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Are We All at Risk for AIDS? It is often said that everyone is at risk for AIDS, but the actual numbers suggest otherwise. After nearly two decades, AIDS cases in this country have remained 94% confined to the originally identified risk groups. (46) The CDC places 88% of American AIDS patients in two categories: men who have sex with men or injection drug users. Just 10% of Americans diagnosed with AIDS cite heterosexual contact as their only risk and of these, close to half (4%) mention sexual relations with users of injection drugs. The classification of AIDS cases by risk group relies entirely on voluntary responses to CDC survey questions, a method of gathering information that is well-documented to be a source of distortion and invalidity. (47) In fact, a number of public health studies show that upon further investigation, 65% to 99% of people with AIDS who initially claim heterosexual contact as their only risk or who claim no risk at all, later acknowledge using injection drugs and/or having male homosexual relations. (48) Although men who have sex with men is the leading risk group for an AIDS diagnosis, this information is not intended to suggest that gay male sex is a cause of AIDS, or that all men who have sex with men are at risk. There are specific health-compromising factors associated with, but that are not unique to, men who have sex with men that are known to cause acquired immune deficiency. Please see If It's Not HIV, What Can Cause AIDS? on page 51 for further information and clarification. It is also important to note that AIDS risk groups are limited to the six categories defined by the CDC and that the CDC accepts all survey responses regarding risks as accurate.
In a contagious epidemic, healthcare professionals working among the ill usually run the highest risk of contracting a disease. During the entire AIDS epidemic however, only 25 cases of AIDS have been reported among healthcare workers who claim occupational exposure as their only risk, and none of these 25 cases have been described in the medical literature. (52) Although the CDC reports that 75% of healthcare workers are women, 23 of these 25 AIDS cases (92%) are men.54 Also of interest is the fact that there are no emergency medical technicians, paramedics, surgeons or dentists among the 25 occupational AIDS cases reported by the CDC. (53) In comparison to AIDS, 1,000 cases of hepatitis infection are reported each year among healthcare workers who attribute their illness to occupational exposure. (54)
Questioning AIDS Why are 88% of Americans confined to two risk groups? Since female prostitutes are at high risk for all STDs, why are they not a risk group for AIDS? While AIDS is often cited as the primary health risk for America's 26 million teens, according to the CDC, new AIDS cases among US teenagers in 1998 totaled 293 -- a drop from the previous year's total of 403. (55) The sum total for AIDS among Americans age 13 to 19 for the entire period known as the AIDS epidemic is 3,432 cases. In Canada, just two new cases of teenage AIDS were reported in 1997 while that same year Canadian teenagers accounted for half of all 4,442 new infections of gonorrhea. (56) Pediatric AIDS is a popular topic in national news and is the focus of many multimillion dollar fund-raising efforts even though there are fewer than 400 cases of AIDS among children age five and under for each year of the AIDS epidemic. (57) Studies have shown that as many as 85% of pediatric AIDS cases in the US and Europe occur among children born to mothers who admit to using IV drugs during pregnancy. (58) New cases of pediatric AIDS -- along with AIDS cases in all categories -- have been decreasing steadily since 1993, and in 1998, only 10 states reported more than 10 new diagnoses of pediatric AIDS. All AIDS cases among children age 12 and under during the AIDS epidemic total less than 8,500. Compare this to Sudden Infant Death Syndrome (SIDS) which during the same period of time has taken the lives of more than 80,000 children, all under one year of age. (59) Actuarial calculations demonstrate that the chance of testing HIV positive following a single act of unprotected vaginal intercourse with a person outside a high risk group is one in seven million, which is less than the chance of being struck by lightning, less than the chance of dying of food poisoning at a fast-food restaurant, less than being injured in an elevator ride, and about the same odds as being killed in a traffic accident while traveling a distance of 10 miles. (60)
Is AIDS Our Biggest Health Threat? In 1998, deaths in Americans with AIDS reached 410,800. This is the total for the entire time known as the AIDS epidemic, a period which spans nearly two decades. (36) Included in this total are deaths from any cause at all -- accidents, noncontagious illnesses, drug side effects, etc. -- in people diagnosed with AIDS. (37) Without dismissing AIDS deaths or the profound suffering of AIDS patients and their loved ones, it is important to give this total some comparative perspective: Over 400,000 Americans die each year of cancer, and there are more than 700,000 annual deaths in this country from cardiovascular disease. (38)
Although most people associate the word "epidemic" with AIDS, one of the last truly devastating outbreaks in history, the flu of 1918, took the lives of 20 million people worldwide in a single year. (40) After almost 20 years, diagnosed cases of AIDS throughout the world total less than 2 million, and included among these are many people who remain alive and well. (41) So why do we think of enormous numbers whenever we think of AIDS? Unlike cancer and most other conditions, AIDS reports typically use cumulative totals. In other words, a current year's cases or fatalities are added to the sum total of all AIDS diagnoses or deaths that have ever occurred, automatically creating a larger figure and the impression that AIDS constantly rises. Also, estimates and projections are frequently used in place of actual AIDS numbers. For example, the 1999 United Nations AIDS Report estimates that 2.5 million people throughout the world died of AIDS in 1998 while the November 1999 World Health Organization (WHO) Weekly Epidemiological Record reports that only 2.2 million people worldwide have ever received a diagnosis of AIDS. (42) The UN estimate is widely promoted while the actual WHO case count is rarely publicized. A little reported fact is that AIDS is not among the ten leading
causes of deaths for Americans. In annual death rates, AIDS lags
behind motor vehicle accidents, non-vehicular accidents and adverse
events, flu and pneumonia, diabetes, septicemia, Alzheimer's disease,
and homicide. (43) It is often reported that AIDS is the leading
cause of death among Americans aged 25 to 44. This statement inspires
great fear and concern until carefully examined. Portraying AIDS as our biggest health threat gives AIDS funding priority over problems that affect far greater numbers of Americans. According to findings by the Institute of Medicine, NIH research expenditures in 1996 averaged $1,160 for every American who died of heart disease, $4,700 for each one who died of cancer, and more than $43,000 for every death in a person diagnosed with AIDS. (45)
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The
risk of AIDS is also disproportionately divided among men and women
in America, with 85% of cumulative AIDS cases confined to males.
(50) In contrast to this fact, HIV testing conducted by the US military
since 1985 reports near equal numbers of HIV positive results among
male and female new recruits.51 If HIV were the cause of AIDS, we
should expect a near equal number of AIDS cases among men and women.
Instead, women have never represented more than 15% of all AIDS
cases nationwide.
During
the period known as the AIDS epidemic, 14 million people died of
heart disease -- 13.5 million more than have ever died of AIDS --
while 9 million succumbed to cancer, which is 8.5 million more than
those counted for AIDS. >From 1981 to 1998, car accidents killed
over 800,000 Americans -- almost twice as many as have ever died
of AIDS. Suicides during the AIDS epidemic surpass AIDS fatalities
by more than 100,000. (38) Loss of life from adverse reactions to
properly prescribed and correctly taken pharmaceuticals outnumber
AIDS deaths in America by more than 1.3 million. (39)
Only
two-tenths of one percent (0.2%) of persons in this age group die
of any cause each year, and among these, deaths from AIDS represent
about three one-hundredths of one percent (0.03%). However, since
AIDS constitutes the leading category for fatalities at about 15%
(85% of people within this age range die of other causes), it is
possible to call AIDS the leading killer. (44) For more information
on the use of AIDS statistics, see Public Health, Public Relations
and AIDS on page 45.