programme in Channel 4‘s Aids Non series asks Is There Going to be a Heterosexual Epidemic?. and thrusts Edinburgh. a city which can still just claim to be better known for its Festival than for its runaway Aids problem. into the limelight.

To investigate the spread of the virus into the heterosexual community. the programme's makers came to the Festival City. where an estimated 2000 heroin addicts. in outlying estates like Muirhouse and Wester I Iailes. are injecting the drug intravenously.

It was through the work of Muirhouse GP Dr Roy Robertson (interviewed on the programme). that the Aids alarm was first raised. These drug-users had fallen victims to the Aids virus in numbers that no one had expected. Robertson had feared an outbreak of hepatitis or some other disease to strike the community as a result of the needle-sharing habit. and had began regularly to test his patients' blood. Aids was unknown in the early Eighties. a nameless scourge threatening American gay males. But when the Aids test became available in Britain Edinburgh doctors turned to Robertson‘s blood samples to test the process. They were astonished to find that 83 of them (50% ofhis patients) were HIV-positive. The excitement that scientists felt at discovering an epidemic at such early stages was matched only by horror that the virus had taken such a foothold in Britain. The January figures for this year record 1381 known HIV-positives in

Scotland ofthcse. 57.4% contracted the virus through intravenous drug injection.

Nearly 27% ofthat 1381 are women. slamming the notion of Aids. in Scotland at least. as simply a ‘Gay Plague‘. Down South the story is different. In the rest of Britain only 7.3% of recorded cases were the

result ofdrug injection. and the number ofwomen infected is correspondingly lower: 6.3% . There seems. though. to be the chilling likelihood that the Scottish pattern will emerge in England and further afield. As Aids Nowexplains. drug-users are a mobile group. The programme’s researchers found that addicts from Edinburgh travelled all over the country. and on to the coast of Europe. to find cheaper and better heroin; naturally. they shared their ‘works’ with the peOple they met there. and in all probability had


As Channel 4 focusses on Edinburgh in anew documentary on Aids. John Dundas investigates the issues.

sexual contacts. With both users and non-users. effectively spreading the infection further into the general population. As one expert in the programme says. ‘If [a heterosexual epidemic] is drugs-related it‘s going to start in Edinburgh‘. though not all would agree with that. One worker with Aids patients rightly pointed out to The List that there are intravenous drug-users in all parts of the country. and that any inroad made by the virus into the greater part of the population could spring from any major population centre. The disparity between the Scottish and English figures none the less show the inexplicable Scottish preference for taking heroin intravenously. Since the early Eighties heroin abuse has been a major problem in British cities. but even in the notorious deprivations of Liverpool the preferred method for taking the drug was ‘Chasing the Dragon‘ (inhaling the smoke of heroin burned on a piece oftinfoil), equally addictive but safe as regards the Aids virus.

In view ofthis, are precautions being made to contain the virus and care adequately for those who are already suffering? The vast majority of Edinburgh‘s HIV-positives are drug users. but the Scottish Office's allocation to the various drug groups in Scotland weighs in at a disappointing £300,000; up on last year. but still not enough to take proper preventitive measures and counsel those already addicted. Many addicts feel that the Aids

problem is one that does not affect them. and continue to jack up regardless. The needle exchange scheme. by which addicts can return used needles for clean ones. has come in for criticism from some quarters. the claims being that junkies are getting half-a-dozen clean needles in exchange for only one dirty one. and are distributing the rest of their old used ones to friends.

David Liddell of the Scottish Drugs Forum. a Glasgow-based organisation which aims to co-ordinate the various drug groups in the country. defends the scheme. which still has another three months to run in its current form. and feels the adverse publicity has mainly been a result of the scheme‘s high profile. A better continuation ofthe project. he feels. would be a more low-key approach. so that needles could be made available through local health centres.

He is philosophical about the Scottish Office’s allocation of money (‘Obviously. we would have preferred more.‘). mainly to social work groups and statutory departments rather than local voluntary groups.

‘The Scottish Drugs Forum hasn‘t been in existence long enough to identify priorities. but local drug agencies in Lothian and Strathclyde have identified the need for Crisis Intervention Centres. to which people would gain fairly immediate entry and recuperate if nothing else. but hopefully more than that. There‘s no immediate access to

detoxification facilities in Edinburgh. There are places in the general psychiatric wards in the Royal Edinburgh Hospital for addicts. but that‘s only two beds per sector. You have to go through a lot of hurdles before you get admitted. The only long-term place they can go for respite and to get away from their environment and their usual contacts fora few weeks is Spectrum House. run by the Church ofScotland. which houses fifteen.

‘There is also a need for more outreach workers. Operating within drug communities themselves. possibly ex-addicts. but that's something we've got to look into more closely.‘

Another important link missing from the scene is a 24-hour drug crisis/information line (similar to The Samaritans. ifyou like). The various agencies. overstressed. can only offer help during office hours.

Counselling patients. maintains Dr Ray Brettle. consultant in charge of Edinburgh’s Aids unit at the City Hospital. is essential in preventing the spread of the disease. Friday‘s edition ofAids Now shows Brettle. seemingly endowed with the patience ofJob. trying to get the message across to an HIV-positive woman that she should tell her partner (with whom she has been sleeping for several months) that she has been infected and may well have passed the virus on to him.

The experts questioned on the programme are in little agreement as to the expected spread of the disease in the population at large. From the view that a heterosexual epidemic is ‘certain to occur— but when and how quickly?‘ to the feelings ofAndrew Moss. a British epidemiologist who has worked extensively in San Francisco and now inclines to the view that there is not necessarily going to be a great explosion. Roy Robertson. who discovered Edinburgh‘s outbreak. predicts the rise ofcases outside of the current high-risk groups will be ‘a background noise. increasing gradually". with various mini-epidemics like that threatening Edinburgh. For whatever comfort maybe derived from it. the optimists just tip the scales but only just.

(John Dundas)

Aids Now: Is There Going to be a Heteroseximl Epidemic? is transmitted on Channel 4 at 10.30pm on Friday 22. Radio Clyde ’s A ids Action Week starts Sunday 31. See Radio section.

The List 22 Jan - 4 Feb 1988 41