Friends of Helga
OCTOBER 1985
WALTER REED ARMY INSTITUTE OF RESEARCH
WASHINGTON, D.C.
What saved them—what helped prevent an astounding purge of gay men from the military—was the study being prepared for publication in those autumn days of 1985, when the AIDS epidemic had at last entered the public consciousness.
By scientific standards, the study, authored by Dr. Robert Redfield for the Journal of the American Medical Association, drew upon a small sample of subjects for its conclusions, just forty-one Army personnel and their dependents who were being treated for AIDS at Walter Reed Army Medical Center. The forty-one subjects included fifteen very special people: They said they were not gay men or intravenous drug users, the groups commonly afflicted with AIDS. Instead, they said they were heterosexual. Of these, five were women who had apparently contracted the disease from their HTLV-III infected spouses, a route of transmission already established. The other ten were the big news, because they were men whose only acknowledged risk behavior was sex with women, mainly prostitutes in Korea and Germany. The study seemed to show, for the first time, that men could contract the disease heterosexually.
The headlines trumpeted the news. That Major Redfield had discovered no fewer than 37 percent of the Army’s AIDS cases were heterosexual (fifteen out of forty-one individuals) seemed to foreshadow a heterosexual explosion of the disease, along the lines of the exponential increase that had marked the spread of AIDS among gay men. Though cases of men who claimed to have contracted the disease from women accounted for only one-tenth of 1 percent of AIDS cases nationally, military doctors believed that their data was the truer presage of things to come. The heterosexual AIDS epidemic was beginning.
The study came at a decisive moment in the history of the epidemic and had profound repercussions not only for the development of HTLV-III policies in the Defense Department but for the entire national debate over AIDS. For the first four years of the epidemic, few had paid much attention to the disease, even as thousands of gay men died and the government’s own frantic researchers warned that death tolls would soon reach into the hundreds of thousands and health-care costs would mount into the billions. For America’s celebrity-driven media, it took the announcement that actor Rock Hudson had AIDS to direct attention to the epidemic in a way that four years of death, suffering, and dire predictions had not been able to accomplish. Suddenly, every newspaper was running a five-part series on the epidemic and every local news affiliate had dispatched an Instant Eye or Eyewitness news team to the Centers for Disease Control.
Media attention mobilized the government, as well. Senators and congressmen who had ignored the disease now clamored for more government funding. Hopeful of a new source of research money and perhaps a Nobel Prize, scientists who had previously thought it beneath them to study a homosexual disease dashed off grant proposals. Even President Reagan spoke the word AIDS in public for the first time. (Not one to be overcome with zeal, it would be nearly another two years before he actually delivered a speech on the subject, by which time more than 25,000 Americans had died of the ailment.) For years, AIDS had been the disease that dared not speak its name. Abruptly, it had become the most discussed topic in the United States.
Just as civilian society finally focused attention on the disease, the military sprang to attention as well, making decisions that had been long delayed. The Defense Department tackled the easier issues first. On August 9, two weeks after Hudson’s announcement, the Armed Forces Epidemiological Board met to consider whether new recruits should undergo HTLV-III testing before being allowed into the armed forces. The meeting brought new faces to the civilian advisory board that weighed military medical issues.
Jeff Levi of the National Gay Task Force was on hand to argue against the testing, maintaining that research was still inconclusive about what HTLV-III infection really meant. Would those who tested positive get sick for sure, and if so, when? No one knew. It would not be fair, he said, to exclude such a large number of people when so many factors were up in the air. AIDS researcher Dr. Mathilde Krim aired concerns over maintaining the confidentiality of HTLV-III test results.
The debate was resolved when Dr. Ed Tramont of Walter Reed asked Krim whether she would recommend inoculating an HTLV-III infected individual with live-virus vaccines. “No,” Krim said, “I would not.”
The board voted to recommend screening for all recruits, with the military rejecting anyone who tested positive. On August 28, Tramont briefed Deputy Defense Secretary William H. Taft IV on the recruit-testing proposal. Tramont explained that bleeding soldiers could infect their comrades on the battlefield. He cited direct soldier-to-soldier transfusions, though such transfusions were very rare and had not been commonly employed by the military for many years. More persuasive were the photographs of the nineteen-year-old recruit at the height of his nearly lethal reaction to the vaccinia virus. Taft was said to be moved by the pictures; two days later, he ordered the testing of all recruits, as well as all applicants to the reserves, ROTC, and the military academies, altogether about 25,000 a month. Testing would begin no later than October 1.
By August, the Defense Department had reached a compromise with civilian blood bankers over the Pentagon’s earlier requirement that the names of all HTLV-III positive donors be turned over. The Pentagon agreed to allow military donors to sign an “informed consent” form authorizing the blood bank to pass on blood test results to military doctors. Soldiers who did not want their test results to go to the military “may leave the blood donation site without providing an explanation,” according to the Defense Department order.
Although the compromise at least advised military donors that their doctors would be notified, it was far less a victory than blood bankers had hoped for. In a private memo to members of the American Association of Blood Banks, Grace Neitzer described their unfortunate choice “of either terminating existing constructive relationships with local military facilities or arranging to collect blood in accordance with the DOD directive.” By threatening to ban uncooperative blood banks from bases, the Pentagon had played its trump card. As blood donors, military personnel were extraordinarily good citizens. In some heavily military areas, blood centers received as much as 18 percent of their donations from military installations. Nationally, 3 percent of the nation’s blood supply came from donors in uniform. At a time when AIDS hysteria had drastically reduced blood donations, the industry could not afford to lose such a reliable source.
Meanwhile, a more significant battle was being fought over whether to test the 2.1 million active-duty military personnel. The debate again pitted the medical branches of the military against personnel commands. That there would be some form of mass screening was never in doubt. There were too many overseas duty stations in areas with high levels of endemic diseases that could endanger immune-compromised soldiers. Although it might be easy to care for an infected person assigned to Pearl Harbor or Lackland Air Force Base, where major medical centers were close at hand, remote duty stations in the Aleutians or Diego Garcia were not well equipped to handle an unexpected case of Pneumocystis carinii pneumonia or cryptococcal meningitis.
The key question was what would happen to those soldiers who tested HTLV-III positive once the mass screening began. The medical branches continued to argue that HTLV-III infected personnel be retained at least for stateside duty until their immune systems declined to the point at which continued work was detrimental. There was no medical reason to boot out otherwise productive soldiers, they maintained; they found allies in some manpower officials with pragmatic views of the expense of retraining HTLV-III positive soldiers. As one official told The New York Times, it took three years to train a military air-traffic controller. It did not make sense to throw that training away if an HTLV-III positive controller was still able to do the job. Their potential value as research subjects was another reason to keep infected personnel. As Lieutenant Colonel Ernest Takafuji, the disease-control consultant to the Army Surgeon General, told Navy Times, “Our feeling is that the military right now is sitting on a gold mine of information to help us get a better idea of the natural history of the disease.”
Uniformed personnel brass continued to argue for immediate separation of HTLV-III positive soldiers. The Army Chief of Staff made no secret of the fact that he favored immediately screening all his troops and removing those who were infected. While the Army and Air Force now routinely issued medical retirements to HTLV-III infected soldiers rather than seeking to punish them for homosexuality, the Navy and Marine Corps continued to scan the paperwork of any serviceman seeking medical retirement with HTLV-III—for evidence of violations of sodomy or drug rules.
The Navy Military Personnel Command stood by its draconian posture in early August when it reaffirmed the separation board’s ruling to discharge Hospitalman Byron Kinney for homosexuality and deny him a medical retirement. Kinney’s attorneys promptly filed a lawsuit in federal court. His congressman had also entered the debate and had publicly taken up Kinney’s cause against the Navy. Although Byron’s health was rapidly deteriorating, he promised to fight the discharge to the end. Hospitalman Third Class Bernard Broyhill, whose health was also failing, continued to fight his gay-related discharge, as well.
The conflicts over the handling of AIDS-stricken sailors had reached the highest levels of the Pentagon. In response to questions about the Broyhill case, Assistant Defense Secretary Mayer released a statement saying he expected “military physicians will adhere to the ethics of the medical profession and honor the tradition of doctor-patient confidentiality to the absolute maximum consistent with national security.” Navy Secretary John Lehman responded by saying that HTLV-III test results in themselves would not be used to punish sailors, but a spokesman quickly added that this did not mean that information gathered by Navy doctors concerning homosexuality would be ignored. Action would continue to be taken against acknowledged gays and their sexual contacts, the spokesman told Navy Times.
Pressure mounted for an end to the dissension. While officials debated, the Air Force Times reported that the Defense Department had imposed a gag order on officials regarding AIDS policy and research. Meanwhile, the military testing issue assumed geopolitical significance. In the Philippines, agitators against the huge U.S. military installations there used the AIDS threat to urge the government to quit leasing property to the U.S. military, saying that American sailors would surely spread AIDS among the massive population of prostitutes who surrounded the bases. Only assurances that all servicemen would be screened could allay these fears.
Similarly, Japan believed its population was only at risk for AIDS because of the substantial American military presence on its islands. Even liberal Costa Rica let it be known that it would not allow American troops within its borders unless they were certified to be AIDS-free. Although Costa Rica hosted no American bases, it was a likely staging area for any military actions against Nicaragua. At a time when so much of the Reagan administration’s foreign policy was focused on overthrowing Nicaragua’s Sandinista regime, the Costa Rican concerns were taken seriously.
It was in these tense days of discord that word of Dr. Robert Redfield’s studies made the military newspapers. Redfield had long predicted that the military would have to grapple with AIDS, and now people were ready to listen. Although all four branches of the services counted a total of only ninety-one cases of full-blown AIDS by September 1985, fifty of them in the Army, studies of civilian gay men had revealed that the largest proportion of those infected with HTLV-III were asymptomatic. These healthy but infected patients were the people who would comprise the six-digit AIDS caseloads predicted for the 1990s. There was no reason to believe that the larger share of the military’s AIDS iceberg was not comparably concealed. Major Redfield’s defense of the notion that AIDS should be viewed as a broad-spectrum disease process reaffirmed this suspicion.
Preliminary results from blood-donor screening in July, August, and September seemed to confirm those fears. Military blood bankers detected 44 HTLV-III positive personnel out of 62,200 military donors, or about 1 out of every 1,400. By comparison, civilian blood banks were reporting HTLV-III positive results in about 1 out of every 2,500 blood donors. Colonel Tramont predicted that within a year, the Army would find itself treating a thousand cases of AIDS and HTLV-III infection among soldiers and their dependents. The problem was going to be significant, Tramont and Redfield argued, and it was not merely going to be a homosexual problem.
Military doctors also had a new argument against those hard-liners who wanted to remove all HTLV-III positive personnel from the services. Most hawks supported discharges not on the basis of any genuine medical or military rationale; they did so on the assumption that infected soldiers were likely to be gay men. The Redfield study showed that, to the contrary, infected personnel were just as likely to be heterosexual men. More patients identified heterosexual sex as their risk behavior than sex with other men, according to Redfield’s study. AIDS had little to do with homosexuality, at least in the military, the doctors argued. To treat the AIDS problem as a homosexual problem was inappropriate.
By effectively separating the issue of AIDS from the issue of homosexuality, the doctors succeeded in making compassion an acceptable feature of military policy on AIDS. There were other factors, too. The military’s skittishness over bad publicity helped. The prospect of one thousand cases like Byron Kinney’s and Bernard Broyhill’s was a nightmare for the public-affairs specialists. Congressional Democrats had made it clear they were adamantly against using HTLV-III test results to purge suspected gay men in uniform.
In three days of private hearings, the Armed Forces Epidemiological Board met at Walter Reed in early September to map out the procedures for screening all women and men in uniform. By September 17, they had written proposals for Assistant Defense Secretary Mayer. Immediate testing of all 2.1 million active-duty troops was not advised “because of the limited availability of trained personnel and medical resources” to accomplish such a task. Instead, the Pentagon should start testing all personnel slated for overseas assignment. Then screening would commence for all 500,000 troops stationed overseas, as well as “deployable” troops, such as Marines in the continental United States who were likely to be quickly mobilized in a military emergency. In keeping with the medical branches’ interest in advancing AIDS studies, the board also recommended “pertinent and longitudinal studies” of HTLV-III positive soldiers.
The fear voiced by gay activists—that the massive screening might lead to pogroms of military gays—was met with indignation by the epidemiological board as well as by military doctors. Dr. Theodore Woodward, civilian chairman of the board, insisted that the military followed the same ethical rules as civilians and would not give information gathered during doctor interviews to commanders interested in ferreting out gays. “I can assure you that this body will have nothing to do with any agency that doesn’t adhere to those standards” of doctor-patient confidentiality, Woodward said.
On October 24, 1985, Defense Secretary Caspar Weinberger issued the order to begin ultimately the largest AIDS screening program in the world, which would ultimately include all troops in the United States military. Although Weinberger’s order provided no time line for the testing, his priorities for AIDS screening generally followed those proposed by the Armed Forces Epidemiological Board a month earlier. The projected cost for the entire screening program was $20 million.
Each branch of the service would designate medical centers for detailed evaluations of soldiers who tested HTLV-III positive. Only those soldiers with evidence of AIDS or of severe immunological problems would be separated, and they would be medically retired so that they would receive pensions and care in military hospitals, as would the victims of any other disease contracted while on active duty. Those HTLV-III infected soldiers who did not demonstrate “progressive clinical illness” would be retained, Weinberger ordered, though they might be reassigned to units that would not be deployed overseas.
An early internal memorandum from the Pentagon indicated that no information from epidemiological interviews could be used “for punitive action against an individual,” but two days later the Pentagon reversed itself. Over the objection of the Defense Department’s health and manpower officials, Weinberger ordered that admissions of homosexuality could be used as evidence in discharge proceedings. Gay personnel would be processed out under regulations allowing the dismissal of service members “for the convenience of the government,” Weinberger said. Robert L. Gilliat, a health-affairs specialist with the Pentagon general counsel, explained Weinberger’s reversal as being “decided in light of the general policy that there’s no place for homosexuals on active duty in the armed forces.”
Jeff Levi from the National Gay Task Force predicted that the order “will guarantee that when people test positive they will not be honest with health officials about how they may have come in contact with the virus.” Levi’s observation explained why it was no longer necessary to debate what to do with HTLV-III infected servicemen who acknowledged being gay. Hardly any soldier or sailor would admit to homosexuality now. The enormous publicity over Dr. Redfield’s study only ensured that military personnel would admit to sexual contact with a prostitute as their sole risk behavior for having acquired the disease.
Within months, few in the military’s medical services doubted that the explanations were anything but apocryphal. Still, the HTLV-III infected GI’s story of sexual contact with a prostitute became so routine that doctors and nurses at Walter Reed joked among themselves that there must have been one very busy HTLV-III infected prostitute at work in Berlin; they even named the industrious hooker who seemed to have infected so many soldiers. When a new HTLV-III positive soldier was admitted to the ward and claimed heterosexuality, one nurse would joke to another, “Someone else who went to bed with Helga.” Gays had for decades hidden themselves by using such code phrases as “friends of Dorothy”; now they were friends of Helga.
Along with spurring media interest and government action, Dr. Redfield’s study was used by AIDS activists to redefine entirely the scope of the AIDS problem within the American consciousness. The new line from AIDS organizations read: “Now, AIDS is everybody’s problem.” The assertion was not merely a statement that everyone should be concerned with AIDS, the activists advanced the idea that AIDS was everyone’s problem because everyone would soon be getting the disease. At the height of the heterosexual AIDS frenzy, Life magazine ran a dramatic cover story with the headline NOW NO ONE IS SAFE FROM AIDS. The inside story, titled “The New Victims,” featured a hemophiliac and his wife, the female sexual partner of a bisexual man, and children of intravenous drug users—all people from previously defined risk groups. The only new addition to the lineup of AIDS patients was the faceless picture of an anonymous soldier who said he had contracted the disease from one of his “scores” of female heterosexual partners.
There was a psychological allure to the new twist to the epidemic. The idea that a disease would stay in narrowly defined risk groups ran counter to the ideals of social democracy. There was almost poetic justice in the threat that AIDS might spread to everyone. It was in virtually no one’s interest to argue otherwise. The notion of an impending AIDS pandemic quickly became the new orthodoxy of the epidemic—largely based on Dr. Redfield’s contention that 37 percent of Army AIDS patients had contracted the disease heterosexually.
Few studies in the history of the AIDS epidemic would have such staggering ramifications or prove so controversial. The obvious question was whether a valid survey could be conducted by an institution that would discharge anyone who said he engaged in anything but heterosexual sex. Redfield acknowledged this problem in the study but dismissed it, saying, “Although military patients may be particularly reluctant to admit to certain risk behaviors, corroboration of patient information was obtained by interviews with family members and other acquaintances and by a physical examination, including a rectal culture for gonorrhea, before including these patients in the heterosexually acquired disease category.” When asked again about the study in late 1992, Redfield reflected that perhaps two of the ten men who claimed heterosexual contact were not telling the truth, which left eight—or about 20 percent of the sample—who he believed were.
But the study was conducted at a time when the armed forces were quite publicly kicking out AIDS-infected soldiers who acknowledged to doctors that they were gay. The Defense Department itself had created a powerful incentive to lie. Young men also frequently concealed their sexual identity from their families, making corroboration from such sources unreliable at best. Some scientists were persuaded of the subjects’ heterosexuality because several were married. By the mid-1980s, however, many gay soldiers were marrying lesbians to conceal their sexuality.
A substantial body of scientific evidence also undermined Dr. Red-field’s assertions. European studies had yet to document many German prostitutes infected with HTLV-III. Testing of nearly two thousand registered prostitutes in Munich, Stuttgart, Berlin, Heidelberg, and Frankfurt had found only seventeen who were infected. Moreover, among the three hundred documented AIDS cases in Germany, not a single one could be traced to a man’s sexual contact with a woman, much less a prostitute. If the tiny number of HTLV-III positive German prostitutes were giving men AIDS, they were doing it on a highly selective basis—to American servicemen only. German health authorities, in fact, became incensed when they learned that American military researchers were blaming their prostitutes for the military’s AIDS problem. New York City health officials also noted that it was strange that while prostitutes in Germany seemed to be infecting soldiers willy-nilly, there was no evidence that prostitutes in New York City, with a much higher rate of HTLV-III infection, were similarly spreading the disease.
The most persuasive argument against Redfield’s study were the current statistics about AIDS in the United States. Only eighteen of the nation’s fourteen thousand AIDS cases could be traced to female-to-male sexual contact. And ten of these cases came from the armed forces.
Redfield pointed out, accurately, that AIDS would be unique among sexually transmitted diseases if it proved to be spread only from men to women. He also argued that the lack of many female-to-male cases could be expected for many more years—studies indicated that people were most infectious at the latter stages of their immunological decline. Since men had been infected with HTLV-III much earlier in the epidemic than women, it was to be expected that they were infecting women at a much higher rate than women were infecting them. The bi-directional infections would come later, he predicted. Indeed, under this scenario, it would not be possible to weigh the threat of female-to-male transmission accurately until the mid-1990s, when women infected in the mid-1980s reached their most infectious stages.
Researchers at the El Paso County Health Department in Colorado Springs remained skeptical of the Redfield data and reinterviewed twenty HTLV-III positive servicemen as part of its state’s contact-tracing program that began on November 1, 1985. Seventy-five percent of the soldiers had told military doctors they had acquired the disease heterosexually; only four of the twenty had acknowledged being gay. To the county health department, however, fourteen said they were gay, three admitted to being intravenous drug users, and only three said they could not identify how they had contracted the virus.
Later interviews by this writer with nearly 150 AIDS-infected soldiers found 150 gay men who had all solemnly insisted to military physicians that their only risk behavior for getting the disease was contact with prostitutes in Germany, Korea, or the Philippines. None of these men were among the forty-one that Redfield studied, but it does reflect the extent to which lying about heterosexuality became routine in the aftermath of that investigation. In truth, Helga was actually Helmut. And the soldier who told his story to Life magazine was not a heterosexual who ran into the wrong woman but, rather, a gay man with a boyfriend in San Francisco’s Castro Street neighborhood.
Despite the questions about the Walter Reed study, few doubts were raised publicly about its validity outside scientific journals. It seemed everyone had a stake in advancing the heterosexual AIDS story. Editors suddenly had a new angle on the epidemic at a time when AIDS stories were hot, and it was an angle that brought the issue home to the great majority of newspaper readers and television viewers, most of whom were neither gay men nor intravenous drug users. Since the imminent threat of a heterosexual pandemic would increase research budgets, the nation’s most distinguished scientists now echoed their concerns. Seeing a possible end to government lethargy and media apathy, AIDS activists also cited the Redfield data to advance arguments for more prevention and public-education efforts.
Within the military, it was even more crucial that Redfield’s data be accepted, since the armed forces’ entire HTLV-III policies rested largely on the fiction that most military AIDS cases were not connected to homosexuality. As late as 1992, press officers from both Walter Reed and the Army Surgeon General’s office would try to prevent Army AIDS researchers from talking to an author about homosexuality and its relationship to AIDS in the military. “We’ve been able to do a lot of good because the two issues [AIDS and homosexuality] are not linked,” a public affairs official said. “It would be better if it stayed that way.”
What was most remarkable about the Redfield study was not its scientific value but the insight it offered into the depth of antigay prejudice in the United States. At the time it was published, nearly ten thousand gay men were dead or dying of AIDS, a fact that had engendered no interest in most of society. The fact that ten cases among heterosexual men could so electrify the country reflected the relative value a heterosexual life had over that of a homosexual. And most heterosexuals continued to deny that prejudice against homosexuals was a matter of major concern.
Although the HTLV-III policies adopted in October 1985 resolved several crucial issues concerning how the military would handle its massive AIDS screening program, important questions remained unanswered. What exactly would the military do with soldiers who tested positive? Though the Pentagon had ruled to retain them, how and where would they be assigned? Would their confidentiality be protected? There were no plans to gear up military hospitals for the one thousand new patients that researchers expected to find during the screening, nor had it been determined exactly what the hospitals would do with HTLV-III patients once they began arriving for the comprehensive immunological evaluations that the Pentagon now required. Although doctors had begun to consider these questions in the final weeks of 1985, the mass screening was not slated to begin until well into 1986. They had time to prepare—or so they thought.
Just one day before Byron Kinney was to be discharged from the Navy for homosexuality, the Pentagon ordered that his separation he delayed. On October 16, 1985, word came from Washington that Kinney would not be discharged for homosexuality, but would be processed for the medical retirement his lawyers had sought. Bernard Broyhill was also notified that he would be medically retired and not discharged for homosexuality. “I feel great!” Kinney told a gay newspaper. “This is what I wanted. I hope this case has helped others.”
The next day, Kinney was admitted to Balboa Naval Hospital in San Diego. Bridget Wilson had suspected that Kinney was clinging to life until his case was won—for himself and for others in the Navy. She was right. Four days later, on October 21, Byron Kinney died.
Bernard Broyhill died in November.