NEW YORK TIMES MAGAZINE
REACHING OUT TO SOMEONE WITH AIDS
May 19, 1985
By George Whitmore

ONE NIGHT RECENTLY, Jim Sharp and Edward Dunn spent a few hours together discussing the nature of God, mortality and eternity. Edward, who has pronounced opinions on most subjects, says he has no answers on this one. Lately, however, he's been asking more questions. Jim, a transplanted Texan and regular churchgoer, will tell you tongue in cheek that his idea of heaven, "based on my childhood beliefs," is "a canasta game with lots of coffee and cigarettes." But he's been asking more questions, too. He's concluded, he says, that God will not give him more than he can handle.

Jim, 35, has Acquired Immune Deficiency Syndrome. Edward, 43, is his "crisis intervention worker," a counselor assigned to him last August by the nonprofit Gay Men's Health Crisis, which, through its 1,100 volunteers, provides nonmedical outpatient assistance to New Yorkers with AIDS. Edward's job is to help Jim and his lover through the many difficulties - financial, legal, medical- they are certain to encounter due to Jim's condition. Jim has not yet had any repeated, protracted hospital stays, but Edward is ready for them. He knows about AIDS. His own lover died as a result of it less than 18 months ago.

Last summer, when Edward called the Gay Men's Health Crisis to volunteer, he did so because, after his lover's death,"I felt desperately that I had to be doing something. I couldn't just sit by impotently and watch." In the training sessions, he listened to other new volunteers talk about AIDS as it were a "gentle, Camille-like wasting away." But, Edward knew from firsthand experience, AIDS is anything but that.

After a rocky beginning last fall, Jim and Edward have become friends. In fact, their relationship has grown into one of special intensity. Nevertheless, there is a distance between them. Until recently, Jim hadn't even introduced Edward to his lover, Dennis, perhaps because to do so would have made AIDS more irrevocably real. And Jim doesn't know very much about Edward's deceased lover, Robert. Once, when he asked about Robert's death, the sadness in Edward's eyes was so profound, he knew not to ask again.

Ultimately, however friendly they might be, Jim and Edward are both aware that Edward isn't really there to be Jim's friend. He's there to help Jim live with AIDS. Now, after months of fear, rage and denial, Jim is willing to try to do that.


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Some of Jim's personal belongings, including a stuffed piranha, a gift from Ed.

ATOP A STEREO SPEAKER IN JIM SHARP'S Greenwich Village apartment is a stuffed piranha. Edward brought it back from Brazil last winter and, when he gave it to Jim, he joked, "This is how you look when you don't get your way."

The fish is poised for attack, bristling, jaws agape. Like AIDS, the piranha is at first glance shocking, repulsive. But after a while, it begins to grow unreal, like something whipped up out of latex and horsehair by an overzealous special-effects man. Thus demystified, it can be dismissed - that is, until your eye happens to fall on it again. Then you wish it weren't in the same room with you.

But AIDS won't go away. In the four years since the epidemic began, some 10,000 people have been diagnosed as having AIDS, and of these 4,963 have died. No cure is in sight and a vaccine, if it can be developed, is far off. The mortality rate for AIDS two years after diagnosis is 80 percent. In the next few years, thousands more will certainly die of AIDS -or, actually, of the opportunistic diseases that accompany severe immune deficiency.


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TWO MEN, ONE WITH AIDS, STRUGGLE TO COME TO TERMS WITH THE DISEASE. Edward Dunn, left, a volunteer counselor, and Jim Sharp, who has AIDS. Jim says he once believed he was in complete control of his life. "This disease has taught me that this is not necessarily so, "he says now.

As it was in the beginning, most of the dead in the foreseeable future will be homosexual males. Thus, although AIDS isn't and never has been a "gay disease" - currently, 27 percent of the cases in the United States are among heterosexuals, one percent of whom were exposed to the virus through sexual contact - the onus of the epidemic will continue to fall on the besieged homosexual community. In most large cities, this means organizations like the Gay Men's Health Crisis.

The kind of information and education that this organization dispenses is vital. In New York City, for instance, with 34 percent of cases nationwide, there are still no pamphlets on AIDS prevention in Health Department venereal disease clinics. The general public might well be learning that AIDS cannot be transmitted through casual contact; but there seem to be thousands of people in risk groups who do not know how, why or whether they are in danger. (A report on how AIDS is transmitted appears on this page.) In addition, while most sexually active homosexual men have radically altered their behavior (many have simply chosen to be chaste), there are indications that the excruciating uncertainty surrounding AIDS has led to an attitude of fatalism in some who are continuing or resuming high-risk sexual activity.

In New York City - in the absence of a coordinated strategy and program specifically designed to help people with AIDS - the homosexual community has shouldered primary responsibility for crucial counseling, public information and support services. The Gay Men's Health Crisis counsels 42 percent of New Yorkers with AIDS. In fact, all callers to the New York City Health Department who request AIDS-related social services are referred to that center, whose caseload has tripled, from 250 to 750, in the last year.

Volunteers carry out tasks that range from grocery shopping to assisting patients in hospitals to supporting the bereaved. These services are provided free of charge and without regard to sexual preference; as many as 20 percent of the patients served by G.M.H.C. are heterosexual.

Though the organization's services are for everyone -as are those of the AIDS Medical Foundation and the AIDS Resources Center - most of the money comes from the homosexual community. Last year, G.M.H.C.'s budget was $800,000, 65 percent of it private donations. New York State contributed approximately $260,000; New York City, $20,000, as opposed to San Francisco's $1.5 million for comparable private-sector efforts to serve one-third the number of cases. New York is reassessing its contribution.

With the AIDS caseload still spiraling, says Rodger McFarlane, G.M.H.C.'s executive director, the organization has reached the limit of the number of people it can serve, given its current financial resources. Human resources, he points out, are quite another matter. Volunteers have been abundant since the organization was founded three years ago by a handful of concerned men, and "that's irreplaceable; you could never pay for that.”

Indeed, among homosexual men and women nationwide, AIDS has led to acts of remarkable altruism, even heroism."We've visited the sick and buried the dead," says Virginia Apuzzo, until recently executive director of the New York-based National Gay Task Force. "And we did it not just because it had to be done, but also because nobody else would do it."


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Jim having dinner with his lover, Dennis. After Jim learned he had AIDS, both men sought help from the Gay Men's Health Crisis, an organization that provides nonmedical outpatient assistance to AIDS patients, their families and partners.

AS SCIENTISTS HAVE come to understand, AIDS is not a black-and-white illness but a whole spectrum of conditions related to immune deficiency. Kaposi's sarcoma, a rare cancer, and pneumocystis carinii pneumonia are the two diseases most commonly used as indicators by the Centers for Disease Control in Atlanta to diagnose AIDS. The more prevalent Aids-Related-Complex, or ARC, is sometimes called "pre-AIDS." Characterized especially by swollen lymph nodes and persistent fever, it falls short of a complete suppression of the immune system. Sometimes ARC turns into AIDS; sometimes it doesn't. In Jim's case, it did by December.

But last August, all Jim knew was that he'd been abruptly jettisoned out of the legions of the "worried well" and into the ranks of the "walking wounded." He called G.M.H.C.



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THE THREAT OF AIDS HAS CAUSED A VAST AMOUNT OF PSYCHOLOGICAL SUFFERING. Jim in his apartment.

Some people fall to pieces when they receive the kind of news Jim did. But, Edward recalls, at their first meeting in Jim's apartment, he appeared quite calm.

There had been an attempt to match them; both worked in advertising. They chatted for an hour or so. Edward offered his services but, curiously, they didn't really talk about AIDS. Edward remembers that it was "as if there were a dead elephant in the middle of the floor and we were both too polite to mention it."

Jim smoked cigarette after cigarette -clearly, he had no intention of quitting smoking - but generally, Edward thought that Jim, for a man who had just received what most people would regard as a death sentence, seemed almost blasé.

Jim was terrified. He knew what AIDS meant. He knew what happens. Your friends desert you, your lover kicks you out onto the street. You get fired, you get evicted from your apartment. You're a leper. You die alone.

Ambitious, aggressive, Jim was used to being in control. A recovered alcoholic, he had saved his life once before. If sheer will power meant anything, Jim would save his life again.

Jim says he grew up to believe "that you get up in the morning and you pull your boots on by the straps. You get up and go.

“This disease has taught me," he adds, "that this is not necessarily so."

THE SOLE REQUEST Jim had of Edward that first month was for help to find a dentist; Edward located one he knew was willing to treat people with AIDS. Jim also allowed Edward to enroll him in a support group at G.M.H.C., but at the meeting he argued with the group leader about smoking. He refused to go back. The truth was, Jim identified with the sickest man in the room and it scared him to death.

Jim still looked good. On the street, he would see people with AIDS - he knew enough about the symptoms to notice the swollen nodes in the neck. He felt sorry for those men. But now his own body was telling him: You have it, too.

Edward called regularly. Jim was distant and polite. No, his lover didn't need a support group; anyway, Dennis was too busy at work. Everything was fine. Jim presented the same bland, good-ol'-boy facade to Edward he was so adept at projecting in business.

Gradually, however, Edward began to understand. Jim had his life strictly compartmentalized - his lover; his longtime psychotherapist; his doctor; his job-and it left him strangely isolated. Edward began to understand the essence of the crisis Jim was enduring. Like many people with AIDS, he felt compelled to deny he had it. Jim was in crisis precisely because he had to deny any crisis existed.

Edward saw that he represented AIDS to Jim. And Jim was determined: Maybe AIDS had its foot in the door, but he was damned if he would let it into the house.

He was deluded. AIDS had moved in.

HI, JIM. HOW ARE you feeling?"
"Oh, I'm feeling fine."
"You're not at work today. Why didn't you go to work today?"
"Oh, because I woke up and I was real tired."
"So are you really feeling fine?"
"Well, I'm not really feeling fine..."

As winter approached, Jim started getting colds he couldn't shake, bouts of flu. He was experiencing chronic and worsening exhaustion. And every week, it seemed, there was another hitch, another irritation: a fungus in his throat, night sweats, aches. Still, and in spite of his doctor's warnings, Jim continued to work long hours and take on more projects.

Depressed and immobilized at first, Jim was now angry. Things were slipping. Fear and rage pinwheeled in him.

One day, he found himself shouting at his doctor: "All my life I've been going to the doctor's with a virus and they give me pills or a shot and I go home and I'm better in three days! Why can't you do this for me?" He had sessions with his therapist when he wanted to leap across the space between them. Many times, it was all Jim could do to keep from walking out.

Edward had been warned to expect hostility from clients; volunteers are often targets for the unappeasable anger of people they are trying to help. Yet Jim didn't actually attack Edward. He feigned indifference, froze him out.

But not completely. Jim knew he couldn't afford to lose Edward. To him, Edward was a kind of spectral "stepfather - he's here, he's going to help you, he'll pay the rent, and you have to put up with him."

The first test of this unacknowledged adoption came in October, when Jim's doctor decided to admit him to Cabrini Medical Center near Gramercy Park. He wanted to make sure the cause of Jim's swollen glands wasn't lymphatic cancer, which was common in AIDS patients.

Edward and Jim talked often throughout the days Jim waited for a bed. Jim was very anxious. Edward rightly suspected that Jim's denial regarding AIDS was “shredding." Jim could no longer ignore the fact he was ill.

After Jim was settled in his room, Edward called. Jim realized he hadn't bothered to tell Edward he'd finally gone into the hospital, let alone his room number. And here was Edward - kind, patient Edward, who'd been giving so much for months and getting nothing back - screaming at him on the phone.

"I've been calling the damned switchboard all afternoon trying to find you," Edward shouted into the receiver. "I called your doctor and they couldn't find you, nobody could find you. Why didn't you call me, for God's sake? I thought maybe you didn't go in, maybe you changed your mind - why the hell didn't you call me?"

Jim was stunned. He listened to Edward, mumbled a few words of apology, and hung up.

At his apartment a few blocks away, Edward held his head in his hands. He was afraid he had just destroyed any chance he had ever had to help Jim.

Yet when Edward visited the hospital the next day, Jim was friendly, even warm. "And he started doing something he hadn't done before. He started complaining about things-how terrible the food was and so forth. I realized, that day, I could be myself with this guy."

"I guess," says Jim, "I just finally got hit in the face -Edward's a human being, too, and he really cares about me.

THE BIOPSY FOR cancer turned out negative for Jim. His physical condition was "stable." Since Jim was no longer in crisis, it was G.M.H.C. policy that Edward move on to another client.

And so, one afternoon in late fall, Jim and Edward met for lunch. A sea change had taken place. Lately, when Edward asked Jim how things were going, he heard the truth: climbing the stairs out of the subway in the mornings was becoming a struggle.

But today Jim was feeling good. Edward was the one who felt rotten. Edward waited until they had finished eating.

"Well, Jim," he began, "I think you're going to be doing fine by yourself now. You're doing so well, you don't need me anymore. So technically, our professional relationship is about to come to an end."

Jim's face flushed red. "Of course, I'll be in touch with you because - I mean, I care about your condition."
Jim was rigid with anger.
"We'll continue to talk."
No, Jim thought, Edward couldn't leave. Edward was his ace in the hole. Edward was assigned to him. Edward had to put up with him, no matter what.

After months of trying to get rid of him, Jim heard himself saying to this familiar stranger, "I don't want you to go away."

Then after a moment, he heard Edward say, "O.K. Don't worry. I'll see what I can do."

Edward managed to stay on the case. A little more than a month later, Jim was diagnosed with pneumocystis carinii pneumonia. Now he really had AIDS.

THE APARTMENT isn't big enough for two people. The platform bed and a large sectional sofa take up much of the space. Most of Jim's things are still in storage. The deer head above the little fireplace belongs to Dennis, Jim's lover, as do the framed Erté prints on the opposite wall.

A year and a half ago, Jim met Dennis, who is now 39, at an Alcoholics Anonymous meeting. They've seldom spent a night apart since. Soon afterward, Jim and Dennis found an apartment and moved in together. That Christmas, they exchanged rings. Now Jim's ring will fit over his index finger.

Dennis says he felt from the beginning that they would go on forever; he was ready for a "forever" relationship. They would work hard, maybe buy a house, go on wonderful vacations, retire together.

Last August, Dennis came home from work one evening and Jim told him he had AIDS. Jim told Dennis he was thinking of going back to Texas, where he had friends who could take care of him. He didn't want to be a burden.

Dennis was numb. He told Jim, "I love you. You love me. We should stay together. I'll take care of you."

Then Dennis withdrew into himself. He thought of suicide. He thought of living out the illness and, when Jim died, killing himself.

Dennis has been tested and says he has "perfect blood." Jim's doctor told them how to have safe sex. But as the months went by, Dennis realized he didn't want to touch Jim. Jim had lost so much weight that, when Dennis put his arm around Jim, he felt his bones.

There was a commercial warning against drunk driving on television. The skeleton hand would reach out and grasp the human hand and there would be the sound of the crash. When Jim touched him, Dennis couldn't help it - Jim's hand was like the skeleton hand.

One night, Jim exploded: "I don't know what's going on with us! I don't know if we're roommates, if we're friends, lovers, what!"

"I'm here every day," Dennis said. "I see what's happening to you. It makes me so sad. I'm engulfed by it. I'm doing all I can do."

Nothing was resolved. Later that night, Jim said, "I want to tell you something. I'm trying very hard. No one will say, if I die, that I did not go out fighting."

Dennis had enrolled himself in a support group for "care partners" at G.M.H.C. He brought it up there. "Somebody in group said, “You're watching too much TV,' and then everyone in group went around the room and told me how important they found touching and hugging and holding each other was in their relationships."

That Saturday night, when they were watching television, Dennis invited Jim to sit next to him. They held hands. Dennis hasn't been troubled by the skeleton since.

Recently, a volunteer legal adviser came to the apartment and drew up a will with Jim. Jim has been looking into cremation.

"When he dies," says Dennis evenly, "I'll have the will. I'll call up the crematorium - if we decide to go with those people. But now is the time to make the decisions." He brightens. "And who knows? Maybe they'll find a cure. And in 20 years when he dies, or 40 years when he dies, it will still be all done."

Jim is slowly becoming an invalid. Dennis has fantasies of escaping with Jim, but that isn't possible. AIDS will be with them forever now. And Dennis has realized, no matter what -if Jim lives or dies - there will always, forever now, be the fear that AIDS is incubating in him, too.

THE EMOTIONAL TRIBUTE AIDS is exacting from the homosexual community is incalculable. In psychological terms, not just epidemiologically, AIDS is like a stone cast into a pond; perhaps diminished, the ripples nevertheless cover the entire surface. No one who comes into contact with AIDS, however healthy in fact, is entirely immune from the havoc it wreaks.

Some homosexual men, faced with the relentless horror of the epidemic, seem compelled to deny its existence. Other reactions that have been reported include grief, anger (especially at what is perceived as the inadequate response of government), depression, but, most markedly, a widespread and unabated anxiety -the incubation period for AIDS ranges from one to five years.

"You get the feeling you're in Beirut or on the front line of a war," observes Dr. Daniel William, whose Manhattan practice is largely composed of homosexual men. Since 1980, 43 of Dr. William's patients have died of AIDS. Thirty-five men in his care have AIDS at present; 200 have symptoms of AIDS-Related Complex.

Dr. William says the notion shared by homosexuals and heterosexuals alike - that only "fast-trackers" with phenomenal numbers of sexual contacts get AIDS is a continuing "travesty."' Many of the homosexual men with AIDS studied early in the epidemic reported they had had up to twice as many sexual partners as a control group of homosexual men without AIDS.

Recently, however, says Dr. William, he has been diagnosing AIDS in men "whose sexual lives were, I think, probably on a par with many single women in Manhattan: They dated and had serial monogamy. They had one person in their life at a time."

It is now simply far easier for a homosexual man to come into contact with the virus than it was in the early days of the epidemic. In fact, the virus is now so widespread, says Dr. James Curran, the head of the AIDS research center at the Centers for Disease Control in Atlanta, that "a single sexual contact for a gay man in New York or San Francisco, or many other American cities, now means a substantial risk of getting infected."

All of Dr. William's homosexual patients, he says, visit him much more frequently than they did in the past. He emphasizes, however, that few can quite be called hypochondriacal. Under the circumstances, it would be remarkable if the majority didn't feel fragile, vulnerable, endangered.

Each news report has repercussions. Speculation last October that saliva might transmit AIDS set off a panic. The development of a blood test to detect antibodies to the AIDS virus (indicating the invisible virus's presence) has also created anxiety. The test cannot in any way diagnose AIDS, and it can only indicate contact with the virus.

"Burnout" among AIDS counselors is chronic. Last February, in the space of two-and-a-half weeks, six clients attached to Edward's team of eight counselors died. The perpetual cycle of mourning grinds down the strongest sensibility.

Health professionals are themselves hardly exempt from AIDS burnout. General practitioners are in a particularly harrowing situation. They are working with patients whom they cannot cure, and most of those patients are young men suffering from illnesses that would normally be seen by gerontologists or oncologists, physicians who make a conscious choice to treat the elderly or those with cancer.

More homosexual men are seeking psychotherapy because of AIDS. The Chelsea psychotherapist Dixie Beckham comments that a few of her physically healthy homosexual patients display levels of anxiety so acute that they "seem almost to be under greater stress than people who have been diagnosed with AIDS."

Commonplace issues of intimacy and coupling have become volatile, laden with existential import. Men contemplating a relationship must face a unique uncertainty. They must ask themselves, points out Dixie Beckham, "Does he have AIDS and will I lose him? Do I have AIDS and can I make a commitment to a relationship?" Such questions, she notes, often must remain "just that questions."

LAST DECEMBER, three days after what would have been the fifth anniversary of their meeting, Edward visited his lover Robert's grave for the first time.

Robert died on Dec. 22, 1983 from pneumocystis carinii pneumonia, Kaposi's sarcoma and myriad other illnesses. His final hospital stay lasted four months. Edward visited him every afternoon. If Robert's family visited, they came in the evening. Edward was known to them as "Robert's friend."

The last few weeks Robert was in the hospital, Edward desperately wanted him to die. Robert was no longer the person Edward had known. He could not walk. He weighed 60 pounds. He was blind. He had lost his hearing. He was in an almost constant state of epileptic seizure. He could not speak. He would not die.

The day before Robert finally did die, Edward watched while the nurse changed his gown. Beneath the withered skin, under the rib cage, Edward could see Robert's heart, its outline. He could see it beating.

When Robert died, Edward's years with him were canceled out in one stroke. He was invited to the funeral, but he couldn't continue to pretend in front of Robert's family that he and Robert were not lovers. That was a charade he had played out, for Robert's sake, when Robert was alive.

Soon after Robert died, Edward sought out a bereavement counselor through G.M.H.C. His counselor says that though Edward had not been able to save Robert, he can, through helping others, retrace his steps.

The cemetery is in a pastoral setting about an hour away from New York City. The stone is very simple -marble, smooth on its face, with Robert's name and dates chiseled into the surface. There was a moment of sadness because of the dates - so few years between them. But Edward knew immediately. Robert was not there.

Every day when Edward visited the hospital, he took Robert a red carnation. It was the flower he'd always given Robert. After standing by the grave a while that day, Edward lay a carnation at the base of the stone and left.

Several weeks after he visited Robert's grave, Edward called Robert's mother, as he sometimes does. "By the way," he said, "I went to the cemetery..."
"I know," she said.
"But how did you know?"
"I saw the carnation."

It had never crossed his mind that she might have known that he was the one who brought Robert a carnation every day. Now, Edward saw, she had known that and perhaps more, but simply could never say what she knew.


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Jim Sharp preparing a meal in his kitchen. He now spends a good deal of time in his apartment.


WHEN JIM WAS diagnosed with pneumocystis carinii pneumonia in December, he refused to go into the hospital.

At first, his doctor thought he was joking, but Jim insisted on being treated as an outpatient. Since Jim's condition wasn't yet critical, the doctor acquiesced and Jim took an antibiotic, the standard medication. It hit him "like a sledgehammer," but he managed to go in to work an hour or so every day. The drug worked and Jim was able to keep the real nature of his illness a secret.

All the same, he found he was putting things off - taking a folder out of a desk drawer to make a notation, for instance - because he was so exhausted. Eventually, Jim was waking up every morning and asking himself, 'Am I going to get out of bed today? Am I going to bounce out of bed, or am I going to lie here a couple of hours?'

Finally, after Christmas, his doctor told Jim he had a choice: He could either work at full capacity or start taking care of himself.

Edward remembers Jim telling him coolly that he was going to meet with his boss. Then, suddenly one morning, Jim was on the phone, in a complete panic.

"I don't know what I'm going to do." Jim was almost babbling. "I have to go in and see the boss. I have to tell him I'm gay, I have to tell him I have AIDS. I don't know what I'm going to say."

Gradually, Edward calmed him down. They arranged to meet at a coffee shop near Jim's office before his appointment that afternoon.

When Edward arrived, Jim was nervously waiting. They went over his options and came up with a scheme for Jim to present to his boss Jim could at least finish up his current projects working out of his apartment.

"So I'll go in and tell him I'm sorry that this has...”
"Don't tell him you're sorry, Jim. It isn't your fault you have AIDS. O.K.?"

When it was time to go, Edward paid the check and walked Jim as far as the lobby of his office building. With a wave of his hand, Jim disappeared into the elevator.

That evening he called Edward. "He is truly a wonderful man," Jim said. "It was very emotional. He said he thought I was gay. He said he was afraid it was AIDS. He said he's been praying all along it wasn't."

Jim was elated. How many bosses would sit down with you and try to work out a way to keep you on if you walked in and told them you had AIDS?

Edward was tremendously relieved. He congratulated Jim. But then, when they'd hung up, Edward thought of Robert - how hard Robert took it when he had to quit his job, how Robert never lost hope, how Robert believed someday he would go back to work.

Jim and Edward haven't yet talked about Robert. They talk about movies, books, the theater - ordinary things. They have also discussed God, mortality and eternity, but not the prospect of Jim's death - not yet, not seriously.

Sometimes they joke about death. Jim will even joke about Dennis's next lover. Jokes mask the fundamental injustice that lies at the core of Jim's and Edward's relationship: It just as easily could have been Edward and not Jim.

But it is Jim. And the probability of Jim's death is like a vast rampart they are approaching. It circumscribes their relationship as surely as does Jim's fierce will to survive. The question isn't whether that rampart can be demolished or even surmounted, but whether Edward can help Jim stay on this side of it.

FEBRUARY. POCKMARKED snow lies unmelted in the gutters, but the sun is out today. From his window, Jim can watch old women and winos skirt the shadows on the sidewalk, adhere fastidiously to the fringe of sunlight along the curb. He is like them, treading a fine line.

Jim often thinks: If this apartment were on the back of the building, maybe facing a brick wall, he'd go berserk.

For several weeks, Jim has been working at home, but today is officially his last day. For the first time since he went to work at the age of 12 in a little country store in Texas, he will be out of work.

The other day, a woman from G.M.H.C. came by and helped him with the applications for disability insurance. His replacement began work yesterday. He heard that through the grapevine. All Jim's doing now is tying up loose ends.

Earlier today, the intercom buzzed. It was Frank, the office messenger. "Yo-bro!" Frank said, and stepped in. He turned off his tape machine and removed his headphones and probably for the last time handed Jim his interoffice mail.

They'd told Jim that Frank was bringing down his check, but it was not in the envelope. Jim needs that check.

There are two phones in the apartment. Often during the last few weeks, Jim has found himself talking on both of them at the same time. Jim loves his work.

Jim called Edward and told him about the check, then he unplugged both phones.

Jim can feel the fires going out in his body. The medicine cabinet, which for a year contained no pills, is now full of them. Sometimes he's too tired to say a single sentence. But it's interesting he still doesn't look the way a person with AIDS is supposed to look, or at least the way people think you should look.

Jim is not afraid of death, but he is afraid of what dying might entail. What he is most afraid of is seeing Dennis cry. Sometimes he thinks it's very selfish on his part. He doesn't want to hurt the people who love him.

Each night when he goes to bed, he thanks God for his sobriety and asks for sobriety for the remainder of this day and all his tomorrows. He asks God to please not let him live in hysteria but in the plane of acceptance.

He's been lucky. His lover didn't leave him. They haven't been evicted from their apartment. Jim lost some friends, he made some.

He wants to be back in the office in the middle of it all, but he thinks now he will probably never go back again.

He knows now that he will have to live with this.

George Whitmore is a novelist and freelance writer based in New York.

HOW CONTAGIOUS IS AIDS?

AIDS is now known to be caused by a virus known as LAV or HTLV-III, and studies of the epidemic since its discovery in 1981 have shown a persistent pattern of contagion. The virus can be transmitted when the bodily fluids -particularly blood or semen - of an infected person are introduced into another person. Sexual contact, blood transfusions and contaminated needles are the usual means of transferral. In the United States, male homosexuals, intravenous drug users of both sexes and recipients of transfusions of blood and blood products have been, so far, the groups at highest risk. Research in Zaire in Africa shows the disease is almost equally distributed between the sexes there, suggesting that it can be spread among heterosexual partners.

Federal health officials, however, say that the risk of AIDS spreading among heterosexuals is small, although it increases with the number of sexual partners, particularly if they are members of high-risk groups.

For those in high-risk groups or those who have had sex with many partners, health officials urge precautionary measures to avoid the exchange of semen and saliva or the contact with blood in sexual practices. (The virus can be found in saliva, but epidemiological studies have shown no evidence that saliva is a vehicle of contagion. Nevertheless, scientists cannot exclude the possibility.) Many also advise prophylactics for the male and abstention from involvement with multiple sexual partners.

AIDS seems to be like most infectious diseases, in that many more people are infected than become sick or die. Most experts believe AIDS is not as highly contagious as, say, measles. So far, among the more than a hundred health-care workers who have accidentally stuck themselves with a needle used on an AIDS patient, doctors have reported that the virus was transferred in only one case. And Dr. Harold W. Jaffe, a leader in the AIDS research group at the Centers for Disease Control in Atlanta, says that the Federal agency has not received a single report of the disease in a classmate, housemate or fellow worker of an AIDS victim unless that individual also had been a sexual partner of the victim's or an intravenous drug user.

Perhaps as many as one million Americans have been infected by the AIDS virus without having become ill, estimates Dr. James W. Curran, the head of the AIDS research group at the Atlanta center. What proportion of those will go on to develop the disease is a subject of intense study. Dr. Curran says that probably l0 percent will do so.

Other hints have come from tests recently conducted on blood samples taken from a study of homosexuals in San Francisco begun several years ago. Of those whose blood is now known to have been positive for the AIDS virus five years ago and who were apparently healthy then, about 5 percent have developed the disease. Of the others, about one in four has developed symptoms of AIDS-Related-Complex, often a precursor to AIDS, and about two-thirds have no symptoms at all, though their blood still tests positive. No one can yet predict the medical future of these individuals.

-LAWRENCE K. ALTMAN, M. D.

END