody who is out and about in Edinburgh is reminded daily to 'take care with sex', thanks to the regional council's advertising campaign on the buses. Perhaps the lack of a heterosexual explosion is the result of all the public education. But how do you prove it?

Yours sincerely,

KARIN S. FROEBEL

Senior Research Fellow

HIV Immunology Unit

University of Edinburgh

Edinburgh

3 December

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