No Aids Obituaries - A First Since 1981

THE SEEMINGLY GOOD news brings tears and cheers amid worries it will create a false impression that the AIDS epidemic is over.

SAN FRANCISCO - "No obits," announced the profoundly simple banner headline on the front page of the Bay Area Reporter.

Some smiled when they saw Thursday's stark announcement in the city's largest gay and lesbian newspaper, long the bellwether for the community's battle with the epidemic. Others wept with joy. Still others just stared in disbelief.

For the first time in 17 years, in a city long considered ground zero of the U.S. AIDS epidemic, a week had passed without a single obituary arriving at the editorial offices of the BAR, as the paper is known.

"Wow," said Paul Wisotzky, a gay man with AIDS who has lived in San Francisco since 1989. Chairman of the San Francisco AIDS Foundation Board of Directors, Wisotzky said he followed the obituaries meticulously until a few years ago, when he stopped because "my circle of friends had died." Just three years ago, he noted, a week without death notices was unthinkable.

That was before the introduction of combination therapy for HIV infection. The therapy involves treatment with at least three different AIDS drugs, one of which is a so-called protease inhibitor.

Combination therapy drops the level of the AIDS virus to below detectable limits in as many as 80 percent of the patients receiving it. It also produces at least a partial restoration of the immune system. That boosting of immune function, in turn, sharply limits the opportunistic infections that are the sign of full-blown AIDS and that are usually the cause of death.

The new drugs are widely believed to be responsible for the dramatic decline in AIDS deaths over the past two years.

"After 17 years of struggle and death, and some weeks with as many as 31 obituaries printed in the BAR, it seems a new reality may be taking hold, and the community may be on the verge of a new era of the epidemic. Perhaps," wrote Timothy Rodrigues in the article that accompanied the paper's headline.

Editor Mike Salinas said the decision to run the headline and story sparked a lively debate inside the newsroom, where some feared that it would create the false impression that the AIDS epidemic was over.

Salinas said that by Tuesday, when no obituaries had arrived for 10 days, he decided it was time for a little rejoicing.

Never before had a week passed without a single death notice.

Reaction to the headline, Salinas said, was instant. "It was wonderful this morning, taking the streetcar and seeing people with the BAR, reading the headline, and other people catching sight of the headline and doing a double take and smiling. I saw people with tears."

Some of the city's AIDS activists fretted that the headline would create a false impression that the epidemic was over.

"The BAR represents mostly the white, middle-class gay community," said Ronnie Burk, an activist with ACT UP San Francisco - a militant group born of the AIDS epidemic that often is at odds with the mainstream gay community. "Even in the article, they said that a homeless man had died of AIDS in the Tenderloin (district) last week and nobody wrote an obituary for him."

According to the San Francisco Department of Health, the number of reported deaths due to AIDS in San Francisco in July was 35.

The number of reported AIDS deaths so far this year is 134. For all of 1997, the number of AIDS death in the city was 347. The peak year was 1992, with 1,816 deaths.

Nationwide, the number of deaths from AIDS dropped from 21,460 in the first six months of 1996 to 12,040 in the first six months of 1997, according to the most recent figures available from the National Institute of Allergy and Infectious Diseases. That represents a 44 percent decline.

But Ron Stall, an epidemiologist and biostatistician at the University of California, San Francisco Medical Center, said he is in no mood to celebrate.

"What concerns me is that people will take this headline to mean that the war is over. I see no evidence of that," Stall said. "As far as I'm concerned, this is a very dangerous time for gay men."

Studies in San Francisco show the rate of young men practicing unsafe sex has gone up by nearly 50 percent in the past two years, Stall said.