Miami Herald (MH) - Thursday, November 21, 1996 Edition: Final Section: Front Page: 1A Word Count: 763
Stephen Smith, Herald Health Writer

TEXT: The AIDS virus has cut a devastatingly broad swath across South Beach, infecting nearly two of every five older gay and bisexual men, disease trackers reported Wednesday.

For the first time, epidemiologists have taken the full measure of AIDS' march in South Beach, epicenter of the region's gay community. Even among men under 30 -- who reached sexual maturity in the age of AIDS -- the virus has proved rapacious, with nearly one in six carrying HIV.

The Florida International University study, led by renowned AIDS expert William Darrow, also uncovered an irony: Revelations about the promise of new drug cocktails seem to be fostering complacency toward the virus among some men, luring them back to risky sexual behavior.

"We've got a terrible problem here and not much is being done about it," said Darrow, who gained fame as part of the vanguard that tracked down the virus in the early 1980s.

"We know that these men know about AIDS, they know how to protect themselves, they know condoms are effective, and yet they find themselves in situations where they are engaging in unsafe sex."

In fact, the FIU survey reports that 79 percent of the men over 29 engaged in unprotected anal intercourse at least once in the preceding year, a rate only slightly higher than the level for younger men, 72 percent.

The study, unveiled in New York at the the American Public Health Association's yearly meeting, came as little surprise to Ivan Bernstein, who has lived in South Beach for six years -- and who marvels that a community so profoundly affected by the virus can remain so immune to prevention messages. "The denial is so great, it's sometimes like a massive concussion," said Bernstein, who has AIDS. "In the movie Jaws , when they found out that there was a shark in the water, they tried not to highlight it so that it wouldn't scare off the tourists.

"I like to call AIDS in South Beach our shark in the water."

In young men, researchers speculate, risky sexual behavior could be stoked by feelings of invincibility. Older men may be fatalistic, believing the virus will get them one way or another.

Emotions, not reason

Among some men, Darrow suggests, unprotected anal sex is viewed as an ultimate expression of affection and affirmation -- evidence that a life-or-death decision can turn on emotions more than rational reasoning.

And the FIU study may be a reflection of its milieu, another AIDS researcher suggests. "We have a culture on South Beach centered around bars and beauty and narcissism," said Al Bay of Health Crisis Network. "This is hardly a culture that encourages a norm of safe sex." Through October, the FIU researchers conducted detailed interviews with 157 men.

The level of AIDS infection mirrors findings in other urban neighborhoods with large gay communities. "In terms of a continuous presence and concern for the problem, I just don't see it in South Beach," Darrow said.

Neither does Bernstein or Bay.

That's why they're both engaged in campaigns to let men know AIDS still lurks as a formidable enemy. Health Crisis Network is tacking AIDS education boards above urinals at nightclubs, gyms and restaurants.

A group that Bernstein is involved with, the AIDS Prevention Task Force, will start distributing a pamphlet Friday that discusses oral sex as an alternative to riskier behaviors.

Dangerous wave of hope

The need to educate is just as acute today as it was at the dawn of the epidemic, because the introduction of powerful new drugs has engendered a wave of hope that is transforming the way people think about AIDS.

"Perhaps people are saying, `So what if I do become HIV infected? We can treat it to so much better that I will live a lot longer, and my life span will be the same as anyone else's,' " said Dr. Karl Goodkin, an expert in psychiatry and neurology at the University of Miami medical school.

The FIU study proved the point: In July, Darrow and his associates, reporting the first phase of their study, showed that 85 percent of the men interviewed viewed AIDS as a fatal disease. As the study expanded in the following months, AIDS came to be seen as a gentler disease, with 76 percent agreeing that there is no cure for AIDS.

"Even as we're celebrating our friends' new health, we have to stress: This is something you do not want in your life," Bay said. "It's still a horrifying disease we can't cure."

CAPTION: color photo: William Darrow (a-Ran in Broward)

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