The disclosure that tennis star Arthur Ashe has AIDS is only the latest evidence that the path of the disease is shifting away from gay white men.
Mr. Ashe appears to have been the victim of a tainted blood transfusion in 1983, before screening was as effective as it is now. His exposure is rare, but increasingly often new cases are cropping up among minorities, heterosexual intravenous drug users and women. Last month, the federal Centers for Disease Control reported that AIDS cases in the nation's capital will triple by mid-decade; in the Baltimore area, the number of AIDS patients is expected to double, to some 1,600 cases, by 1995, when as many as 25,000 people in the region may be infected with the virus that causes AIDS.
Local health officials say education and prevention are still the main tools for fighting the epidemic. But they concede that efforts so far have produced mixed results. "It's one thing to give people information about the causes of the disease and how to avoid it," says Brenda Pridgen, the city AIDS coordinator, "but getting people to change their behavior is much more difficult."
The difficulty is evident in the city's sexually transmitted disease clinics, where about 5 percent of those coming in for treatment test positive for the HIV virus. Rates for sexually transmitted diseases are high in the city, an indication that the message of safe sex has not sunk in for large numbers of people. Moreover, a significant number of those who test positive for HIV later return for treatment of subsequent sexualy transmitted disease infections, suggesting that not only are they not practicing safe sex but that they are exposing their sexual partners to AIDS as well.
To date, 1,997 city residents have been diagnosed with AIDS, of whom 1,344 have died. In Maryland, 4,408 AIDS cases have been reported since 1981, of whom 2,882 have died. Officials fear the numbers could explode if the main pathway of the disease shifts to heterosexuals.
Projections of the future course of the epidemic are imprecise, however, because of the difficulty of gauging the prevalence of HIV in the general population. Officials hope that will change with the enactment by the General Assembly of a measure allowing the state health department to collect data on people infected with the virus without recording their names.
Meanwhile, what is certain is that, despite all efforts at education and prevention, the outlook so far remains grim and many thousand more Marylanders are likely to die of this scourge before the decade is out.