Ten Years later, AIDS cure,answers remain elusive


HAGERSTOWN--When Audrey Winzor Harrell first hear about AIDS,she prayed it would spare her son

"Not John, please, not John."

For Ms. Harrell, the words were a mantra.

Last August, John Harrell's family and closest friends scattered his ashes at a beach north of Los Angeles, where he had worked as a cosmetologist. Mr. Harrell, who was gay, had lived with AIDS for four years. Finally, it killed him. He was 28.

Ms. Harrell, a Hagerstown researcher, lives now with her son's legacy. AIDS ended his life, and it has forever changed hers.

Ten years ago, on June 5, 1981, the first five cases of a mysterious "gay cancer" that would be identified later as acquired immune deficiency syndrome were reported to the federal Centers for Disease Control.

There isn't a region in the nation that has been excluded from the pain of AIDS, including this slice of small-town Maryland. The disease has triggered a nation's fear and tapped into its compassion.

Its unassuming arrival a decade ago did not portend the grip it would come to have on an unsuspecting public.

Today's is a grim anniversary: In the past decade, 174,893 people have been diagnosed with AIDS, and 110,530 of them have died. Nearly 1 million more Americans may be infected with the virus that causes AIDS.

Worldwide, the deadly human immunodeficiency virus has infected 10 million people, according to the World Health Organization, and 40 million infections are projected by 2000.

"Where some might see statistics, I see faces," said Ms. Harrell, an interviewer for a medical research program in this working-class city of 35,000. "I went to the doctor's in Los Angeles with John; I saw the patients. It's the people I think about, their eyes."

In celebrity-conscious America, it took Rock Hudson's disclosure 1985 that he had AIDS to bring the disease home.

"It was when that movie star died that I first heard about it," 52-year-old church custodian John St. Clair said yesterday. "Now I know what everyone else knows: It's one hell of a disease. No one's safe."

Hagerstown may be far from the AIDS epicenters of New York and San Francisco, but as in communities all across America, AIDS has become part of life's fabric.

Amanda Elliot, 12, recalls playing doctor with her friend, Sarah, .. last summer.

In a chilling version of the old game, "Doctor" Amanda used plastic baggies filled with vegetable oil and sugar water to administer chemotherapy to her playmate, a pretend-AIDS patient.

"We like to think up cures for AIDS. . . . We've tried to think of ways to kill the disease."

In Washington County public schools, AIDS education begins in the fifth grade and continues through high school.

For the past two days, middle school students at the Alternative School for troubled teen-agers in Hagerstown have listened to county health educator Harriet Schwartz give the drill on AIDS.

Fifteen-year-old Jerome Broadus snickered at some of the terms Ms. Schwartz used in her lecture: breast milk, semen, vaginal fluid.

Later, he confessed privately: "I may laugh in there, but I feel sorry for [people with AIDS]. I just feel bad sometimes. It could happen to me. When it comes down to it, I care about it a lot."

Twenty-seven AIDS cases have been reported since 1981 to county health officials.

The earliest patients were Haitian farm workers who had been infected in their homeland and elderly people who had contracted the human immunodeficiency virus through transfusions of tainted blood.

Dr. John Newby, the county's top AIDS expert, estimated yesterday that at least 200 people in the community now are infected with HIV. Most probably don't know it because of the disease's long incubation period, he said.

While Washington County has not yet had to deal with large numbers of AIDS cases, it has begun to prepare itself: For a time, a banner that warned "AIDS Is Your Problem" hung over a well-traveled street here, and from time to time AIDS pamphlets are distributed on Public Square.

Health educators frequently lecture on AIDS to church, home and civic clubs. And an AIDS crisis intervention team of local doctors and county health officials is in place, though it has been employed only once.

For a short time, a support group for AIDS patients and their families met in Hagerstown. It disbanded because people were afraid of being spotted at an AIDS meeting. Now, most people travel to other cities to seek such support.

"I've been lucky," said Ms. Harrell. "People at work and in the community have supported me. But I know a woman here whose son has AIDS, and she had to stop going to church and she quit her job because of harassment."

A Gallup Poll last month showed that 46 percent of respondents believe that all Americans should be tested for the virus, and 59 percent said they believed that "people with the AIDS virus should be made to carry a card to this effect."

In the recently published national survey, "The Day America Told the Truth," 40 percent of those polled believed that "AIDS sufferers deserve it" and 52 percent believed that the names of AIDS carriers should be made public "to protect the general population."

While gay white men still account for the bulk of AIDS cases, transmission through intravenous drug use and heterosexual activity is increasing.

The disease, for which there is no known cure, also is striking more and more women. This year, AIDS is expected to become the fifth-leading cause of death for all U.S. women of childbearing age, after cancer, accidents, heart disease and murder.

In the past 10 years, more than 17,200 women have been diagnosed with AIDS, almost one-third of those in the last year.

Medical scientists marvel at the speed with which the AIDS virus was identified and treatments created, but a vaccine, they say, is still 10 to 20 years away.

Bill Urban, a Baltimore journalist, will probably be dead by then. Mr. Urban, 35, was diagnosed with AIDS four years ago.

"Unless you've held someone's hands until they took their last breath, or changed someone's diaper, you just won't get it," said Mr. Urban, who has attended more than 100 funerals of friends and acquaintances who have had AIDS. "I had so many hopes and dreams in 1987, and they were completely

shattered with the words: You have AIDS."

Ten years ago, playwright Larry Kramer and a few other men in New York formed the Gay Men's Health Crisis to support those with the disease. They thought theirs would be a temporary job. They were wrong. GMHC, the nation's oldest AIDS organization, continues to get 50 new clients a week.

Over the years, attitudes about AIDS have swayed from public apathy to panic. For a time, despite evidence to the contrary, people were afraid that AIDS could be transmitted by mosquitoes, toilet seats and kissing.

In recent months, alarms have sounded in the medical community, where there is an increasing concern over doctor-to-patient transmission.

AIDS is a public health problem that has been highly politicized because of its link to homosexuality, and activists have long contended that the federal government has failed to drum up the proper resources to fight the problem because of that.

"It's a combination of homophobia and indifference. To me, the federal response has been disgusting and frightening," said Andrew Velez, a member of the AIDS Coalition to Unleash Power, whose trademark is Silence = Death. Since 1987, dozens of ACT-UP chapters have formed across the country.

"All the evidence suggests we are headed into a dark, dark time," Mr. Velez added. "We haven't seen the worst of this. We're living through another holocaust, and we've only touched the tip of it. Whole families are being wiped out."

At the Gay Men's Health Crisis in New York, spokesman David Eng paused the other day to reflect on a friend's death from AIDS.

"I watched him die. He didn't know who I was," said Mr. Eng. "I had known John 10 years. He raved about the color of the sheet, saying the color of the sheet was wrong. And he kept yelling, 'The pillow is trying to kill me.'

"It happened so quickly, and I felt so completely, completely helpless. With this disease, you can't take care of things. You don't know how to.

"I like to think there is hope," he said. "I would like to feel that there is hope. But the reality is, it's 10 years later, and there aren't any breakthroughs on the horizon. It is hard to feel hope."

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