201 CHRONICLESnTHE POLITICS OF AIDS RESEARCHnby Irving Louis HorowitznThe epidemic of AIDS highlights a crisis in policy onnwhich the social sciences may shed some light. In thenprocess, it may also move the study of policymaking to somensubstantial higher ground. Whenever we pose a question innterms of understanding rather than resolving, we run thenrisk of hearing social research denounced as irrelevant, if notndownright obstructionist. Yet such a risk is minor comparednto a bland acceptance of a presumed common wisdom thatnoften points to an uncommon folly. With AIDS, fornexample, a recitation of raw numbers of potential victims isnof less importance for policy than the demographic, geographic,nand sexual characteristics of those involved.nWe need to begin, then, by a disaggregation of macropolicynfrom micro-policy. In one sense, the former is anbundle of issues composed of the latter. But each hasndynamics of its own. Affirmative action is a macro-policy.nBut it is derived in part from Executive Order No. 11246nissued during the Lyndon B. Johnson White House years.nIn its specifics, this order concerned government hiring.nNow mandated quotas have been imposed on ever widernareas of both the public and private sector. At such a level,nthe concept of policy is a 20th-century equivalent to then19th-century notion of geist or espirit. Racial equity is notnso much a crafted political position as a broadly felt need ofnthe age. It exists across class no less than racial boundaries.nThe issue of developing a policy toward AIDS isnsomething else again. It is a specific disease which afflicts anspecial segment of society, for the most part urban homosexualncommunities, and to a far lesser degree those whonuse drugs or have had blood transfusions. Further, it is annarea in which a general policy consensus does not currentlynexist, and hence, the capacity to impose a policy on a societynis more readily strained. Finally, it is an area in whichnneither the scientific nor medical parameters are entirelynunderstood. For example, the length of the incubationnperiod varies greatiy, and only recentiy has it been publicizednthat AlDS tests may fail to indicate the infection fornmore than one year. Hence we can look at the AIDSnproblem as a relatively “pure” case of the extent to whichnpolicy is effective in contexts of both scientific doubt andnintense social polarization.nThe policy differences between those who, like EducationnSecretary William J. Bennett, advocate avoiding premaritalnsex and illegal drugs as the most virtuous, safest, andnsmartest way to prevent AIDS infection and those who, likenSurgeon General C. Everett Koop, emphasize prophylacticnand public health measures to reduce the risks among thensexually active, are indicative of a general crisis in policy asnsuch. In the intensifying debate between the abstentionistsnand pragmatists, and a corresponding confusion over nor-nIrving Louis Horowitz is Hannah Arendt Professor ofnSociology and Political Science at Rutgers University andneditor in chief of Transaction/Society. His most recentnbook is Winners and Losers: Polarities in AmericannPolitics.nnnmative frameworks of behavior, description rather thannprescription may well prove to be the order of the day.nThat, at any rate, is what Hiatt and Essex (1987) claimnwhen they urge politicians to clarify their policy persuasionsnon such issues as: (I) conflicts between public healthnrequirements and the homosexuals’ rights to privacy; (2)nwho should pay for treatment; (3) what ancillary programsnshould be introduced for drug users; (4) what should bendone to prevent AIDS in the newborn; (5) how researchncan be encouraged; (6) what educational programs shouldnbe advocated; (7) how international cooperation can benfostered in AIDS research and prevention; (8) how fiscalnpriorities would be set, and at the expense of which currentnprograms.nBefore such a leap into policy considerations is made, it isnimportant to state a few social truths about AIDS. It isnprecisely these tha’t are dangerously obscured by phrases liken”alternative life-styles” (as opposed to “safe life-styles”) andn”high risk groups,” in contrast with specific mentions ofnhomosexual populations, as well as the “homophobic bias,”nwhen the issue of victims is broached in a concrete fashion.nThis avoidance of the brute fact that nine out of 10 victimsnof AIDS are homosexuals (the figure would be even highernif the so-called bisexuals were included) is typical of peoplenwho want clear-cut policies even as they move to obscurenclear-cut evidence.nAt present no AIDS vaccine is available and no satisfactorynantiviral drug exists. The widely used azidothymidine, ornAZT, is so toxic that roughly 50 percent of AIDS patientsncannot take it. We also know littie about the origins ofnAIDS. It seems that the disease exists in a benign fashion innthe green monkey of Africa, but that it becomes virulent innhumans. AIDS can incubate for a great period of time, cannbe transmitted from the female no less than the male, and isninfectious in carriers for years without the victims’ knowledge.nAs a further complication, testing for AIDS is notnallowed, and on those rare instances when it is, it is notnalways possible to identify specific individuals as carriers.nThus, generating policies for AIDS is at best a vague andngeneral activity, which comes hard against the granite wallnof constitutional law, no less than it does against medicalnand chemical inadequacies.nWhat we see instead is the development of long-termnpolicies based on demands for increased funding for AIDSnresearch in order to bypass or avoid dealing with short-termnrealities. The policy of treating AIDS has turned into anmetaphysical disposition to develop a way to disregard socialnconsensus, limit the scientific information base, and confusenmoral premises. A good example of this is the manipulationnof the AIDS epidemic by groups like the Planned ParenthoodnFederation of America to foster the need for an”nationwide sexuality education,” with littie, if any, commentarynon the actual problem of the plague (AIDS) asnsuch. Given the nature of special interest groups in America,nthis sort of tendentious spin-off approach may benexpected to become common currency among all sorts ofnsecular and religious groups, on all sides of the issue.nWhenever a serious problem emerges in Americannsociety, the call for public action is sure to follow. Onen