A survey reveals what went wrong with network coverage of a sensitive issue

By Edwin Diamond

Back in June, ABC News and The Washington Post did a poll on public knowledge of AIDS (Acquired Immune Deficiency Syndrome), a new and usually fatal disorder that causes victims' internal defenses against disease to shut down, leaving them vulnerable to illness, including pneumonia and a rare form of cancer. Some 80 per cent of those surveyed said they had heard of AIDS - an extremely high level of awareness, according to the polltakers. On the other hand, though, fully one-third said they were worried that AIDS might be a threat to them or their families - an extremely high level of fear and misunderstanding, for as ABC's Max Robinson pointed out in the course of reporting the poll figures, "Medical experts say only a few segments of the population are at risk."

As anyone who watches TV or reads newspapers knows, these same medical experts have been telling us over the past year that the major risk groups for AIDS are male homosexuals, heavy intravenous users of drugs and Haitians. (It turns out that they were probably wrong about Haitians; more about that later.) So the question naturally arises: how did the general public - everyone who isn't a male homosexual, an IV drug abuser or a Haitian - pick up the idea, undeniably scary and patently false, that they were in danger of getting AIDS? The obvious answer: the public got this notion from the same sources that alerted four out of five of us to the existence of AIDS in the first place - the medical experts and the media.

If a lot of people who should not be worried are worried, it is common enough in our television-sensitive society: someone with a cold appears on our home screens, and a lot of us get sniffles. But AIDS is so far from the mainstream of public-health dangers that our News Study Group (NSG) at MIT decided to look at how the AIDS story was spread to the American public, particularly by network television. We found that the role of TV news in creating an exaggerated fear of AIDS in the public mind is a textbook case of the interplay of experts and media - and of fear, error, sexual politics, reticence and sensation.

The History. Three elements of the AIDS story immediately attracted media attention. AIDS was something new in the world (it was first described in 1981), hitting vigorous adults, and thus newsworthy. AIDS was something mysterious - doctors didn't know the agent(s) that caused it, and, more dramatically, didn't know how to treat it - and mysteries always grab audiences. Finally, AIDS was proclaimed as reaching epidemic proportions, with five new cases a day being reported. And the epidemic was deadly: few AIDS victims remained alive three years after getting the disease.

AIDS, however, was not found in most neighborhoods, and that changed the story. From the beginning, AIDS hit a specific segment of the population: promiscuous male homosexuals living in New York and San Francisco accounted for perhaps as many as three out of four reported cases. Drug abusers who took drugs intravenously, the other major risk group, also didn't live in most neighborhoods. Still, as more became known about AIDS, it increasingly became thought of, in the words of one young man quoted on the CBS Evening News., as "the gay cancer."

The Coverage. The young man, Larry Kramer, identified by CBS on the screen as "Gay Health Activist," suggested to correspondent Barry Petersen that "the country" - health officers, the media. the public - was ignoring the AIDS epidemic because most of the victims were homosexuals. But our News Study Group analysis, concentrating on the coverage in the period August 1982 to August 1983, discloses that the three television networks, in particular, not only covered the story but appeared to be scrupulously correct in presenting "gay spokespersons." True, the tabloid words came exploding from the screen when the continued anchors were billboarding the news of AIDS: "Terrifying ...mysterious ...out of thin air" (Tom Brokaw, NBC Nightly News, April 29); "Killer disease..." (Jessica Savitch, NBC, May 8).

But the words and images were carefully modulated when talking about the victims of AIDS. In early March 1983, for example, on ABC's World News Tonight, correspondent George Strait said there was a new AIDS risk group - hemophiliacs and "other people who depend upon blood transfusions." Since June 1982, Strait reported 27 people had contracted AIDS from blood transfusions (there are some 10 million blood transfusions performed each year in the United States), and 10 of these people had died. Strait then explained that while health officers were setting up guidelines to exclude male homosexuals from contributing to blood banks (because the AIDS agent might be incubating in their bloodstreams), the authorities would also try to "balance the rights of those who donate blood with the rights of those who need it..."

In its strained evenhandedness, the ABC report is emblematic of much of the strangely schizophrenic coverage of AIDS. The "mystery" epidemic appeals to network news instincts for the good story; but the homosexual "angle" makes these same news-people very nervous. The aggressive news hounds become prim Victorian gentlemen and ladies. In August 1982 the CBS Evening News with Dan Rather was blunt about the majority of AIDS victims being male homosexuals, but not until May 1983 could CBS bring itself to report on the Evening News that sex is the second major way to transmit AIDS. The first major way, according to the CBS script is transmission through blood - in fact. A much less important factor than sexual activity, CBS had it wrong because, since the beginnings of the AIDS epidemic, health officers have been saying that it isn't just sex that is linked to AIDS outbreaks, but continuous, casual (what in a more judgmental era was known as promiscuous) anal and oral sexual contact, often involving dozens or even hundreds of different partners.

Health officers weren't heard saying such things on the evening news because a "family" medium like national television (as well as this magazine) understandably finds it very hard to use even the above words, much less to describe precisely and graphically exactly how such homosexual contacts can transmit infectious diseases.

In fact, for years before the appearance of AIDS, doctors have seen a whole "zoo" of diseases - rare viruses, virulent bacteria, animal parasites - coming out of the gay bathhouses and back rooms of bars catering to commercialized homosexual sex. But, except for a fleeting reference here to "personal contact" or "sexual intimacy" and a phrase there about "the bathhouse culture of cities like New York and San Francisco," a viewer could look in vain at all three network news programs to find any hint of the unpleasant crucially important details about the prime suspected environment of AIDS. It would only be a slight exaggeration for the attentive viewer to conclude, based on network viewing, that partners get AIDS from holding hands. This carries "taste" and "responsibility" perhaps too far.

The Sources. It is a journalistic truism that news organizations are dependent on their official sources; police reporters on precinct captains; White House correspondents on Administration spokespeople. Medical and scientific reporters are no exception; indeed, given the complex, technical nature of a medical story like AIDS - or like Agent Orange, or dioxin or toxic shock syndrome, for that matter - reporters may be even more dependent on experts such as immunologists, infectious-disease specialists, internists and chemotherapists.

The networks' AIDS coverage reflects this dependence, and it seems that a few "expert sources" of tentative and preliminary research information probably contributed as much to the public apprehension about AIDS as any other single factor. One such source was Dr. James Oleske of the New Jersey School of Medicine and Dentistry in Newark. He appeared on a CBS Evening News story in December 1982, and talked about AIDS in children: he said the afflicted children he studied were born to, or lived in houses with, high-risk adults. Another source was Dr Anthony Fauci of the National Institutes of Health, who editorialized in the Journal of the American Medical Association about Dr. Oleske's research. As NBC Nightly News told it in May, Dr. Fauci wrote that children could have picked up AIDS "through routine close contact."

 The "everyday contact" story, at most a hunch based on a handful of cases, sent AIDS coverage into a new and semihysterical orbit during the spring of 1983. Police and prison guards demanded surgical gloves and face masks when dealing with homosexuals: nurses and hospital workers recoiled from treating AIDS patients: funeral parlors refused to embalm AIDS victims - and the networks reported these episodes in fast moving roundup pieces. The TV coverage had few of the excesses of, say, the New York Post (AIDS SHOCKER AT BELLEVUE ... GRANDMOTHER DIES OF AIDS), but together the inconclusive research and the perfervid headlines and vivid images succeeded in scaring tens of millions, as the results of the ABC-Washington Post poll indicate.

Just how dangerous it is for journalists to rely on anyone expert when a story is fast changing and complex was illustrated by the example of the Haitians. For the past year, Haitian immigrants to the U.S. have been included in most stories as a major AIDS risk group. When Haitians lost their jobs or housing as a result of the AIDS publicity, it was just one more burden for a largely poor and uneducated underclass. In recent weeks, however, some health officials have been backpedaling and reclassifying the Haitian AIDS cases often into the homosexual or IV drug-abuser categories.

As the story unfolds, it seems that the Haitian victims of AIDS. who speak mainly Creole, were interviewed by English-speaking doctors. These doctors did not know that homosexuality and drug taking were taboos in Haitian culture, and that Haitian men who may have broken the taboos therefore would be unlikely to admit it. The NBC "Special Report" on June 21, reported by science correspondent Robert Bazell, fully explored the story and the apparent injustice done to Haitians by singling them out as a separate risk group, based on faulty interviews.

The Lessons.  Bazell's "Haitian Connection" was the second of a two-parter he did on the Nightly News. His work stands as a model of how television can succeed by demystifying and explicating the new and the terrifying. Bazell studied immunology at the University of California, Berkeley. As a full-time science correspondent for NBC, he has been given time to develop the AIDS story, to go to Haiti, and to draw on many medical expert sources, rather than one or two.

One thing anyone who has looked at audience research knows is that medical stories don't need a lot of hype; the audience is engaged as soon as you begin talking about health. Medical and science coverage on television doesn't have to be dull. It does require time and resources. Our News Study Group concluded that television, at least on the network level, imposes too many limits on its news coverage; the network news is too squeamish to speak plainly; it is too reactive to events - such as a medical journal article - to prod experts and question facts; it is too enthralled by what it is being told to push stories beyond the headlines.

Indeed, when NBC's Bazell chose to surface with his conclusions about AIDS sexual breeding grounds, about Dr. Oleske's no more than suggestive research and about the overblown AIDS "threat" to the general public, he turned to print and a magazine article in The New Republic. This meant that perhaps 100,000 people read his realistic discussion of AIDS, rather than the 10 million or more who watch NBC Nightly News. We conclude that television news' reporting of AIDS and other health hazards will come of age when such grown-up materials can be presented in depth and with care on the evening newscasts. The audience deserves as much.

Edwin Diamond is adjunct professor at MIT and director of its News Study Group - TV GUIDE OCTOBER 22, 1983