AIDS and public policy

AIDS has become a public policy issue of wide currency. But care should be taken that the official response not overwhelm the rights of individuals to privacy in health, occupational, and other matters. Without doubt, the burden in personal suffering and in economic and health service demands has contributed to the political saliency of the issue, requiring government leaders to respond. AIDS is the subject of a five-day conference in Washington this week, at a fundraiser for which President Reagan proposed wider testing for the disease among immigrants, aliens seeking permanent residence, federal prison inmates, patients in veterans' hospitals, and couples seeking marriage. AIDS policies will be on the agenda of the seven-nation Western economic summit in Venice next week.

At the more extreme end of political response, the conservative West German state of Bavaria last month called for regular quarterly testing for AIDS among male homosexuals, prostitutes, intravenous drug abusers, and foreigners seeking visas. Elsewhere as in the United States, ``education'' programs are proposed, with mailings of information about the disease, its transmission and prevention.

The Reagan administration as a whole has been rather slow to react, whether in terms of funding for research or in formulating a comprehensive response. It has hesitated to follow the more vigorous lead of its own surgeon general, C. Everett Koop, out of fear of appearing to condone nonmarital sexual relations by advocating prophylactic measures. The administration's tendency to treat AIDS sufferers as culprits rather than as victims led it initially to consider vastly wider testing.

Because testing is not foolproof, widespread mandatory testing could lead to false ``positive'' results for as many as one-fourth of those tested, critics say, with potentially devastating employment or personal consequences. To the health issue of AIDS would be added the intrusive and oppressive posture of government, which could lead many citizens to avoid public health officials entirely. Voluntary testing programs - which are favored by many health officials - would be less effective if citizens feared their privacy would be violated.

Room should be maintained for individual response. For some citizens, abstinence from sexual relations outside marriage, or a voluntary test before marriage, seems the obvious recourse for protection. For some who believe an intense public focus on disease is itself unhealthy, information and educational campaigns can be kept to what is required to assure an informed citizenry. For some who believe that the individual is not helpless even before a generalized health threat, the public clamor over AIDS should underscore the need to keep thought, practices, and conduct in line with their conviction, so as to support the general resistance to the challenge as well as their own exemption.

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