26/2/00
8:56 pm BST

Ann Bradley

Aids panic over?

Until recently when anyone involved in the provision of public services wanted money they would try to hook it to an Aids-related budget. There was no money in the corporate pot to house the homeless - but if you set up a project to stop the spread of HIV among the homeless, grants started flowing. Hospices for Aids sufferers mushroomed while funds for care for the elderly shrivelled. Health spending on Aids has risen while virtually every other area of health spending has been axed. Last month, junior health minister, Tom Sackville confirmed that the government had spent £886m on its Aids campaign since 1986--probably enough to have kept us all in free condoms.

However, the Aids gravy train seems finally to have been pulled off the tracks. The government has announced plans to reduce spending on the Aids publicity campaign. Britain's largest Aids charity, the Terrence Higgins Trust is to have its three-year grant of £450 000 cut by £300 000, and the London Lighthouse hospice is also to feel the knife. 'We need to refine our strategy', said health secretary Virginia Bottomley, announcing plans to target Aids funding at high-risk groups.

Has the Department of Health just woken up to the fact that the projected Aids epidemic among heterosexuals has not materialised? As we've indicated many times in Living Marxism, projected increases in the number of Aids cases in Britain have always been wildly off the mark. In 1988 it was officially estimated that up to 50 000 people in Britain had already been infected with HIV, of whom 5000 had allegedly been infected through heterosexual contact. Now, five years on, estimates from the same official sources put the maximum number of HIV carriers at 30 000.

Move from guesstimates to hard data, and the picture becomes clearer. New figures from the Public Health Laboratory Service reveal that there hasn't even been an epidemic among those in high-risk groups - mainly homosexual men and intravenous drug users - let alone the rest of the population. The number of reported Aids cases among homosexuals seems to have plateaued at about 1000 a year, and there are still just 63 Aids cases in Britain among people who have no known connection with high-risk groups. During the time that the government spent that £886 million, 7731 cases of Aids, and 16 164 cases of HIV, were reported in the UK.

It is inconceivable that the government's reversal of health spending policies is based on a sudden realisation that Aids is not a rampaging epidemic. Nor is it likely that they only recently discovered they had spent more than £37 000 for each HIV/Aids sufferer. Every quarter the Public Health Laboratory Service and Communicable Diseases Surveillance Centre issues statistics demonstrating the incidence of HIV and Aids. Living Marxism has often used these figures to demonstrate that the Aids panic has been wildly out of proportion to reality. The Department of Health, meanwhile, has ignored or distorted every set of figures that didn't back up their 'safe sex or death' message.

So why the change of heart? A central motivation is the desire to save money. The economic slump has put the squeeze on all areas of public spending, and health services have been granted no immunity. Bottomley has already announced plans to ration health services in the future. But the Treasury wants action to save money, not just in the future, but now. Although spending on the Aids publicity campaign has developed the status of a sacred cow, it is one that can be sacrificed with relatively little bloodshed today because it has largely served its intended purpose.

The panic about Aids was never rooted in a genuine desire to prevent the spread of a deadly epidemic. Right from the start of the government's safe sex campaign in 1986, Dr Michael Fitzpatrick has both exposed the medical myths about Aids and pointed out that the government's concern was not with public health. Its main motivation for sponsoring an Aids panic, he argued, was to manipulate people's fears of a sexually transmitted disease in order to popularise old-fashioned family values. The government didn't invent Aids. But it recognised that Aids had a useful quality as a vehicle for a moral message. The message was that if you lived a 'blameless life', restricted sexual relations to those you could love and trust and stayed clear of drugs, you were safe. However, those who rejected 'decent' standards, were at risk. And to an extent it has worked. Sexual conservatism has become fashionable again, in words if not in deeds.

But the limitations of the moral panic are becoming clearer with every report that is published. It is no surprise to find the Department of Health now trying to put a bit of distance between it and the 'use a condom or die' predictions.

All the latest studies into sexual behaviour have shown that while we talk about the problems of casual sex, we still engage in it. And while we understand the 'need' to use a condom, when push comes to shove, many of us can't quite bring ourselves to roll on the rubber. Yet we're still alive and uninfected.

Epidemiologists are also now identifying a link (first revealed in Living Marxism four years ago) between the safe sex campaigns and a rising rate of teenage pregnancy. It seems that teenage girls have taken the safer sex message closest to heart and switched from the pill to the condom. The consequence: lots of teenagers with great protection against HIV (which they're unlikely to encounter) but miserable protection against sperm (which they are very likely to meet). The result: a rising rate of teenage pregnancies and abortions - not something which the Tories want to be associated with. When leading gynaecologists start admitting in their own journals that they seem to have got the safe sex message slightly wrong, it's time for the government to shift emphasis.

Taken together, all of these factors provide the government with a reason to scale down the Aids panic and save some money. Don't expect Aids to drop out of the headlines. The 'moral message' is far too useful for the government to abandon altogether. But moral panics run into trouble when their message flies in the face of people's experience and of the facts - and the Aids panic is looking increasingly short of facts to support it.

Reproduced from Living Marxism issue 56, June 1993

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