The New York Times - November 7, 1986

Some experts fear it is, but so far the evidence for breakout is far from conclusive. AIDS is not easily acquired and does not spread through casual contact. The virus is principally transmitted among homosexuals by anal intercourse and among drug addicts by sharing needles.

The AIDS virus can also be transmitted, much less efficiently, in vaginal intercourse. Many of the regular sexual partners of drug addicts with AIDS show signs of exposure to the virus. But the likelihood of transmission in a single sexual encounter seems small. In vaginal transmission, the virus seems to pass more easily from men to women than women to men. That suggests AIDS will not spread along a chain of people as rampantly as other venereal diseases.

So far at least, heterosexually transmitted AIDS cases reported in this country remain a tiny percentage of the total. Most are partners of drug addicts or bisexuals. In New York, 156 people, about 2 percent of AIDS victims, contracted the disease heterosexually. Only two of them were men. Why then in Central Africa do men and women suffer in equal numbers from AIDS? One explanation is widespread medical use of unsterilized needles; another is the wider prevalence of sexually transmitted diseases, whose sores may give the virus access to the bloodstream. If so, there is no reason for the African pattern to be repeated in the United States. Others fear that Africa differs only in being ahead of America. Five years may elapse between contracting the virus and coming down with the disease; Federal tallies of AIDS patients are way behind the real progression of the epidemic. A committee of the National Academy of Sciences warned last week of "substantially more" AIDS virus infections among heterosexuals in the next 5 to 10 years, particularly among "the population at risk for other sexually transmitted diseases."

There's little evidence of such spread so far. As Erik Eckholm reported recently in The Times, some 257 of the 331,000 blood donors in New York last year carried the virus. Of those, 90 percent had previous homosexual or drug experience or a partner who did. It's alarming that more than 1 percent of recent military recruits from New York were rejected because of exposure to the AIDS virus. But among those who sought counseling, the known risk factors were present in the usual proportions.

Even if AIDS stays confined to the present risk groups, there's a strong case for educating everyone how to guard against the virus - essentially by using condoms and by avoiding anal intercourse and unclean needles. But crash programs can be overzealous, like the swine flu vaccination program against an epidemic that never arrived.

With the homosexual community acting to educate and protect itself, the prime target for preventive efforts remains intravenous drug addicts. There is no proof yet that the general public is equally at risk. To prevent further spread of AIDS, the smartest thing to do now is to resist exaggerated fears of heterosexual transmission - and to fund more drug treatment programs.

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