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Article submitted to the U.S. Osho magazine, VIHA Connection in November 1994. Most of it was reprinted as a letter to the editor. I have modified a few words to make it more accessible to a broader audience, and shortened it slightly.
How AIDS is NOT Transmitted
by Sw Prem Srajano
I was very pleased to read Jayapal's article in your last issue citing some facts about AIDS showing that "the likelihood of transmission through casual contact would seem to be minimal". It seems to me that the publication of currently known facts about how AIDS is not transmitted is useful to avoid false debates.
Since you opened the VIHA "inquiry" I have done some research in the medical literature and found a particularly interesting article (1) that strongly supports Jayapal's hypothesis. The authors report on a study they conducted on people who lived in the same household as someone with AIDS, but who were not sexual partners. This particular study covered 206 household contacts of 90 patients with AIDS. No contact acquired the HIV infection.
In their study, the average time in which the contacts lived with the AIDS patients during the most infectious period of the disease was about two years. During this time there was extensive sharing of household facilities and items and personal interactions, including hugging, kissing, bathing and sleeping with patients. Most of this contact took place before the diagnosis of AIDS, so that no precautions had been taken in the household during this period.
In a second article (2) published in 1993 I found a discussion of precautions to be taken in social settings such as health-care, schools, day-care centers, playing fields and the home, in regards to preventing HIV infection. Its recommendations are very relevant for the context of a meditation center.
In this article 17 studies like the one above are summed together, giving 1167 household contacts of 657 AIDS patients studied with not a single infection by casual contact. Medical researchers consider that the risk of getting AIDS through casual contact is too small to measure. This would appear to contradict the idea held by many sannyasins (disciples of Osho) that meditating together with HIV positive people is dangerous.
I am not an expert on AIDS but I have read these articles carefully, and I fail to see the flaw in them. If you want to try to find the error, write for reprints of the articles at the addresses given below.
The authors of the first article also make some interesting comments about the significance of their work. "Misconceptions... appear to be greatest in areas reflecting lack of knowledge about how HIV is not transmitted, rather than how the virus is transmitted". For example they cite an extensive survey of American high school students in which "84-98% knew that AIDS was transmitted by sharing needles used to inject drugs or through sexual intercourse. However only 42-65% knew that AIDS is not transmitted through using public toilets". They cite many similar surveys and make the observation that "there was a striking correlation between misperception of modes of transmission and individuals' willingness to agree to the most coercive preventive measures such as quarantine."
This is illustrated by two letters from the last issue of Viha Connection. Both letters compare AIDS with the plague, and suggest that if persons with the plague, which is not necessarily fatal, must be quarantined, then why not persons with AIDS, which is fatal. The answer is that the plague is immeasurably more infectious than AIDS.
I think that there is however a possibility that new diseases worse than AIDS are on the horizon. Microbes are mutating as they learn to cope with antibiotics. The indiscriminate use of antibiotics, such as in the recent Indian "plague" panic, only exacerbates this problem. A highly infectious incurable disease could easily be just around the corner. Then the quarantine proposal would be very relevant.
This may have been what Osho was hinting at when he talked of AIDS being transmitted through tears or sweat. This is not apparently a problem today, but these words of Osho could actually be referring to another impending disease, or possibly a new strain of AIDS. To me Osho's words are not to be taken too literally. Their meaning is for each of us to fathom. As the world evolves, his words may take on a new significance that is even more profound than what we originally thought. Let's be open to this possibility.
After all, I think Osho himself has already hinted that it is unwise to take what he says too literally. "But as far as my qualifications are concerned, I am not qualified to say anything about AIDS. I have never even taken the course on first aid. So please forgive my entering into something which is not my business. But I go on doing that, and I am going to continue to do that." (3)
Universal precautions to prevent AIDS transmission
The article mentioned above on precautions, categorizes different body fluids according to the risk of infection.
"Body
fluids to which universal precautions apply:
• Blood, and body fluid containing visible blood
• Semen and vaginal secretions
• Body tissues, cerebrospinal, synovial, pleural,
peritoneal, pericardial, and amniotic fluid
Body fluids and
procedures for which hand-washing is sufficient for preventing
transmission of blood-borne pathogens (unless fluid contains
blood):
• Urine, stool, vomitus, nasal secretions, diaper changing
• Tears
• Oral secretions"
The precautions for the first list are called universal, because these fluids should be assumed contaminated from all people. After all, even an AIDS test is only meaningful from three to six months after the infection has already taken place. Rubber gloves should be worn in handling the fluids of the first list, as was also recommended by Osho.
The precautions for casual social interaction are centered on transmission through contaminated blood as this is the only known danger. Studies of persons splashed with contaminated blood showed a risk of 3 in 1000 of infection if splashed on mucous membranes (such as the lips) and 4 in 10,000 if splashed on the skin. If you think of how many times you get splashed by blood while meditating in a meditation center, and then consider the chance of being infected by this, you can see that this is not a serious probability. Covering lesions on your skin will reduce the danger.
Particular precautions are described, for example, for day care centers. These are relevant to a meditation center. Any accident involving bleeding requires immediate attention to limit bleeding, and to clean up using rubber gloves, followed by disinfection with bleach solution (diluted 1:10 to 1:100).
It is important to seek balance between minimizing and exaggerating the risks.
In general I find that sannyasins tend to attach too much importance to isolated anecdotes of persons apparently infected by non-sexual means, and forget that this only proves at most that there is a risk of infection, not that the risk is significant. It is important to seek balance between minimizing and exaggerating the risks.
I am thankful that Osho instructed us to take measures such as the use of condoms so early in this epidemic. Following his guidelines was a question of trust for me in his deeper wisdom, and not whether he was right or wrong about medical facts. I am sure it has saved the lives of many of us. But nobody can say what is Osho's guidance today on the segregation of HIV positive people.
for up-to-date online references, see Studies of Casual and Other Exposures in Households in the AIDS Knowledge Base of the U.S. Centers for Disease Control.