The AIDS Exception: Privacy vs. Public Health

Abstract:
In 1997, the Centers for Disease Control and Prevention (CDC) recommended that states require reporting of cases of HIV infection, not only AIDS. This article preceded the CDC recommendation and supports essentially the same view, noting that the public health community has dealt with HIV/AIDS differently than other infectious diseases. Typically, standard public health measures have included routine testing for infection; reporting to local health authorities the names of those who test positive for infection; contact tracing to identify any people who may have been exposed to infection; and notification of the possibly infected people that they may have been exposed. In contrast, the author states, the "chaotic patchwork" of public-health steps against HIV/AIDS are inadequate to contain and eradicate the disease. Even limited routine testing (such as voluntary testing of certain hospital patients) would be of value in identifying previously unrecognized cases of HIV infection. The author argues that the reasons for "AIDS exceptionalism" presented in the mid-1980s--that the disease seems to constitute a marker for homosexuality, that the confidentiality of testing would inevitably be violated, that contact tracing would be ineffectual due to the large number of sex partners involved, and that reporting of HIV infection is pointless because of the lack of cure or treatment--are no longer valid. The article is well written and admits to flaws in the conservative position (such as an unwillingness to provide funds to help all of these newly identified people with HIV infection). The large-print lead-in to the article is of concern; the article later makes clear that "It's time to stop granting 'civil rights' to HIV" refers to the virus itself and not to people with the virus, but the statement is too easily misinterpreted. The article will primarily be of interest to those with a background in public health, who understand the difference between reporting test

Author(s): BURR, Chandler

Publication: The Atlantic Monthly


Date Published: 6/1/1997

Pages: 9

Location Code: 13023