The High Stakes of Carnal Knowledge


June 07, 1991|By ELLEN GOODMAN

BOSTON — The obituaries come with enough frequency to dull the senses. A 42-year-old choreographer dies, leaving behind his longtime companion. A 29-year-old artist dies, leaving behind his parents.

Sometimes the obit will say right out that he died of AIDS. Other times it will say, conspicuously, nothing. Or it will name the last of a dozen attacks -- pneumonia perhaps -- on the defeated immune system.

Occasionally it will even announce how the disease was contracted. But only when it came from a blood transfusion. Or from a dentist.

More often there is no obit at all. Now that some 110,000 Americans have died from one disease, now that it sounds as familiar as cancer, only the most prominent or public get their names in the paper. Drug addicts and their babies rarely make the cut.

This is the state of AIDS today, at the beginning of the second decade of the epidemic. AIDS is not the mystery that it was 10 years ago. We now talk publicly about the once-unspeakable. Since that first report on June 5, 1981, of a disease that struck five gay men, words like ''safe sex'' have become as common in the public vocabulary as condoms.

Television anchors who had to practice saying ''anal intercourse'' in front of a mirror, are now unfazed in their descriptions of bodily fluids and how they are exchanged. Newspaper readers who were once appalled to find sex acts described in their family newspapers, read them now with a dispassionate eye.

Sexual and religious conservatives who opposed sex education on the grounds that it would encourage sexual license, may now approve this teaching on the grounds of sexual restraint. Men and women who want to get to know each other are more aware of the high stakes of carnal knowledge.

AIDS has become, in the words of the media gatekeepers, ''old news.'' The disease itself is on the rise. Some 80,000 Americans are newly infected with the HIV virus every year. But consciousness, it seems, is leveling off. So too, perhaps, is public compassion.

To get an AIDS patient on page one, it must be a toddler playing with a used syringe, a heterosexual woman who had sex just once with a bisexual liar, a senior citizen infected through a transplant -- some victim of a new and preferably ''innocent'' route of infection. This is not just because of American impatience with problems that we can't quickly solve. It's also American ambivalence when human behavior is the lethal ''risk factor.''

Ever since it came to attention as the ''Gay Plague,'' AIDS has carried with it all the baggage of sex -- gay and then straight -- as well as drug use. At the beginning, one group of Americans framed AIDS strictly as a moral issue and another framed it as a medical issue. The moral attitude was more severe in those days but the medical attitude was more sympathetic.

The first wave of AIDS patients had, after all, no way to know they were at risk. But today, after all that has been known and taught, most infections still come through shared needles and sex. And while many of the infected were ignorant or misled, those who have taken risks are subject to more ambivalence.

It's a part of an American duality. We don't want to ''blame the victims.'' We do want to hold individuals responsible for their behavior. It's not always clear how you do one and not the other.

This is a question that comes up in many -- not just HIV-positive -- ways. The smoker who comes down with lung cancer. The accident victim who wasn't wearing a seat belt or a helmet. The pregnant girl who wasn't using birth control. Our sympathy is often muted by frustration at human behavior. And our criticism is muted by the knowledge that, yes, anybody can make a mistake. This time with tragic consequences.

On the first week of the second decade of AIDS, the conflict seems especially vivid. Far from a cure, dependent on each other's responsible behavior, we are not just, as one activist fears, becoming numb to the numbers.

We may have learned a lot about safe sex but we've also learned a lot about slippage. Ten years out, we're still hoping for a breakthrough in medical science and for a breakthrough in human behavior. At times, one seems as elusive as the other.

Ellen Goodman is a syndicated columnist.

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