As just one day's dreary headlines show, AIDS is nothing if not an ever-changing picture:
"So many kinds of illness are tied to the HIV infection that scientists say their earlier view of the disease was defined too narrowly."
"One in 61 babies born in New York City in December had AIDS antibodies, an indication that their mothers were infected and many of the babies were carriers."
"The government counted 50,265 AIDS cases in the United States at year's beginning, just about what they projected."
As researchers daily learn more about this 20th century plague, the good news is that, albeit at ever such a snail's pace, the message about this virus is finally beginning to get to even the most hard-to-reach groups.
But the bad news is that another need is surfacing simultaneously. In this city, region, and across the country, more alternative sites for high-quality testing are desperately needed to slow down the spread of AIDS in the groups most likely to get it.
The groups that are primary carriers are well-known: homosexual men, prostitutes, intravenous drug abusers, and as a "bridge" to heterosexual females, bisexual males. Now there is an additional group: those who have contracted it from one of the first groups and are wittingly or unwittingly carriers or spreaders themselves. With an additional 33,000 AIDS cases predicted by the end of l988, some observers point out that these numbers are only the tip of the iceberg. It is, they stress, the HIV carriers -- those persons who haven't shown AIDS- related symptoms -- who are the "Typhoid Marys" of AIDS because they can spread the disease.
And that is the biggest argument for the availability of more sites for voluntary, anonymous testing and counseling. If we are to curb the spread of AIDS, we have to make the carriers and potential carriers aware through education, testing and counseling that safe sex practices are critical not only for their own lives but also for those with whom they interact.
Currently in the District, two testing sites are run by the D.C. Public Health commission: the Whitman Walker Clinic, at 1407 S St. NW, and the Southwest Health Clinic at 850 Delaware Ave. SW.
"More resources are definitely needed. We book up two weeks ahead of time now," said Dr. Peter Hawley, medical director of the constantly swamped Whitman Walker Clinic. "It doesn't take any time at all to get fully booked. We definitely have more people who want testing than what's available. People can go to their private doctors, but some worry about the issue of confidentiality. We are totally anonymous and we offer counseling as well."
Two other organizations -- Planned Parenthood of Greater Washington, with several sites around the metropolitan area, and the Washington Free Clinic at 14th and Newton streets -- also are hoping to incorporate AIDS testing centers into their medical operations within the year. And in the minds of both groups, the issue of stopping the spread of AIDS by carriers is uppermost.
"The population we serve is likely to be a point where the HIV virus will be spread through IV drug users, partners of drug users and experimental IV drug users into the heterosexual population. The Centers for Disease Control and the D.C. government are recognizing a need to stop the spread," says Sharon Zalewski, medical program director of the Washington Free Clinic in Mount Pleasant's racially, culturally and economically diverse community.
Indeed, Dr. Reed V. Tuckson, director of the D.C. Public Health Commission, agrees on the need for sharply increased testing and counseling sites. "We have taken the position we're going to offer counseling and testing in most sites where we treat sexually transmitted diseases and women of child-bearing age," he said. Tuckson said he expects to have testing and counseling available in five such sites within the next several months.
In the ever-changing picture of AIDS, Tuckson has another reason that education and high-quality testing and counseling will be increasingly important: Referring to drug testing that is taking place at research centers around the country, he said, "Ultimately, as we begin to learn more about the person who tests data positive but doesn't have the disease, we may begin to intervene. There will be some subtle things we can observe early. And, over time, I hope and pray there will be ways to catch the problem early."