Subject: Warning about Oral HIV Testing effects on Prevention
From: [email-masked]
Date: Sat, 5 Jul 1997 13:20:44 -0400 (EDT)

AIDS activists unsure about Orasure
Are the AIDS  Industrialists  spreading ignorance in a mad dash to gain
revenue?

by Wayne Turner and Steve Michael
ACT UP Washington

 Ten years after ACT UP launched its HIV prevention campaign "Kissing Doesn't
Kill," the advent of oral HIV antibody testing threatens to undermine the
best efforts of AIDS educators.  The oral HIV test sends a dangerous message
at a time when ignorance and fear surrounding AIDS are still widespread:
 that HIV can be casually transmitted.  
 Prevention activists have for more than a decade highlighted the highest
risk activities responsible for most new HIV infections:  needle sharing and
sexual intercourse without latex condoms and water-based lubricants.  The
introduction of oral HIV antibody testing has forever altered AIDS education
and prevention.  

 Safe Sex guidelines issued by the US Centers for Disease Control and
Prevention contrast activities based upon relative risk.  Non-penetrative
forms of intimacy, such as kissing, or even 'deep kissing' only pose a
theoretical danger of HIV transmission.  Oral sex with a condom is safer than
oral sex without a condom.  And only a handful of cases have ever been
documented tracing HIV infection to oral sex with ejaculation.  Front-line
outreach workers increasingly encounter clients who are confused by oral HIV
testing, led to believe that kissing and oral sex are high risk activities.
 Such persons could be less inclined to use condoms or sterile needles if
they view HIV infection as inevitable.

 To date, there have been no formal studies examining the perception of
relative risk and behavioral changes that result from oral HIV testing.
 Several large AIDS service organizations have recently adopted oral HIV
testing without considering its ramifications.

 Pharmaceutical giant Smith-Kline Beechum, which produces the test under the
brand name Orasure, has embarked on an aggressive, multi-million dollar
marketing campaign to promote its product.  Here in Washington DC, for
example, the Whitman-Walker Clinic entered into a marketing deal with
Smith-Kline for a reported half million dollars.  Yet nowhere in the glossy
ad campaign do Smith-Kline, or Clinic spokesmodels emphasize that the HIV
transmission risks posed by oral sex or kissing are low to non-existent.  

Even NAPWA has been compromised...

 Even the National Association of People with AIDS has been compromised.
 NAPWA's recent National HIV Testing Day, financed by Smith-Kline Beechum,
highlighted Orasure in promotional materials mailed to service providers
throughout the country.

 AIDS services providers have been turned into sales representatives for oral
HIV testing without asking questions regarding Orasure's implications around
prevention.   Smith-Kline Beechum has effectively silenced the debate
surrounding Orasure.  Meanwhile, the real work of preventing new HIV
infections among increasing at-risk populations, is being ignored. 

 HIV testing has increasingly been used as the primary means of HIV
prevention, under a steady stream of dollars flowing to service providers
from the Centers of Disease Control and Prevention.  HIV testing has turned
into the cash cow for the AIDS Industrial Complex, with plenty of indirect
costs for overhead and infrastructure.  In addition, higher rates of
sero-positivity guarantee increases in federal formula dollars for AIDS
services.

 In most large US cities, bowls of free condoms and lubricants have all but
vanished from Gay bars, schools, shelters, and other distribution venues.
 Most big city AIDS organizations have scaled back, or abandoned these
efforts in favor of programs that can accurately document the number of
clients served in time for the next CDC grant cycle. 

 HIV prevention educators face a formidable challenge presenting a great deal
of complicated information in a simple, easy to understand format.  By
centering HIV prevention efforts around testing, educators have a captive
audience.  However, for many anxious testing clients, their attention is
focused on one thing, the results.  The only lasting impression regarding HIV
transmission comes from the process of drawing a blood sample as it relates
to needle sharing, and leaving a clinic with a handful of condoms.   

 Despite the efforts of activists and health educators over the past ten
years, many of the myths about AIDS are still pervasive.  The saliva of a
person with HIV is considered a deadly weapon in many jurisdictions.  The New
York Times featured a case several years ago in which an HIV+ prison inmate
in Texas spat on a guard six weeks before he was scheduled to be released.
 Although the guard remains uninfected, the inmate was convicted of attempted
murder.  In Washington DC, emergency medical personnel refused to touch a Gay
bashing victim who was perceived to be HIV positive.  Posters advertising a
recent blood drive at the Metropolitan Police Department in Washington
emphasized that you can't 'get AIDS' from donating blood.  Pioneer Gay
activist Quentin Crisp, who wrote The Naked Civil Servant, stated in an
interview in the current issue of Arts and Understanding magazine that he
believes that HIV can be transmitted through air.

 Peer-led, culturally competent prevention campaigns targeting the African
American community are beginning to counter the legacy of mistrust of the
medical establishment as a result of the Tuskeegee syphilis experiments.  In
some communities, educators are still confounded by the view that AIDS is a
conspiracy, and that condoms and cleans needles are actually tainted with
HIV.  Arguably, oral HIV testing only aggravates suspicion and mistrust.
 AIDS educators must now work twice as hard to convince clients that kissing
and oral sex are relatively safe, and that unprotected intercourse, and
needle sharing remain the highest risk activities for HIV transmission.  

 Millions of dollars from Smith-Kline Beechum have effectively bought the
silence of large AIDS organizations...

 No data currently exists, and no studies have been planned to address these
concerns.  Millions of dollars from Smith-Kline Beechum have effectively
bought the silence of large AIDS organizations.  Nevertheless, activists are
urging the US Centers of Disease Control and Prevention to study the
behavioral implications of oral HIV testing.  

 The second decade of the epidemic has turned into the era of the AIDS
Industrial Complex, in which bureaucracies have become self-perpetuating, and
where the guiding force behind health policy is the generation of revenue.
 HIV infection rates continue to rise as prevention resources are devoted to
salaries, overhead, conferences, and travel expenses.  Kissing Doesn't Kill.
 Ignorance and greed do.

for more information contact
ACT UP Washington at 202.547.9404