Focus: Washington

Senator's bellicosity kindles bigotry

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.6999.216a (Published 22 July 1995) Cite this as: BMJ 1995;311:216
  1. JOHN ROBERTS, North American editor,BMJ

    Since the first cases were reported in gay men in 1981 AIDS has been labelled by many Americans as a gay disease. The religious right has called it God's punishment for unnatural acts. During his eight year term President Reagan avoided using the word AIDS, and he failed to reach out to patients with AIDS, even when his Hollywood friend Rock Hudson contracted it. But at the end of the 1980s an Indiana teenager, Ryan White, touched America's heart.

    The boy had contracted HIV through a blood transfusion, and during his final illness he preached tolerance and compassion for all those with the disease. In fact, his attitude translated into law. The Ryan White Comprehensive AIDS Resource Emergency Act of 1990 has provided pounds sterling1.2 bn to clinics and hospitals to treat poor people infected with HIV, and AIDS. So far the fund has been popular among both Democrats and Republicans. That is, until a couple of weeks ago.

    The senior senator from North Carolina, Republican Jesse Helms, said he would try to block the Ryan White appropriation this year because the money served homosexuals “deliberately engaging in unnatural acts” whose disease was caused by “disgusting, revolting conduct.” The surprise was not that Senator Helms made his speech: just a few months ago he demanded an end to US aid to poor nations, saying it was “like pouring money down a rat hole.”

    What was interesting was the reaction. Colleagues and columnists decried his bigotry. But, even as they did so, they revealed a covert bigotry that Helms may have reignited. A physician writing to one newspaper condemned Helms for ignoring children with AIDS. Other writers focused on heterosexual patients and those who contracted AIDS from blood products.

    For years, the term “innocent victims” has pervaded public discourse about AIDS, and last week the phrase was revived even among Helms's antagonists. (No one uses the term when speaking about cancer or heart disease.) It was left to President Clinton to call for simple compassion. In a short extemporaneous speech at Georgetown University in Washington, Clinton used Helms's statement as an example of a “politic of hatred….Gay people who have AIDS are still our sons, our brothers, our cousins, our citizens.”

    After a few days the media were starting to review the “facts” that Helms claimed. For example, in asking whether AIDS in America was a “gay disease,” the New York Times reported data from the Centers for Disease Control showing that most patients were not gay (43.3% compared with 26.9% intravenous drug users, 10.3% through heterosexual contact, 6.3% other (mainly through blood products), 1.3% children, and 11.9% not reported).

    Helms also demanded “equity” in the amount of research money spent, claiming that spending on AIDS research outran that on conditions that kill many more Americans each year. In terms of spending per patient, his statement seems true. The American Heart Association estimated that the government spent pounds sterling22 977 on research for each person who died from AIDS in 1993, compared with pounds sterling2318 for each one who died of cancer, pounds sterling545 for each who died of heart disease, and pounds sterling457 for each who died of stroke. But in terms of total spending the numbers are different. Federal spending (including clinical care) in 1995 will reach pounds sterling3.75bn for HIV/AIDS, pounds sterling10.9 bn for cancer, and pounds sterling23.8bn for heart disease.

    No one in Washington believes Helms will be able to stop the money that provides treatment for the 200000 uninsured patients with HIV infection. But his bellicosity is expected to slow down the appropriation until the end of the year. Perhaps worse, his relabelling of AIDS as a “gay disease” may further alienate patients with AIDS from America's mainstream conscience.

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