AIDSPolicyWisMag1986 Transcript

- Carol Larson: This week, a study reported in the New England Journal of Medicine contained new evidence that AIDS poses little or no risk to those who come in casual or non-sexual contact with AIDS patients. That study may help reduce public fear about AIDS, something that is sometimes referred to as the second AIDS epidemic. In Wisconsin there have been 62 reported cases of AIDS, 41 of those patients have died. Still, as Carol Larson reports, Wisconsin has not suffered the worst of the AIDS epidemic or the epidemic of fear. 

- I think it's a sickness just like everything else. People don't ... ...put people down for having cancer, it's just another illness.

- Carol: Would you mind if you knew somebody in your workplace had AIDS?

- No. It doesn't make me any difference, long as they don't come tryna deal with me in any kinda way, you know? 'Cause I don't believe it-- it's not catchable.

- I would be more worried about what the other people, what'd be the impact on the other people and trying to keep hysteria down. And a few things like that. I personally would not be concerned.

- In general I've been finding it that people have been very supportive.  I haven't had too many people  turn away from me or point at me or anything like that, so it's been going pretty good.

- Carol: Larry Baumann has AIDS. Last October, he nearly died of pneumocystic pneumonia, one of the opportunistic infections that take advantage of an AIDS patient's damaged immune system. Now on a strict, self-imposed health regimen, Larry is active, social, and trying to be as productive as possible.

- You gotta wanna fight. You wanna, you have to wanna go on living. You have to want to ...  Have a good life and enjoy it and, for me, the fear is a lot greater than what reality is really turning out to be. For me, the fear of AIDS, I think when I thought about it way back when, was a lot more fearful than what it is. It's like telling my parents I was gay. I mean, I had all sorts of ideas and all sorts of different stories inside my head that was gonna take place, and when it actually happened, it was just like, none of those were true. It wasn't anything like what I imagined it to be, and I think people's imaginations really go wild with them and ...

- Carol: Wisconsin does not seem to have gone wild about AIDS. In random street interviews in Madison, passers by voiced little panic about its presence. What if you found out that someone in your office had AIDS? How would you react? Would you be concerned?

- Wouldn't concern me at all.

- Carol: No?

- No.

- Carol: You wouldn't be thinking about it or what you did or change your behaviors?

- No, not from what I know about it.

- People do seem to know an awful lot about AIDS, using phrases like "blood to blood transmission" and "the exchange of bodily fluids," as if they were medical students studying for an exam. This studied interest may not make Wisconsin unusual, but what does make this state unusual is that as early as last year, the Wisconsin State Legislature passed a law protecting the confidentiality of those who test for the AIDS virus. Reassuring high risk groups, still mainly the gay community, a protection from public fears and discrimination. Author of the law, Madison state representative, David Clarenbach.

- There is clearly a social leper syndrome related to the AIDS hysteria. The public is concerned out of proportion for the public health and safety. Not that we should be unconcerned about the epidemic of AIDS. We should because it is clearly the number one public health danger in America today. But we have to be equally concerned about the rights of individuals, and that is why Wisconsin and several other states have chosen to provide these extraordinary protections to the gay community in particular against discrimination in employment, and the potential abuses for the disclosure and use of these antibody tests.

- And we are relying very heavily on this test, in terms of the blood supply. If the test is positive on blood, it's not used, if it's negative, we are going on the presumption the blood is safe.

- Carol: The Wisconsin state task force on AIDS meets every several weeks to discuss AIDS issues, making recommendations on what schools, prisons, or employers should or should not be doing about AIDS. Recommendations are released as they are agreed upon, though a final report will not be completed until August.

- You know, even in the most minimal circumstances, the assailants' results are gonna be made known, and maybe we agree that's necessary. But it is getting impact in the confidentiality. There's somebody else who's gonna have a right to know now.

- Carol: The task force is weighted with medical experts, and healthcare workers, and their task is a delicate one. Balancing public safety with individual rights, in circumstances ranging from injuries on the job, sexual assault, to protecting those undergoing kidney dialysis.

- At this point, there is no evidence that AIDS, or HTLV-3 virus, can be transmitted through casual contact.

- Carol: Dr. David Kindig of the University of Wisconsin Madison is chairman of the task force. Like many members, Kindig finds little evidence that would require public testing for AIDS.

- The general inclination of the committee not to say mandatorily screen for HTLV-3 status  in the general population, for example, or in all prisoners for example. Those are things we have taken action on. It's not really, it's the confidentiality is not the primary reason for that, the primary reason is because we don't feel that there's any evidence that warrants it. At this point, no one can be tested for HTLV-3 in this state without a written, informed consent.

- Interviewer: Would you be concerned if your child was at school with someone who had AIDS?

- With children I feel a little bit more concerned about that because I think there's less control and, or again, we get back to the story, or the answer, you know, how easy is it? You know, how easy can it be spread? 
[school bell rings]

- Carol: So far there have been no AIDS children reported in Wisconsin schools. Though schools are where people most often voice a concern. The task force recommendations are to allow children with AIDS or the AIDS virus to attend school, to lead as normal a life as possible. Though the confidentiality laws do not require their parents to tell school officials if a child has AIDS. And that worries some people.  As a precaution, schools are warned to treat any bodily fluids, like blood or urine, as if the child does have AIDS, and that such precautions will in turn prevent all sorts of school related infections. But it is still the special case that worries parents. Say, if a child were a biter.

- We have said that there may be circumstances, say in which a child couldn't control their bowel movements, or where they have open sores. And there's no evidence that it's transmitted in that way, yet in our action, we said there is or not, we don't know for sure, and there is fear about these situations, and then so in those situations, parents and doctors and school officials should sit down together, and decide whether some kind of special placement ought to be, school placement, ought to be arranged for a child like that.  
[door slams]

- Carol: Hospital care of AIDS patients has in the past been the center of controversy. Instances where nurses refused to treat AIDS patients. And the patients felt dehumanized by the severe precautions taken by the staff.

- I think in a hospital, everybody, they may have signs on the doors, and they may have certain precautions.  But I found that everybody kind of took their own precautions, whatever they felt like was necessary. You know, it was kind of a strange setup. When somebody would come in, there wouldn't, there'd be always a mix up on people that were there that were already gowned and gloved, and then people coming in with maybe gloves. Or just a mask. And I found that to be, especially for my family, they felt awkward because they were sitting there all gowned up, and then my friends would come in like, "How you doing?" You know? And just sit there and talk. And they felt a little uncomfortable, because they were doing this, and my friends were doing this, and they thought maybe I was gonna look at it like, you know, kind of in a negative way, I guess.

- Dr. Dennis: There's always that hypothetical concern about the spread of this virus, because even though the risk may be very low, and the evidence indicates that the risk of spread in the hospital is exceedingly low.

- Carol: Dr. Dennis MacKey treats AIDS patients at the UW Madison hospitals, and is a member of the AIDS task force.

- We're talking about a very serious disease, and with greater potentials for spread, and for instance there is a greater risk of needle stick injuries in the hospital setting than there would be out in the community. So that we do take special precautions, but we don't take, it's not considered necessary to take the very draconian precautions that  were taken three, four years ago before we understood how this disease was transmitted. Most patients in the hospital who have AIDS, who have HTLV-3 infection, can be cared for in a fashion indiscernible from other patients, and the major precautions that we take are to try to make every effort not to sustain a needle stick injury, or a puncture injury, from a needle or other object that may have come in contact with the patient's blood.

- Carol: The AIDS task force will review the subject of hospital policies in March.

- I was in prison myself once, so it really, it's another sickness. Just like, you know, cancer or leukemia, if I shy away from somebody who has cancer, that's just as bad as someone shying away from someone who has AIDS.  
[door slams shut]

- Carol: It is in the prisons that some members of the AIDS task force thought that they should reverse their recommendation for no mandatory testing. Despite assurances from prison officials that violent or assaultive inmates are regularly segregated.

- We have been concerned about  the blood borne transmission from inmates to guards or from inmates to other inmates, or the sexual transmission. Either of coercive or non-coercive from an inmate to another inmate.

- Carol: State health officials estimate as many as 30% of all prison inmates may carry the AIDS virus, but in Wisconsin, prisoners have the same rights to consent as anyone else. That is, they must give written consent to being tested for AIDS, and if found positive, that information can only be revealed to the proper state health officials and that person's healthcare provider.

- We're debating now and we haven't decided, but it's possible that mandatory screening, say, of inmates or of other individuals,  on the street, who assault someone, sexually or physically, they might be required to be mandatorily tested. That's something that we could approve.

- Carol: If you heard that someone in your office had AIDS, would you be perhaps more careful or do things differently? 

- I guess I would like to say no, I wouldn't do things differently, but I guess maybe in the back of my mind there would always be a little bit of doubt, just because there is so much unknown about the disease.

- I had this person come in contact with me and I could just tell she was very very frightened of the whole situation when she was getting, you know, coming near me, kind of taking care of me, watching me. It was ... It was a weird experience. 
[machine whirring]

- Carol: Public doubts about safety often center around working situations. Especially jobs with a direct contact with the public, like food and personal services. It has been suggested that individuals with AIDS or those who test positive to AIDS, be removed from such positions. Based on the medical evidence, the task force recommended that such restrictions were again, unwarranted. And under Wisconsin law, employers cannot take it upon themselves to restrict employees suspected of having AIDS.

- Even if someone were to be tested positive on an AIDS antibody test, they could not be fired, and in fact an employer cannot require as a condition of employment submission to an AIDS antibody test. That is flatly prohibited in the state, until it has been determined that in those limited job categories they are placing a population at risk, and since that has not yet been established, then no employer can discriminate against someone in those areas.

- Carol: Do you think there should be some restrictions on people who have AIDS?

- Definitely, yes.

- Carol: What kind of things? 

- Put 'em in one area of the country.

- The fact that Wisconsin has made discrimination against AIDS patients and those who carry the virus an illegal act, does not mean that it doesn't happen here. One man from a northern Wisconsin city has reported that after his condition became known, he was shunned by various relatives, found a death threat on his car, and was rammed with a grocery cart while doing his weekly shopping. In other words, Wisconsin does not provide an absolute haven of goodwill and sympathy, even though time and further research seems to have tempered public sentiment.

- I think Wisconsin has a tradition of progressive social legislation. And a tolerance towards individuals. Now, that is not to suggest that we are free and clear. The hysteria continues, and there is an effort in the legislature now and will certainly be during the elections this fall and during the next legislative session, efforts to repeal or modify these protections for the gay community, and so I think the citizens of this state should be vigilant for these potential hysterias catching on. 

- We've got a lotta homophobia floating around and, I've been to a lot of other states and it doesn't surprise me.

- It's almost like, you know, being a leper, in olden times, you know, you go put them in the dirtiest parts of the village and keep 'em away from society, and I guess I can't see something like that happening in today's supposedly enlightened society. 

- Carol: As to what Larry Baumann says to the suggestion of restricting or segregating AIDS patients, the man who swims, bikes, and runs five miles every other day replied, "They'll have to catch me first."

- See, and I don't think I'm sick. 
[laughs]

I don't look at myself that way at all. And if I'm gonna die, I'd rather be out there living my life and if I go, I go. But I don't wanna sit here and get depressed and  sit and wait to die, I ... I can't understand that, and I can't understand having anybody else not wanna fight and just, get out and do what they wanna do. 

- Carol Larson produced our report, Frank Bull was the videographer and editor.