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AIDS: A day with a global killer

Uganda - With just hours to live, Dominic Mwanje lies inside his home in Uganda. At 1:30 in the morning, he died, a victim - like his wife and two of his brothers - of what his town calls "the Slim Disease."
Uganda - With just hours to live, Dominic Mwanje lies inside his home in Uganda. At 1:30 in the morning, he died, a victim - like his wife and two of his brothers - of what his town calls "the Slim Disease." J KYLE KEENER / Staff Photographer, file
Uganda - With just hours to live, Dominic Mwanje lies inside his home in Uganda. At 1:30 in the morning, he died, a victim - like his wife and two of his brothers - of what his town calls "the Slim Disease." Gallery: AIDS: A day with a global killer

This article was originally published on Oct. 22, 1987.

It has circled the globe. It has spread farther, faster than any plague in history.

Yesterday, teams of Inquirer reporters and photographers around the world recorded its impact - the toll it takes on whole communities, its power to reshape social behavior, its resistance to every effort to control it.

Their reports give a view of humanity's most frightful disease, on a global scale and in the compass of a single day.

It was dawn yesterday when the clan began digging Dominic Mwanje's grave. He had stopped breathing at 1:30 a.m., on a mat on the floor of his yellow cement house in Kyotera, a town in southwest Uganda. He was 38. He weighed 75 pounds. He had AIDS.

"This is not the end of it," said Mwanje's brother, Vincent, of the epidemic his tribe calls "the Slim Disease." "This Slim," he said, "is spreading like a curse."

He was right.

AIDS is almost everywhere now.

It has moved across Africa, up and down the Americas, across Europe. It is knocking at the doors of Asia. It is menacing the entire globe.

Other epidemics have caused more deaths - so far. But AIDS is different. It is unlike anything the human species has faced before. No other plague has spread so far so fast, or stirred such frantic worldwide reaction.

One way to grasp the magnitude of AIDS is to look at a single day in this global epidemic. Yesterday.

In San Jose, Calif., a funeral home mailed back the cremated remains of a young man who had gone west from Columbus, Ohio, eight years ago to live a freer life and to establish a career as a theater producer.

In Paris, a graduate student spent the day studying a new type of AIDS virus that could lead to a second wave of infections.

In Brooklyn, the infant twins of an AIDS victim lay in a hospital nursery, as they have for the last five months, because they had been abandoned by their mother.

In Newark, 70 people worked feverishly in a dusty factory assembly line to keep up with the demand for condoms.

In Atlanta and Geneva, public health officials compiled the latest tally of victims.

By day's end, the count in the six-year-old AIDS epidemic had passed 62,000 stricken, 35,000 dead.

And by nightfall yesterday, in the Philippines, in Bangkok, in Newark, in New York and in Philadelphia, the AIDS virus was claiming new victims. Prostitutes took to the streets to sell their bodies, drug addicts shared needles, and gay men sought out strangers in bathhouses to have sex.

This is a story about a single day in the AIDS epidemic.

It begins at midnight, Philadelphia time.

In Kyotera, it was already dawn.

The crunch of the clansmen's picks and the shrill cries of the mourning women at Mwanje's deathbed foretold more deaths to come. Kyotera has become a killing ground of AIDS.

The Engo clan (whose name means leopard in the Laganda language) has lost count of the number of their people who have died of the Slim Disease, as AIDS is known in Kyotera because of the emaciation it causes.

Mwanje was the fourth in his immediate family to die, following his wife and two brothers to the graveyard in the banana grove beside his house.

Since Uganda's first victim died of AIDS in Kyotera in 1982, more than

2,000 of the town's 30,000 residents have succumbed to the epidemic. This unofficial count is kept by Badru Rashid, an elected town official who documents the death toll by collecting photos of the victims. Among them are two of his own brothers.

The incidence of AIDS in Kyotera is among the highest of any small city in the world. Health officials say the virus was brought to the town by Tanzanian traders who consorted with the prostitutes in Kyotera's ramshackle bars.

Dominic Mwanje, the town's latest victim, was, in his prime, a tall, vigorous man, the manager of a coffee-processing plant. He had been ill for more than a year. For the last five months of his life he was bedridden, eventually becoming emaciated, sucked dry by chronic diarrhea.

By Tuesday evening, as Mwanje lay dying on his mat, it was difficult for him to speak. Because of the raw sores inside his mouth and throat, he managed only a whisper.

And then yesterday, as the first streaks of orange light shone through the tiny window of the Mwanje homestead, Dominic Mwanje's brothers and cousins arrived with picks and shovels to tear open the ground for his grave.

The number of fatal cases in Africa doubles every four to six months - twice as fast as in the United States.

If AIDS ever hits the rest of the world the way it is hitting this part of Africa, the consequences will be hard to imagine.

One hundred miles to the north of Kyotera, in Uganda's capital city of Kampala, 10 percent of the sexually active population - 16,000 adults - are thought to be infected with AIDS. Twenty-four percent of the pregnant women tested in one Kampala clinic tested positive. So did 30 percent of Ugandan troops stationed in the northeastern section of the country.

International health experts estimate that more than 50,000 Africans have the disease, though the official count is only 6,000. Add to that two million people who are infected but have not yet shown symptoms of illness.

If these estimates by the World Health Organization hold up, they mean that Africa, with one-tenth of the world's people, has at least one-fifth of the world's 10 million AIDS infections.

Paris

A small step toward a vaccine

Mireilla Guyader had never heard of Dominic Mwanje as she walked through the wrought-iron gates of the Pasteur Institute yesterday morning, thinking about the puzzle awaiting her at work.

Unraveling that puzzle is the basic work of molecular biologists like Guyader - work that someday could save Dominic Mwanje's brother Vincent, or perhaps a younger nephew.

Pasteur is one of the world's leading AIDS research facilities, and piece by piece, Guyader, a graduate student, and her colleagues are disassembling a virus called HIV-2, trying to understand how each part works.

HIV-2 is a mass murderer, one of five related viruses known to cause AIDS in human beings.

This one is the most lethal AIDS virus in West Africa, and it is branching out. It hasn't yet reached the United States, where HIV-1 is the only AIDS virus. But it has reached Europe, and scientists are certain it will spread to North America. They fear it could cause a second wave of the plague.

"We don't know exactly how the virus causes disease," said Pierre Sonigo, a young molecular biologist at Pasteur. "But if we can learn what part of the virus does what, perhaps we can find a drug to fight it."

There are nine genes in HIV-2, and Guyader's work is to help determine what role each gene plays in infecting humans and disabling their immune systems.

Scientists at Pasteur have already cloned the genes of HIV-2, giving them a supply to use in experiments. And on Tuesday, Guyader had chemically altered a few specimens of the "X" gene so it would not function normally. Scientists at Pasteur call it "X" because they have no idea what it does.

Guyader's goal is to discern how the HIV-2 virus will function if it has a chemically altered "X" gene. This will help them understand what the "X" gene does.

So yesterday morning, Guyader, 23, wearing a white lab coat over her jeans and light green turtleneck sweater, walked briskly to what is known as the ''warm room." The room is heated to 98.6 degrees, the temperature of the human body, creating the ideal climate for bacteria to multiply.

From the warm room, she took a dozen petri dishes filled with the altered genes mixed in a bacteria solution, and took them to her laboratory.

She placed the petri dishes on a formica counter, and, one by one, held them to the light to see whether the genes had begun replicating themselves.

If the experiment worked, Guyader would know at a glance. Colonies of the bacteria would be visible on the petri dishes as small scattered dots. This would mean she had reproduced the chemically altered "X" gene, the first step in ultimately producing a virus with that defective gene.

A smile played at her lips. It had worked.

Another small, small step in the war against AIDS had been taken.

Nobody yet knows how many more will be needed.

Philadelphia

Safer sex in a bathhouse

At the Chancellor Athletic Club, Philadelphia's premier gay bathhouse, up to 100 men used to writhe together in the "orgy room." But the orgy room is now an exercise room, and the gays who used to have sex with as many as 30 partners a night don't do that anymore.

At 3:30 yesterday morning, while some men lay sleeping and others posed on their beds with towels draped over their crotches, Carlos Calvo, 22, was in his second-floor room, running his fingers through wavy dark locks and sweeping them behind his ears. His dark eyes appeared made up, though he said they were not. Smoke from his cigarette drifted from his lips and curled around his one dangling earring.

A visitor to the baths since he was 16, he said the scene used to be more freewheeling and fun, before AIDS.

"In the old days, at worst you got a penicillin shot. Now it's like playing with your life," he said. "You have to be more careful or you just won't be around."

In the hall, a tall, slender, youthful man padded around the second floor of the athletic club in a jockstrap. The doors to some of the rooms were ajar, and he peeked inside one cubicle and then another, trying to discern something about the occupants in the rheostat-dimmed light.

"Do you want company?" he finally asked one.

"Sure," a voice from the darkness replied.

Then came the sound of kissing and rubbing, a discussion about pinching, and a few moments later, the sound of light slaps.

Some of these men say they still engage in anal sex, a practice that the surgeon general considers dangerous even with condoms, because the condoms can

break. But in general, the men are more careful now.

At the Club Philadelphia baths, around the corner from the Chancellor, George Alger Steubben, 55, a chef from Washington, sat in a chair underneath a poster promoting condoms. He comes to Philadelphia about once a week, because the nation's capital has no bathhouses. "If I didn't feel safe here," Steubben said, "I wouldn't be driving 250 miles."

Club Philadelphia was quiet now. The carpeted, four-tiered, mattress- covered platform known as Bare Mountain, where groups sometimes congregate for sex, was deserted except for one fully clothed guy watching TV.

The basement dormitory that has been the scene of orgies - and is nicknamed the Helen Keller Memorial Chapel because of its total darkness - was empty.

Moscow

No 'Glasnost' on AIDS

Alexander and Stanislav were finishing off a bottle of sweet champagne in the upper hall of Cafe Sadko.

"Personally, I don't believe that all these people are ill with AIDS," said Alexander. "I heard there are over 100 cases. I believe that only six people are really ill."

Stanislav protested. "They gave the figures on the radio," he said.

"I don't care," responded Alexander. "This is what I believe."

It might have been just another cafe chat about AIDS. Except that this cafe was at No. 5 Pushkin St., a few hundred yards from the Kremlin.

Homosexuality is a crime in the Soviet Union. In practice, the law is

rarely enforced. Mostly the militsia, or police, merely harass suspected gays, known as goluboi, or "blues," because of a Soviet perception that homosexuals consider themselves part of a superior race, blue of blood.

Gays are reluctant to come forward for testing, and even in a more open Soviet society - last March was the first time AIDS or homosexuality was openly discussed in the Soviet press - safe sex is defined by choice of partner, not prophylactic.

Official Soviet figures cite 165 diagnosed cases of AIDS, all but 23 involving foreigners. Avoid foreigners and avoid problems, the message appears to say.

"Blues" often congregate in Sverdlov Square in front of the Bolshoi Theater. Or the Metro station on Karl Marx Avenue. Because of the apartment shortage and the existence of many communal, multifamily flats, where to be gay is more of a problem than with whom.

Inside the Sadko, Stanislav and Alexander were in a room designed to look like the reception hall of an old Russian mansion. One wall was covered with a mosaic depicting St. Nicholas.

Both men are artists in their 40s. Stanislav does drawings from photographs. He was dressed in charcoal pants, a black sweater over a black turtleneck and a well-worn black leather sportcoat. He had a full black beard and a heavy mane of gray-black hair swept back from a low brow.

"This is a closed society," he said, lighting a smelly Kosmos cigarette. ''AIDS is a problem everywhere. But it is closed here."

"I'm not having anything to do with foreigners," said Alexander, getting drunk. He was wearing jeans and a sweater. His florid face was etched with a bristly Fu Manchu moustache. "You aren't either," he added.

Stanislav was solemn: "There is an iron gate in this country. The disease is trying to get in. But we have an iron gate across the border."

"I don't want to discuss it. I don't want to think about it. Do you?"

"No."

"Let's go drink vodka," said Alexander, pulling on a ski jacket. They left.

Newark

Prostitutes and drug abusers

Monique now makes all her tricks wear condoms. Even for oral sex.

Early yesterday morning, just south of the downtown business district, she strutted in front of a Chinese restaurant. She was clad in hot-pink, skin- tight jeans, a pink sweatshirt and a black jacket.

A gleaming red Corvette pulled up to the curb.

"You want a date?" Monique asked.

"Yeah," said the man, and gestured that he wanted oral sex.

"Thirty dollars," Monique said, sliding into the car.

Although Monique herself had not been tested for the AIDS virus, she was certainly a prime candidate. According to a Centers for Disease Control study announced this spring, Newark's prostitutes have a higher rate of AIDS infection than those of any other city in the United States - 57 percent.

Despite their high infection rate, Monique and her colleagues have no trouble getting customers. Each night, Monique says, she services at least 10 men and takes in a minimum of $400.

Not far from where Monique had been working, Pat was making her way toward a brown house on Pennsylvania Avenue, her reed-thin legs straining against her white minidress.

After several hours of turning tricks - performing oral sex and other acts for $20 and up - Pat was ready to do a different kind of business. She was ready to pay for a much needed fix. Minutes later, Pat emerged from the brown house, carrying cocaine and a needle and looking for a place to get high.

Like many of her colleagues, Pat works as a prostitute to support her drug habit. It is the drug-addicted prostitutes, health officials say, who are most likely to be infected with the AIDS virus, because they often share needles with other drug users. It is just such women as these, health officials say, who are most likely to spread AIDS into the wider, non-drug-using heterosexual population.

Pat does not worry about such matters. Sometimes she insists that men wear condoms. Other times, when she runs out of them, she doesn't.

Besides, Pat has other things to worry about.

She is five months pregnant.

Brooklyn

The littlest victims

At 7:37 a.m., Baby A circumnavigated his crib in an awkward crawl. His mouth formed a wondrous W. He clutched a corner of his Winnie-the-Pooh crib pad and considered the polka-dotted dog hanging from an IV pole overhead.

He and his twin sister, Baby B, had awakened before daylight, hungry as usual, and anonymous still. Two innocents orphaned to the plague.

"When a baby is born, he's supposed to go home," said nurse Betty Blair, sadly, as she bathed one of the alphabet twins.

For more than five months, ever since their birth to a 34-year-old intravenous drug abuser infected with AIDS, the alphabet babies have been abandoned to the confinement of a drab room full of metal-frame cribs and

incessant cries - the Kings County Hospital nursery.

The twins may have the AIDS virus; they may not. It will be several months to a year before tests prove it either way. Doctors must wait that long before they can accurately measure an infant's response to such an infection.

Without knowing, no foster home has been willing to care for them.

They have never been outside the hospital. Behind the grimy windows, in Room B7103, the days fade into monotony: Feeding. Diaper change. Sleep. And, of course, fear. Is this cold just an infant's sniffle? Or might it be a first sign of the disease?

So far, AIDS has struck at least 500 children under 5 in the United States. Most, like Babies A and B, are infants born to infected mothers. There likely will be more. Fifty thousand women in New York City - 3 percent of all the city's women of childbearing age - are unknowingly infected. Many, perhaps most, eventually will develop the fatal form of the disease. In the meantime, many of them will give birth to doomed babies.

"They're all cute," said a hospital neonatalogist, Dr. Leonard Glass. ''And God knows, some of them will get damn sick. And some of them will be dead."

It may be impossible to keep professional distance from an innocent. One doctor long ago lost all pretense with Babies A and B. To Kathy Irish, they are Michael and Michelle, Mickey and Shelly.

Yesterday, as always, she ignored the blue card taped on each crib, warning that gloves and gowns should be used when changing diapers or feeding.

"Oh my goodness, Shelly, this is it," she cooed as B squirmed in her lap. ''This is good. You're picking your head up. Come on Shelly, pick your head up."

She left them to sleep, eat, be changed. She would be back. These are Dr. Irish's medical instructions to the nurses: "Hold daily."

Rio de Janeiro

The flamboyant tradition

It was just after lunchtime yesterday when the flamboyant transvestite prostitute known as Duda told his friend Luis that Cicero the hairdresser was dead. "Only 22 and dead of AIDS. He went at 11 o'clock this morning," said Duda, stirring the fragrant stew he'd made for lunch in his one-room apartment in Rio's gay district.

To tell the truth, Duda, 36, whose given name is Adao Eduardo, was not particularly broken up about it. "After all, who among us escapes death?" Duda shrugged. "If I die of AIDS, I want to be laid out dressed up like Carmen Miranda."

Duda's carefree attitude toward AIDS illustrates the problems health officials face in a country where sexual abandon is a proud tradition, proudly exhibited. This is, after all, the country where tens of thousands of people

from all over the world dance nearly naked in the streets each February, during Carnival, literally "a feast of the flesh."

The country has 2,013 cases of the disease, twice the number of all the other countries in South America, Central America and Mexico combined. More than 80 percent of Brazil's cases were sexually transmitted.

The prevalence of transvestite prostitutes compounds the problems of curbing the epidemic. Many of Duda's customers, for example, are married men who could transmit the virus - if Duda became infected - to their wives. ''I've had fathers and sons together," Duda boasted to Luis yesterday, while tossing his bobbed blond hair and jangling the three silver bracelets on his left wrist.

For this luncheon, Duda, who is svelte as a mannequin, was wearing tight jeans and a denim jacket. He keeps his business clothes - wigs, high-heels, pretty dresses - in a prostitute hotel nearby.

Duda said that the reason so many married men like transvestites has a lot to do with "Brazilian machismo."

"There are men who are homosexual but who must marry and father sons

because their parents insist on it. They enjoy having sex with a man and being the passive partner. But they can't go to the corner and pick up a boy prostitute. Oh, no, that wouldn't be macho. So they come to a transvestite, and everyone pretends it's a woman, and then it's acceptable.

"Of course, when they go home they still have sex with their wives," said Duda, pouring some beer for Luis. "But it isn't enough for them. As the saying goes, my dear, 'You can't get champagne from a cow.' "

During his business encounters Duda never wears camisansas - the Brazilian slang for condoms (literally "little shirts"). "I don't like them, and

neither do my customers," he says, pursing his lips and tossing his hair.

Luis, on the other hand, is afraid of AIDS and is very careful. He and his lover - an older man who is a teacher - are committed to each other. Both have tested negative for AIDS. Luis' last affair was a long-term liaison with a married man who had two children.

Luis read in the paper yesterday that the Health Ministry estimates there are close to 360,000 Brazilians infected with the AIDS virus who have not yet shown any symptoms of the disease.

While Luis worries, Duda couldn't care less.

"Gays never die, my dear," he says to Luis with a wink.

"They come back as gold powder to cover the bodies of the samba dancers at Carnival."

Grand Forks, N.D.

Feeling safe, for now

In the student union of the University of North Dakota yesterday, a young couple sat at a table arrayed with condoms stapled to AIDS literature.

But there was a bigger crowd around a sorority pumpkin sale across the aisle; for every student who stopped to learn more about AIDS, 20 walked past with barely a glance.

Even many who took away condoms didn't seem anxious; AIDS has claimed only seven victims in this state of 700,000 people. That is fewer cases than in any other state.

"It's easy for AIDS to seem remote, sitting in North Dakota," said Ken Miller, 24, a senior studying psychology. "We're kind of cut off from the rest of the world. You can still go and pick somebody up at a bar and not have to worry."

Miller never uses condoms, and sees no need to as long as he stays within what he has defined as an AIDS-free "safe zone" - essentially, the Farm Belt, between the Rocky Mountains and the Mississippi River. "When I graduate, I plan to move outside of the safe zone," he said. "You can bet I'll use condoms there."

Mike and Amy Mohn were fretting yesterday as they planned dinner with a gay friend.

"I get nervous when I shake his hand," said Mike, 24. "And when we go to Pizza Hut, I won't dip my breadsticks in the sauce after he does."

The fear of AIDS has prompted them to quit drinking from the common wine cup at church, and from public water fountains. And it will keep the young couple from job-hunting after graduation in cities such as San Francisco and New York. They simply feel safer here.

"We want to stay in the Midwest," said Amy, 21. "We'll stick with the cold, and away from AIDS."

Maryanne Lustgraaf, the student union director and a member of a task force that wrote a policy banning discrimination against AIDS victims at the university, thinks students are naive in their sense of security.

"It hasn't hit home here," she said. "It will. It's not a matter of if a case shows up here; it's a matter of when."

Across town in a Ramada Inn meeting room yesterday, 25 area personnel administrators shuddered as state AIDS coordinator Eileen Doctor showed them graphic slides of the cancerous purple blotches that are emblems of Kaposi's sarcoma, one of the leading causes of death for AIDS victims. She warned them that eventually, they probably would have to confront homophobia, union demands for quarantines, even mass resignations and work stoppages the first time an employee gets AIDS.

Within four years, the state's seven cases should increase more than tenfold, she predicted.

"By 1991, we anticipate that everyone in North Dakota will know someone or be related to someone who has AIDS or has died of AIDS.

"Our young people are leaving the state, and many of them are getting AIDS. They're coming home to die."

Washington

The legislative battleground

By 9 a.m., the AIDS issue was awakening to another day of politics.

Henry A. Waxman (D., Calif.), who represents posh liberal enclaves north of Los Angeles, was in his office assessing the latest damage report.

On Tuesday, the House voted 368-47 to bar the use of federal money for programs that might promote homosexuality. That, Waxman feared, could be used to stop funding of publicity about safe homosexual sex.

On top of that, Waxman's own AIDS bill was in trouble. He had hoped to have it approved by the health subcommittee he chairs, but votes were evaporating and he was about to postpone the meeting for a third time.

The bill would finance confidential AIDS testing and counseling and prohibit discrimination against AIDS victims.

The legislative battleground over AIDS is largely indirect. Faced with an anxious electorate, federal and state politicians are rushing to pass legislation even though little can be done against a disease that can neither be treated nor prevented with vaccines. So, much of the legislation deals with AIDS testing.

Two states - Illinois and Louisiana - require testing of all marriage applicants. AIDS experts doubt that such measures will do much to contain the epidemic. Researchers from the Harvard School of Public Health said in a recent study that public health would be much better served and at much less cost with more AIDS education programs.

The Harvard researchers estimated that it would cost $100 million a year to test the 3.8 million people who get married each year and that this would

serve little purpose because premarital sex is commonplace now and 63 percent of babies are born out of wedlock.

The budget for the Public Health Service, which is leading the federal government's AIDS effort, has jumped from $5.5 million in 1982 to $494 million this year. The PHS has requested $790.9 million for 1988.

While Waxman was lamenting his situation, next door in the Longworth Building, Rep. William E. Dannemeyer (R., Calif.), from conservative Orange County, plotted a counterstrategy. Dannemeyer, a tall, rangy man who is known approvingly among the religious right as "Dynamiter" for his penchant for confrontation, had a goal: Lobby colleagues to stop Waxman's bill.

"Are we going to say to the people of America that it is their duty to work side-by-side with people with AIDS?" Dannemeyer said. "I don't think that the members . . . of the House want to tell (voters) that they gave people with a communicable disease, that is incurable, the rights of anti-discrimination laws."

The subcommittee meeting was described by Dannemeyer's aide Paul Mero as ''High Noon."

But by midday, the faceoff was once more a standoff. The great AIDS debate had been postponed again.

Atlanta

Tracking the statistics

At 10:33 a.m. Dr. Timothy J. Dondero convened his biweekly meeting to stalk the beast.

Ten of Dondero's key assistants on the AIDS Surveillance and Evaluation Branch at the Centers for Disease Control gathered around a conference table.

These are the people responsible for tracking the AIDS epidemic - of determining the number of cases, the number of deaths, the modes of transmission, of learning who is getting the disease and where.

They discussed a White House memo about moving ahead with the continuing surveillance studies. President Reagan has approved a recommendation to conduct "a family of surveys to monitor the dynamics of HIV infection, including the rate of spread." It will mean a hectic six weeks for Dondero's branch. A progress report is to be filed by Nov. 30.

And then Dondero fielded questions, mostly about money and staffing, and then reviewed statistics.

The toll of AIDS victims in the United States had reached 42,370; more than half the victims were dead. On a per-capita basis, the United States has up to 10 times as many cases as countries in Europe.

Infection rates among gays have slowed, but cases among heterosexuals and intravenous drug users are going up slightly.

And the figures show that the epidemic is continuing to spread out from such high-risk areas as New York and San Francisco to other regions that until recently had been free of AIDS.

Dondero concluded the meeting at a little after noon, and the staff members returned to their honeycomb of offices.

These CDC epidemiologists and their couterparts at the World Health Organization in Geneva are monitoring what seems apt to become the worst epidemic in history.

With about 35,000 deaths worldwide, AIDS still has a long way to go numerically: The bubonic plague killed 25 to 50 million in the 14th century, and the great swine flu epidemic of 1917-18 killed 22 million.

But no plague has ever spread so fast or so far. And never before have epidemiologists understood so well the infectious process. They can predict with awesome accuracy how this plague will grow.

The World Health Organization expects three million AIDS cases by 1991, with 50 million to 100 million new HIV infections.

Based on six years of tracking AIDS, the epidemiologists know that at least 30 percent of people infected with the HIV virus develop the fatal form of AIDS. That would mean 15 to 30 million deaths.

Some limited studies forecast death rates of as high as 75 percent. If that proves to be true, the death toll will surpass anything ever recorded.

New York

In the art world, thinning ranks

The reclining nude was cold and emaciated, puckering wounds spackling his bleached torso, while a bouquet of laurel and white roses hung weightless in a swirling gray sky over his head.

The painting, by artist Juan Gonzalez, adorned a window facing Washington Square, and yesterday morning a steady trickle of students and passers-by paused in the spitting rain to study the ravaged figure.

"I hate that thing," film student Art Worley said as he whipped past. ''Gives me the creeps."

In the next window at the Grey Art Gallery and Study Center in the Main Building at New York University, a scroll lay unfurled, surrounded by a thick, black border. A series of increasing numbers ran down it, each carefully crossed out until the final one - 24,698 - screamed to pedestrians.

It was the number yesterday who had died of AIDS in the United States, as estimated by the federal Centers for Disease Control in Atlanta, and it has been updated weekly during the display organized by the Artists With AIDS League. "It is even more powerful at night," gallery director Thomas W. Sokolowski told one of the passers-by. "Then, it's illuminated with a ghostly, blue light."

The impact of the disease on America's visual-arts community has been ''tremendous," Sokolowski said. "Off the top of my head, I can name 15 people who have died. All of us have had friends, professional and personal, who have died."

The same has been true for the worlds of ballet, fashion, opera, theater, classical music - virtually all forms of the performing arts that have been affected by "the disease which has sapped America's artistic community," in the words of critic Richard Corliss.

"In terms of actual percentages, I'm not so sure that AIDS affects the art world to a greater degree than any other segment of society," Sokolowski said. "I just don't know. But in terms of people who are more visible, and more visibly gay, the effect in arts and culture has been devastating."

The late morning was growing chill. Students scurried quickly through the slick streets.

Sokolowski watched them pass. Some paused and looked at the painting of the wasted nude in the window.

"Even if people don't want to come into the gallery, they can't help but be confronted with the issue of AIDS," he said. "They can't help but think, for just a moment, about the work that is being lost."

Kunkletown, Pa.

Deserted by his classmates

Six-year-old Craig Stenger was just part of the confusion as children poured out of Eldred Elementary School in Kunkletown, Pa., yesterday searching for the right buses and cars.

But despite appearances, the little boy with blond bangs and sturdy white sneakers was not just one of the crowd.

Craig Stenger carries the AIDS virus. His father, Bill Stenger, believes the boy was infected by his mother, Donna, who received the virus in a 1984 blood transfusion.

And because of that, there are only five children in Craig's first-grade class. The others scheduled to be his classmates have gone elsewhere, and about 80 parents in this northeast Pennsylvania area have formed a group demanding that all children with AIDS be segregated.

Even though public health authorities insist that there is little danger of AIDS being transmitted in the classroom, fear has made children like Craig Stenger victims twice over. There are hundreds like him in schools around the country. They carry the AIDS virus, but many are otherwise healthy. In a few years, there will be thousands.

Bill Stenger drove his son home yesterday along the scenic two-lane highways that overlook the valleys south of Stroudsburg.

At home, Craig spilled his bookbag on the kitchen table. There was a reading book, wax candy from a friend in class and math worksheets marked with heavy red pen: "Good job, Craig."

"We had a contest today,' he said, proudly displaying a small toy monster he won as a prize. "We played with half of another class (because) there are only five kids in my class."

Kansas City, Mo.

A fundamentalist view

To U.S. Surgeon General C. Everett Koop, Paul Cameron, 47, a soft-voiced psychologist from Lincoln, Neb., is one of the most dangerous people in America.

Cameron is an anti-gay activist whose proposal for ridding the world of AIDS is to tattoo and quarantine its victims. Actually, he said yesterday during an interview in Kansas City - a day after giving yet another speech on the subject at the University of Nebraska - the country's main health problem is not AIDS, but homosexuality.

"You cannot paganize sex without having your society fall apart," he said yesterday.

"I think we're well on the way, as wealthy and powerful a social system as we are, to becoming a burned-out signpost in history."

Cameron has helped defeat gay-rights legislation in the state of Maine and in cities ranging from Houston to Baltimore. Next week, he's headed for Chicago to assist in a pre-emptive strike against gay forces there.

The standard Christian fundamentalist view is that AIDS is a plague sent

from God to punish homosexuals. Cameron believes AIDS is a heaven-sent moral test for mankind.

"I think that actually AIDS is a guardian. That is I think it was sent, if you would, about 40 years ago, to destroy Western civilization unless we change our sexual ways.

"So it's really a Godsend. . . . It's going to chew the hell out of us, but it's going to result in the saving of humankind, I think."

San Jose

A box in plain paper

David A. DeLong's journey home began yesterday.

Eight years after he arrived in San Jose with his Volkswagen packed with belongings and dreams, he started home to Columbus, Ohio, his cremated remains in a square copper box.

The box was wrapped in white paper and bound with brown paper tape. It weighed 8 pounds, 5 ounces - more like a newborn than an urn full of ashes.

They wrote his parents' address on the box in black ball-point pen and taped on a sticker that said: "This package contains the remains of David A. DeLong."

On the box there was no hint that at 2:30 a.m. last Thursday, DeLong, tortured and wasted by AIDS, pneumonia and hepatitis, his blood a virtual ''poison," had died after 37 years, four months and two weeks of life.

There was no way to write on the plain paper how his friends had watched him suffer or how he had braved the catastrophe that bore down on him.

And there was no writing what a joyous rogue was this handsome man with the chiseled face and hopelessly kind eyes, no telling how he had maddened his friends yet how they had loved him.

He had come to San Jose in 1979 - it had reminded him of Columbus - with a love of the theater and the aim of starting a professional theater company.

That had not worked out. But he later poured his energy into the founding of a gay newspaper and then into the San Jose Repertory Company, where he had simply hung around until they gave him the job. He worked there as box office manager, publicist and finally as company manager.

There he found a home. He liked to be called "Dad" - after his initials - and wielded what one friend called "a wit like a paper cut."

He was impossible and lovable, outrageous and considerate. He loved bowling and left-wing politics.

He had a reckless lifestyle, living on pizza, donuts and Coke and scheduling his annual medical checkups on April Fool's Day.

And he came to captivate people - from the men he had lived with to the Roman Catholic priest from Ireland who brought him Holy Communion as he lay dying.

But none of that could be put down on the little box yesterday as a funeral director placed the package on the counter at the Station B post office in San Jose.

His friends had all said goodbye at a memorial service the night before. And now, at 3:50 p.m., he was in the hands of strangers.

A postal clerk pounded the sides of the box with a circular rubber stamp that told the date and time it was received.

The box would go by registered mail. The fee would be $14.99, the clerk told the funeral director. The undertaker made out a check for that amount. Then he left.

And David DeLong, dead of AIDS at 37, was on his way home.

Newark, N.J.

A condom factory thrives

The enormous machine was spitting out - at the rate of 2,000 a day - products with names such as Saxon, Embrace Her and Pleaser. Women in white laboratory coats, their hair tucked into plastic caps, busied themselves grasping the products, testing them, sealing them, boxing them.

In her 13 years at the company, Nancy Street had never imagined anything like it. Just 18 months ago she supervised 35 workers; now, about 70. Production has doubled. Street puts in two hours overtime a day and sometimes works Saturdays.

Street marveled about this growth industry yesterday as she went about her job as a supervisor at Circle Rubber U.S.A., the smallest of the four U.S. manufacturers of condoms.

In a decrepit, dusty 25,000-square-foot factory, Street was overseeing one more day in a condom boom wrought by fear.

"Business is definitely better," Street said yesterday. "People are trying to protect themselves."

As Street talked, condoms were following a three-day path from manufacturing machine to drying machine to automatic pinhole tester to water test to cartons to prepackaging line to packaging line to wrappers to boxes and, finally, to the shipping floor.

Mitsuo "Mickey" Faito, executive vice president of the 45-year-old firm, smiled yesterday as he grabbed a condom pressed into an aluminum package shaped like a gold coin and said: "This is the device against the AIDS virus. The American people are waking up."

Philadelphia

No letup at the testing site

It was busy yesterday, as usual, at the Philadelphia Community Health Alternatives AIDS testing center on Walnut Street. All day, people went in to be tested. The hotlines rang constantly.

There were calls from:

* A 47-year-old married man fearful he had AIDS because a purple spot had appeared on his arm after he had been with a prostitute for oral sex.

* A 32-year-old alcoholic concerned over repeated sex with a woman who used IV drugs.

* Another man whose concern about the effects of vaginal sex with a prostitute in 1985 were immediate: He was planning to get married.

The anxiety filling the small offices on Walnut Street was part of a wider concern.

This summer the Dallas Cowboys instituted voluntary testing of players, because they frequently come in contact with blood on the playing field.

Police in West Philadelphia started keeping a list of known AIDS victims. And on at least two occasions this year, police and rescue squad paramedics have balked at handling AIDS cases.

The U.S. Agriculture Department announced that it would dismiss or reassign any meat or poultry inspector who developed AIDS.

The U.S. Labor Department has made it mandatory for health-care workers to use barrier devices such as gloves when handling the blood of patients.

A Florida court quarantined a sexually active teenager in a mental hospital after he became infected with the AIDS virus.

And the New York City school system has started to provide 1.5 million rubber gloves for its employees to use when assisting bleeding students.

Still, the mood in the AIDS testing center yesterday was not unrelievedly fretful.

In one room, a gay man of 23, who had been sexually active since age 13 but had used condoms for only two years, convulsed with relief on learning that he was not infected.

In another office near the hotline phones sat a gay engineer, 25, who had just gotten the good news: He was HIV-negative.

"I never thought I'd be as nervous as I was," he said. "I almost felt like fainting."

Amsterdam

Fighting back with needles

It might have been just any city bus, pausing on Waterloo Square.

But this one, a distinctive burgundy and white, was parked yesterday. Inside, two city health department nurses sat on stools behind a Plexiglas

window, dispensing methadone and syringes to heroin addicts. Nearby, a vending machine provided condoms.

For each new needle handed out, a bloody used needle was dumped by an addict into a locked trash bin. Each discarded used needle was one fewer that could spread AIDS.

"The needle exchange has really made a difference," said an addict who emerged from the bus. "Just a few years ago, many people would use the same needle over and over again. They would share it with their friends. Nobody does that now in Amsterdam. One shot and you get rid of it."

The exchange system, begun in 1984, is credited with sharply curtailing the spread of AIDS. Of 308 AIDS cases that have been detected in the Netherlands through June 30, only 12 - or 4 percent - can be traced to intravenous drug use, according to Annet Verster, the coordinator of Amsterdam's AIDS programs. By contrast, 16 percent of U.S. AIDS cases have been linked to intravenous drug use.

Attempts in the United States to establish needle exchanges have been stymied by opponents' fears they will promote drug use, although that hasn't happened in Amsterdam.

Each day in Amsterdam, 70 percent of the city's 2,500 or so intravenous drug users exchange old needles for new at 15 sites, two of them buses.

"I'm not afraid of getting AIDS anymore, because every time I use a needle I just go into that bus and get a new one," said the addict.

By nightfall yesterday, the bus' bin was crammed with needles to be carted off to a hospital incinerator.

Bangkok

The new western import

No. 78 smiled as she made eye contact. She blew a kiss. Her filmy yellow gown, already slit well up her thigh, was hiked a bit higher.

It's not easy being noticed as one of 200 women sitting in a big glass room - on display and waiting for someone, quite literally, to call their number.

In a plush dark corridor, dozens of men studied the choices yesterday at the Mona Lisa massage parlour, one of Bangkok's huge, gaudy and ever- multiplying palaces of sex.

Mona Lisa touts worked the crowd in English, Chinese, Japanese, German and Thai.

"78 is for you," a tout told a paunchy American. "Talking English, and doing whatever you want."

The shopper nodded. The number was called. Seventy-eight hopped out, took the man's hand, strolled him to the cashier to pay the 1,000-baht ($40) fee - Mastercard and American Express accepted - and upstairs they went to a sumptuous fantasy room.

Bangkok, a city of seven million, has somewhere between 100,000 to 300,000 ''commercial sex workers," and Thailand up to one million.

What Atlantic City is to gambling, Bangkok has become to commercial sex.

But lately foreigners have been bringing in more than huge sums of cash.

"It happened so fast - all of a sudden everyone is talking about AIDS," No. 78 said after her assignation with the paunchy American. No longer on duty or display, her tough sexiness turned to shy politeness. She was 19 years old.

So far, most of the 166 AIDS or AIDS-related cases reported by Thai authorities have involved gays or drug users. But last month the government announced the inevitable: At least seven Bangkok bar girls and massage workers have tested positive for AIDS. People familiar with the sex scene think the actual number is much higher.

To protect their investments, some sex palace owners are considering the kind of drastic action taken by the owner of a place called Cleopatra's: He announced that he no longer would accept American or European customers.

The image-conscious Thai government has been reluctant to aggressively attack AIDS, contending that its low-key approach has been effective without causing panic. The government recently approved $1.5 million for a five-year AIDS testing and education campaign - roughly the cost of building a new sex palace.

At least some of the women who have tested positive are probably still working. "We urge the girls to get another occupation," said the Health Ministry official overseeing the AIDS program. "But how can we force them?"

Olongapo, Philippines

An outpost in the battle

About 30 young women sat in a room at the Olongapo Social Hygiene Center yesterday, sipping Sprite, smoking 100-millimeter cigarettes, and listening to a nurse tell them that death awaits them every time they go to work.

The young women were part of the more than 6,000 licensed prostitutes who work near the Subic Bay Naval Base, one of the largest U.S. Navy installations in the world.

The nurse spoke in Tagalog, the women's native language, but bits of English punctuated her speech: AIDS and condom and important.

After the lecture, a few of the prostitutes hung around to talk.

"Our mamasan is always talking about AIDS," said a woman named Luz, who has slept with more U.S. Navy sailors than she can count.

"I don't know," said Amy, who has worked in Olongapo for three years. ''If you have VD they just give you a shot and it's gone. I don't know about the AIDS."

There is considerable ignorance about AIDS here, but a growing concern. In a two-year, $800,000 screening program funded by the U.S. military, more than 55,000 Philippine prostitutes were tested for AIDS. Only 46 were found to be carrying the virus - a minuscule percentage compared with comparable numbers among American prostitutes.

Everyone expects those numbers to increase, though. U.S. authorities predict 4,000 cases in the Philippines by 1990, and more and more as the years go by.

Some people - mainly those who oppose the U.S. military presence here - complain loudly that it is the American servicemen who have brought the disease to this country. Navy officials maintain that all their men have been tested before being sent overseas.

"You're dealing here with a large country that has a lot of transients - businessmen, tourists, journalists," Lt. Cmdr. J.D. Van Sickle said in an interview yesterday. "Now, the Navy's been tested. I don't know about the businessmen or the tourists or the journalists."

Still, the Navy has no program of regular retesting, so there is a good chance that any sailors who contracted the AIDS virus after their initial testing may now be introducing it into the Philippines, and spreading it to one another through the Olongapo prostitutes.

"Anything's possible," Van Sickle conceded. "It's possible our guy gets off a ship clean and goes into Olongapo and comes back infected. It's possible the Philippine population could be giving it to us. . . . Statistically, the odds are much higher," he said, "that it is being brought here by someone" other than the American sailors.

Back at the Olongapo Social Hygiene Center, a prostitute named Rose, who is infected with the AIDS virus, waited with her 2 1/2-month-old son to have the baby's blood tested. She was crying softly as she spoke about losing her job as a bar girl, and about not being able to find a place to live for lack of money.

Rose said she had kept her disease a secret from her family out of fear that if they found out they might reject both her and her baby boy.

The baby's father, she said, was a Navy sailor. She said she believes he was the one who gave her the virus.

She said he is no longer around.

"He's dead," she said as tears inched down her cheeks. "I just say he's dead."

Bethesda, Md.

A soldier in the fight

Jonathan Silver's petri dishes were clear. None of his specially engineered bacteria cultures, inoculated with bits of the AIDS virus, had sprouted overnight. He viewed the results yesterday afternoon with a pensive scowl. It was a minor setback, a day's misstep in a process that unfolds over months and years.

Side by side in creaking swivel chairs in Silver's cluttered little lab, in the northwest corner of the third floor of Building Seven on the National Institutes of Health campus, Silver and his assistant, Jim Felser, pored over the complex microscopic mechanics of the experiment, looking for what might have gone wrong.

Silver is trying to grow a workable batch of genetically altered bits of the AIDS virus. He hopes to find a way of replacing the vanquished immune- system cells of AIDS victims with modified cells that can resist the killer virus. It is what he calls "a wacky idea with a slim chance of success," but no one would ever know that by the intensity of his pursuit.

Silver, 41, is a mid-level scientist on the staff of one of 68 labs that make up the National Institute of Allergy and Infectious Diseases intramural research program. His current project takes up one page in the thick volume needed to outline the basic science going on at the NIH. His is one of hundreds of labs increasingly absorbed by the urgent battle against AIDS.

Gentle piano notes of Eric Satie tinkled out of a radio tucked on a shelf among boxes, jars, beakers, pipettes, rubber gloves, test tubes and a hundred other lab implements as Silver jotted dimensions with a blue pencil and Felser pounded at a calculator the size of a credit card.

As they arrived at a measurement integral to their research, Silver announced the precise figure and pressed too hard on the pencil, snapping its point as he made his own.

The snippet of human immunodeficiency virus Silver is working with manufactures the protein envelope, or outer coating, of the virus cell. Silver has already shown that mammalian cells possessing that strand of DNA can fend off the virus' attack - but there are many complicating factors. Cells possessing the gene also tend to fuse and die. Silver believes he has now isolated that destructive trait and weeded it out, but the mechanics of gene construction have consequently grown more complex.

The thrust of yesterday's problem was to further perfect the bacterial cells that will eventually be used as tiny factories for the specially engineered genes, making them in large enough amounts for broader experiments with human tissues and in mice.

But in their efforts to tailor the mix just so, something hadn't connected. The scientists considered it just a slight engineering problem, something they will work out in a matter of days.

But there's no telling for sure.

SAN ANTONIO

Keeping the test chimps happy

Linda Brent, an animal psychologist, made her regular rounds yesterday at ''Infectious Village," home of the world's largest colony of chimpanzees infected with the AIDS virus.

Dressed in a green surgical gown, black rubber boots and a white face mask, she walked quickly from concrete hut to concrete hut inside a fenced-in area of the Southwest Foundation for Biomedical Research.

In Building 414, she turned on the television so the still-sleeping chimps could watch the morning news when they woke. In Building 420, she greeted Irving, a powerful male, who turned several flips to get her attention. And in Building 418, she observed that Lisa was still "painting" the walls with her feces.

"These chimps are so human-like that you need to find things for them to do," said Brent. "Imagine locking a person inside a cage. They'd be so bored they'd probably die."

That's why the foundation, one of the world's largest primate research centers with 179 chimps and 2,800 baboons, has hired Brent - to make the chimps feel happier.

The 30 infected chimps have to live in total isolation. They have separate cages inside 10 bunker-like buildings. Each building is marked with a red ''biohazard" sign and the black letters "AIDS" on the doors.

Before Brent and other workers enter, they must walk through a disinfectant solution, don white coveralls and put on latex gloves.

Scientists here have injected the chimps with AIDS-infected blood and inoculated them with four separate experimental vaccines. In each case, the vaccine failed.

One year ago, Dr. Jorg W. Eichberg, 47, thought a vaccine could be developed in three to five years. "Now, I have doubts whether we will ever be able to develop one," he said.

Nor does Eichberg think that human vaccine trials, which are under way in France and Africa and scheduled to begin in the United States later this year, will succeed.

"These vaccines are no different from what we have tried here," he said. ''They failed in chimps. It is preposterous to think they will work in people."

Eichberg is concerned about the welfare of his chimps because some have lived in isolation for more than four years. To keep the chimps active, Brent has placed tires and toys in their cages. During yesterday's rounds, she played tag with some, fed popcorn and bananas to others, turned on radios and a black and white television. The chimps particularly like the soap opera All My Children.

Eichberg has taken the extraordinary step of creating a $400,000 retirement fund for the chimps - the only one of its kind in the world. By 1997, he hopes, the fund will reach $2.9 million, enough to care for 80 AIDS-infected chimps until 2025.

But for Brent and the other chimp handlers here, there are more immediate concerns. The chimps have bitten some handlers and spit in their eyes.

"Obviously, there is a concern among all of us that we someday will become infected with AIDS," said Brent yesterday. "But on a daily basis I don't worry about it. If I did, it would be impossible to work with the chimps."

North Carolina

AZT: Hopes and concerns

In his office in Research Triangle Park, Edward Collins fielded his usual steady stream of phone calls yesterday.

A Dallas physician treating an AIDS patient who had not yet developed full- blown symptoms wanted to know whether his patient would benefit from AZT, the only approved drug available that slows the progress of the disease.

"We don't know the answer to that yet," Collins told the Dallas physician, repeating a sentence he uses often.

Collins is a pharmacist who works in the U.S. headquarters of Burroughs Wellcome Co., the firm that manufactures the chemical azidothymidine, or AZT.

Marketed under the trade name Retrovir, AZT was approved a mere seven months after clinical trials of it began. A group of 145 seriously ill AIDS patients did better after taking the drug than a control group that did not receive it, and desperate need outweighed the normal precautions. Breaking all speed records, the company began producing the drug, rationing it to only the most seriously ill patients.

But as a consequence of this speed, a lot about the drug is still not understood. It has not been tested in patients who are not yet seriously ill, and it has not yet been tested, or approved, for children. And although it holds out precious hope, AZT is an extremely toxic drug that can have life- threatening side effects. Doctors are unsure what is an effective, but safe, dose.

The supply problem recently has been overcome. For months, Wellcome has been synthesizing batches of the white crystalline powder in Britain and at its only U.S. plant. Wellcome now has enough AZT to sustain 50,000 patients. The company finally dismantled the rationing system five weeks ago. All AZT for the U.S. market comes from a facility in Greenville, N.C.

But the sudden ample supply has just made the lack of answers more glaring.

Collins oversees a 12-member staff that is trying to answer the flood of questions. Often the answers they have for eager callers are disappointing.

A California doctor who has just begun to treat a 70-year-old heart patient with AIDS called Wellcome yesterday. He asked how AZT would interact with four other drugs that his patient must take.

The answer: No studies of the problem have been done.

A doctor in Pensacola, Fla., called Wellcome yesterday to ask about use of the drug with children. He has been treating five children with AIDS and wants to know the best dose for youngsters.

There has been no time to study the drug's effect on children, Collins explained.

Despite its toxicity, pediatric studies are now under way, though, at Duke University Hospital and two other medical centers.

There are dangers, Collins said, but "the kids deserve a chance."

San Francisco

A human guinea pig

Ron stretched out on the examining table, his thin frame half-clad by a hospital gown.

"If you could find something to stop my diarrhea, you'd get my man-of-the- year award," he sighed to nurse practitioner J. B. Molaghan.

Ron is a volunteer. An AIDS guinea pig. A focus of frail hopes that science can come up with solutions, soon.

He is part of a study of an experimental drug treatment for the disease. And yesterday, in Ward 86 of San Francisco General Hospital, Molaghan worried that Ron might be too ill to continue. It wasn't just the diarrhea, but a puzzling rash on his legs and back.

The diarrhea is probably not a side-effect of the drug, but the rash might be, Molaghan told Ron. The nurse rubbed Ron's right arm affectionately. He didn't want to have to remove Ron from the study, he said, but he might have to.

At 34, J.B. Molaghan is a veteran of tough calls. Ward 86 is the AIDS clinic at San Francisco General. The hospital has more than 350 patients involved in 28 drug trials, making it one of the nation's busiest centers for research and experimentation with new AIDS drug treatments.

Ron and five other men with AIDS or AIDS-related conditions were being examined for their responses to the drug dextran sulfate. Doctors hope the

drug will slow the spread of the AIDS virus and boost the patient's immune system. The drug has been tested in laboratories.

Now, the question is, will it work in humans? And at what level could dosages prove harmful? And, for Ron, can he continue to be part of the search?

Molaghan asked Ron more questions. He learned that Ron had been at a friend's house, and the friend had a dog.

"I think you brought fleas home with you," Molaghan said, grinning.

The rash was solved.

But the diarrhea was not. It meant Ron would have to be taken out of the study, at least temporarily, because another drug in his system might confuse the results.

Ron seemed unperturbed. "You know, I don't have to be in this study to get these," he said of the white pills. "I've got a friend on the street who can get them for me for 45 cents apiece."

San Diego

A victim treats himself

Yesterday was hazy and cool in Southern California, and Tom Hanson was standing bare-chested in his kitchen, just beginning his daily battle against AIDS.

He swung open a cabinet door and took down bottles of green tablets, beige capsules and pills of every color and size - food supplements with such names as kyolic garlic, selenium, dandelion root and Astro-8. They made small tapping sounds as Hanson measured them out into three separate portions, one to go with breakfast, one with lunch and one with dinner.

Before the day was over, Hanson would ingest more than 50 different vitamins, chemicals and supplements. And this was just a part of the elaborate daily regimen that he has designed for himself - a personalized concoction of Western, Eastern, New Age and faddish California medical philosophies mixed with spiritualism and exercise.

Nontraditional treatments are commonplace among AIDS victims these days. Almost anything that can be imagined has been tried by someone, somewhere. In Houston, a doctor has injected AIDS victims with their own urine. In a clinic outside Tijuana, Mexico, people have taken intravenous doses of hydrogen peroxide mixed with the industrial solvent DMSO.

Tom Hanson's regimen is less bizarre and probably more typical of the AIDS self-help movement. Since March, when Hanson learned he had AIDS-related complex, one of the signs of an advancing HIV infection, he has become obsessed with nutrition. He has also learned how to acquire such nontraditional, hard-to-get medicines as DNCB, a skin irritant that Hanson has spread on his upper arm in hopes that it will promote production of white blood cells.

Hanson is a 31-year-old man with a square jaw, upturned nose and deep brown eyes. He once thought of being a lawyer but got sidetracked into the department-store business in his 20s. By 1983, he was an alcoholic, a serious

drug user and a frequenter of the gay bar scene.

AIDS has changed all that. Hanson has quit cigarettes, alcohol and drugs. He gets plenty of sleep, exercises every day, prays, and tries to imagine good things for himself.

In the old days, he might have eaten bacon and fried eggs for breakfast. Yesterday it was a blended mixture of fruits and fruit juices, bee pollen, protein powder, psyllium husk, powdered shiitake, reishi mushrooms and egg lecithin.

Hanson calculates that all his pills and potions cost him about $500 a month.

He has no symptoms, and he said he feels good.

"I'm not really sick," he said. "I'm recovered."

Philadelphia

The changing singles' scene

Faith Elko of New Jersey and Joyce Wexlei of Philadelphia walked into Houlihan's, a Center City bar popular with singles, yesterday a little before 6, as the downtown business day was giving way to the downtown nightlife.

They had come from a nearby personnel office, eager to put the workday behind them. They sat at the edge of the square mahogany bar and ordered two beers.

It was happy hour at Houlihan's, a noisy, smoke-filled bar that surrounds customers with red brick walls decorated with trinkets from the past.

The two women sat alone for over an hour, sipping their drinks and glancing about. At 7:15, a man who said his name was Andrew walked over and stood next to Wexlei. She saw him yawn.

"Don't do that. It's contagious." she said.

Andrew smiled. He was dressed in a dark blue suit and yellow paisley tie. They began to talk.

He drank his gin and tonic. They discussed work.

He said he was in marketing.

Meanwhile, Elko, 25, had started a conversation with the lone man sitting next to her.

Three years ago the two women would have considered going home with such men, but not anymore, not with AIDS, they told a third woman at the bar.

Wexlei, 29, said she no longer lets a man even think she will consider casual sex. Elko agreed. She said she comes to bars these days with the intention of leaving alone.

With fewer than 100 heterosexual AIDS victims in Philadelphia, it's unlikely that a heterosexual will run into an infected person. But everyone knows that the number of infected heterosexuals is growing and that more and more people are afraid to take chances.

Elko and Wexlei remained at Houlihan's until 11:15, when they left by themselves. At midnight, their earlier companion, Andrew, was left drinking alone.

Meanwhile, on the streets of Philadelphia, Newark, Paris and other cities of the world, the prostitutes were out in force.

In the nursery in Brooklyn, Baby A was awake in his crib, playing with his Winnie-the-Pooh crib pad. And Baby B was sleeping with her rump in the air.

By 11:30 last night, 37 men had checked into the Club Philadelphia on 13th Street for a night of "relaxation."

And in California, Tom Hanson, who had spent the day medicating himself against the infection in his body, prepared for bed by meditating and eating fruit.

 


Contributing to this report were Tanya Barrientos, Michael Matza, Timothy Dwyer, Mark Bowden, Susan Levine, Carol Morello,, Eric Harrison, Laura Quinn, Rick Lyman, Roy Campbell, Ron Wolf, Jim Detjen, Fawn Vrazo, Paul Nussbaum, Michael E. Ruane, Matthew Purdy, David Zucchino, Marc Duvoisin, Mike Leary, Marc Kaufman, Edward Power, Steve Goldstein and Beth Gillin.

Donald C. Drake and Loretta Tofani Inquirer Staff Writers
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