Aids

AIDS--the very sound of the word strikes fear in the hearts of all of us. Yet it was not until 1982 that the term was formally defined in the medical literature. In a decade AIDS has gone from near obscurity to front page headlines, and it now threatens large segments of the world's population.

What is AIDS?

AIDS is an acronym that stands for Acquired Immune Deficiency Syndrome. The AIDS virus is known as the Human Immuno-Deficiency Virus (HIV). The virus can destroy a body's immune system so that it cannot fight off infections. Eventually a person with the HIV virus succumbs to life-threatening infections and opportunistic diseases (including unusual forms of pneumonia and cancer).

The origin of AIDS is unknown, although many trace its origins to Central Africa. The green monkey of Africa carries a virus similar to AIDS, and many researchers believe that the virus was transmitted by monkeys to people. Apparently those infected with the virus either moved to other countries or infected American tourists, who brought the disease to this country.

Although AIDS seems to have arrived in the United States much earlier than the 1970s, it was only formally identified in 1982 when doctors were confronted with a previously unknown disease. Within five years after its formal identification, AIDS had spread rapidly. By that time over 40,000 Americans had been diagnosed with the disease, and fewer than half of those who had been diagnosed were still alive.

While getting accurate estimates of the number of people diagnosed with the disease is difficult, getting accurate estimates for the number infected with the HIV virus is even more difficult. In 1987 the Centers for Disease Control (CDC) estimated that 900,000 to 1.4 million Americans were infected with the HIV virus. Some experts believe that the CDC estimate is low and should be 10 to 50 percent higher.

Stages of AIDS

Physicians have identified three stages in the progression of AIDS. Stage one is the asymptomatic carrier stage. People in this stage are infected with the HIV virus but show no discernable signs or symptoms of AIDS. Unless they have had a blood test, these people may be unaware they have the disease. Nevertheless, these carriers can infect others with the virus even though they themselves do not manifest any visible sign of infection. Some people remain in this stage for a number of years.

The second stage is AIDS-Related Complex (ARC). Individuals begin to show some of the symptoms of HIV infection when they enter this stage of infectioin. Such symptoms include sudden unexplained weight loss, night sweating, diarrhea, swelling of the lymph nodes, neurologic disorders (memory loss, partial paralysis, or loss of coordination), and chronic fatigue.

The third stage is full-blown AIDS. This stage is characterized by opportunistic infections, which occur due to a deficiency of the person's immune system. A healthy immune system would normally protect against the damaging effects of these diseases, but the HIV impairs the normal immune protection system and allows these infections to weaken and eventually kill the infected person.

AIDS Transmission

The HIV virus is transmitted through the exchange of infected bodily fluids. Some 89 percent of persons known to have AIDS are homosexuals or intravenous drug users. Another 3 percent became infected through blood transfusions (most before blood banks began testing for the AIDS antibody), 1 percent are infants and children, and 3 percent are undetermined.

These figures leave 4 percent of known AIDS patients who became infected with the disease through heterosexual contact. Some health officials estimate that in the 1990s the number of AIDS cases resulting from heterosexual contact will increase to 6 percent, though this is still a matter of some debate in the medical community.

A more alarming statistic is that, based upon the 1986 Surgeon General's Report, we have at least 1.5 million carriers of the HIV virus in the United States. Most of these people do not know they are carriers and thus may unknowingly transmit the virus through sexual activity or intravenous drug use.

Although there is some disagreement about the number of modes by which the AIDS virus can be transmitted, there is near universal agreement that it can be transmitted in at least four major ways: sexual activity, intravenous drug use, blood transfusions, and perinatal infection, which occurs when an AIDS-infected mother passes the virus to her child during pregnancy, labor, or delivery.

The primary modes by which the HIV virus is spread are blood, semen, and vaginal secretions. The virus has also been found in other body fluids such as saliva, tears, breast milk, and urine. Yet there is scant evidence that AIDS is passed through casual contact. The Public Health Service has stated that no evidence exists to suggest that there is a risk of contracting the HIV virus from day-to-day social or family contact with someone who has AIDS.

An AIDS study reported in the New England Journal of Medicine in 1987 supported this conclusion. Doctors studied the nonsexual household contacts of patients with AIDS or ARC (AIDS-related complex). The study analyzed 101 people (68 children and 33 adults) who had contact with one of 39 AIDS patients for at least a three-month period. These subjects shared household items (razors, combs, towels, clothes, drinking glasses), facilities (bed, toilet, bath, kitchen), and washing items (dishes, bath) with the patients. Moreover, there was a measurable amount of social interaction (shaking hands, hugging, kissing) between the subjects and the patients. Yet the doctors found that only one out of the 101 subjects evidenced infection with the virus: a five-year-old who most likely acquired the virus perinatally.

The results of this study, however, do not mean that the AIDS virus can never be spread by casual contact. Dr. Jerome Groopman of Harvard and Dr. Robert Gallo of the National Cancer Institute reported in the British medical journal Lancet that saliva was the mode of transmission from a man with transfusion-acquired AIDS to his wife. And, in the same journal two years later, one documented case of non-sexual, within-family transmission of AIDS was reported.

AIDS Education

One important aspect of a comprehensive AIDS policy is education. Many in our society are ignorant of the facts and need more information. A study of young people in San Francisco revealed that 30 percent believed AIDS could be cured if treated early, and one-third did not know that AIDS cannot be transmitted merely by touching someone with AIDS.

Many AIDS activists, however, have seen education as the primary or even the sole means of fighting the AIDS epidemic. And while education is certainly important, information alone is not a sufficient means of fighting AIDS. Indeed, there are some serious concerns surrounding AIDS education.

One problem is that AIDS information is often dispensed in a so- called value neutral environment. Educators and counselors try to discuss AIDS and human sexuality in an amoral framework. But in attempting to be amoral, they often end up being immoral. Teaching the facts about subjects like condoms and homosexuality without teaching the moral values associated with them is tantamount to encouraging immorality.

A second concern about AIDS education is that it sometimes misrepresents the facts. Various medical and governmental reports, for example, have touted the condom as an effective means of reducing the risk of contracting AIDS. But while it is true that condoms reduce the risk of contracting AIDS, they by no means eliminate it.

Condoms used for contraceptive purposes fail about 10 percent of the time over the course of a year. Former Surgeon General C. Everett Koop warned of the "extraordinarily high" failure rate of condoms among homosexuals. And a study done at the University of Miami Medical School showed that 17 percent of women married to men with AIDS became infected within a year despite the use of condoms.

Third, AIDS education is frequently used to promote the homosexual lifestyle. While AIDS is not exclusively a gay disease, it has often been used by gay activists to promote acceptance of homosexuality. Although we should reach out to AIDS victims with compassion, we should not compromise the biblical teaching that homosexuality is unnatural (Rom. 1:26-27) and an abomination (Lev. 18:22).

Fourth and last, there is some question about the general effectiveness of AIDS education. While educating people about AIDS may provide them with the basic facts, we should not be so naive as to believe that information alone will necessarily change their behavior. If it did, then our country's massive anti-smoking education programs would have been followed by a precipitous drop in smoking and lung cancer, and the numerous venereal-disease education programs would have substantially reduced the number of sexually transmitted diseases.

The inadequacy of education became evident through a survey that asked students at the University of Maryland about their knowledge of AIDS and their subsequent sexual behavior. Seventy-seven percent said they knew condoms can be used to limit the risk of infection of AIDS, but only 30 percent reported increased use of condoms. Eighty-three percent of the male students who said they have homosexual relations said they had made no change in their behavior.

Why hasn't AIDS education been more effective? One reason is that people use selective perception to screen out most of the messages they receive. We do not, for example, pay much attention to lawnmower commercials unless we are in the market for a lawnmower. If people do not think they are at risk for AIDS, AIDS information may not get through their perceptual screens.

Compounding the problem of selective perception is emotional denial. High-risk groups often ignore messages they do not want to hear, and those at risk for AIDS are no exception.

Last and perhaps most important, human sin nature frequently keeps us from doing what is right and leads us to practice evil (Rom. 7:15-19). All have sinned (Rom. 3:23) and fall short of the glory of God, so we should not be surprised that people engage in dangerous sexual behavior even when they are armed with the facts.

AIDS Testing

AIDS testing is one of the more controversial aspects of a comprehensive AIDS policy. Although testing for AIDS has generally been endorsed as wise policy, there are still many who argue that education is the only weapon against AIDS and therefore reject attempts to expand AIDS testing.

These advocates of an "education-only" policy, however, ignore the educational value of testing. Public health officials estimate that only a small percentage of people who carry the HIV virus know they have it. Routine AIDS testing would compensate for the educational problems of selective perception and emotional denial by alerting AIDS carriers to their condition. They would then be able to receive additional information and counseling and to adjust their behavior to avoid infecting others.

Critics of AIDS testing say it is costly and unreliable. Both concerns are unwarranted. A single test is very inexpensive and certainly a worthy investment in order to alert those who unknowingly are carrying the AIDS virus.

The AIDS test is also very reliable, especially when multiple testing is used. Blood reacting positive to an ELISA test is tested two more times. If one or both of those tests are positive, the blood is then subjected to the Western Blot test. If that blood tests positive, another blood sample is taken and a second Western Blot test is administered to confirm the previous results. According to Dr. Fred Darr, medical director of American Red Cross Blood Services, "when a person is Western blot confirmed, that has a very, very, very high degree of reliability. It's like fingerprinting the [AIDS] antibody, and it's very, very specific. Reliability of the Western blot test is very high."

AIDS testing should not be seen as an impediment to education but rather an aid to education. Testing educates society by providing important epidemiological information about the development and spread of this disease, and it educates the individual by alerting him or her to the presence of the AIDS virus.

AIDS, Homosexuality, and the Bible

Although the Bible does not say anything about AIDS, it does address the issues of sexual promiscuity and homosexuality. When the Apostle Paul warned that "he who sins sexually sins against his own body" (1 Cor. 6:18), he was not warning against AIDS. But there are physical consequences (such as sexually transmitted diseases) to sexual promiscuity. When Paul, talking about homosexuality, said they "received in themselves the due penalty for their perversion" (Rom. 1:27), he was most likely talking about a spiritual penalty. Nevertheless, there are physical penalties to homosexual relations as well.

Gay activists constantly state that AIDS is "not just a gay disease," and that is true. But it is a disease that has struck a disproportionately large number of homosexuals and has been spread through homosexual and bisexual sex.

We cannot ignore the homosexual factor, but neither should we overemphasize it. In Africa, for example, AIDS affects men and women equally. Africans therefore perceive AIDS as a venereal disease rather than a homosexual disease.

Christians must respond to AIDS and homosexuality with both biblical convictions and biblical compassion. The Bible clearly teaches that homosexuality is an abomination to God (Lev. 18:22). It is not an alternative lifestyle. In fact, Scripture says that it is unnatural (Rom. 1:26-27). The Bible also warns that God will judge homosexuality (Gen. 19:12-26, Judg. 19:1-30, Lev. 20:13, Rom. 1:18-23, 1 Cor. 6:9-10, 1 Tim. 1:8-11).

We must also respond, however, with biblical compassion for those suffering with AIDS. Christ came into the world to save sinners (1 Tim. 1:15), including those caught up in the sin of homosexuality. Christ died for homosexuals and can by His grace deliver them from their practices (1 Cor. 6:11). They can become new creatures (2 Cor. 5:17) and break the bondage of sin in their lives.

Is AIDS a Judgment of God?

Some Christians have said that AIDS is a judgment from God on homosexuals. But if AIDS is indeed God's hand of judgment on homosexuals, it is certainly an indiscriminate one. AIDS strikes seemingly innocent children through blood transfusions and leaves lesbians (one of the lowest risk categories for contracting the disease) intact.

If AIDS is a judgment from God, it is a judgment in the sense that all disease is the result of God's judgment on this earth because of the Fall (Gen. 3). Sometimes God may directly judge sinful disobedience by striking a person with a disease. Cotton Mather taught, for example, that "sickness is in fact the whip of God for the sins of many." But, more often, diseases such as AIDS are the logical consequences of disobedience to God's Word.

AIDS, like a host of other sexually transmitted diseases (STDs), is the logical consequence of sinful behavior. All of these STDs (herpes, syphilis, chlamydia, gonorrhea) are the natural consequences of sexual disobedience. In the case of AIDS, homosexual promiscuity is the triggering mechanism; homosexual sex is the sowing that lead to the reaping of AIDS.

As Christians we must respond with both conviction and compassion to AIDS victims. These are the two points we should keep in mind as we develop a balanced response to the AIDS epidemic.