From one end of America to the other for the past year, state legislatures have been busily grappling with the multiple challenges represented by the disease AIDS. Most of the 550 AIDS-related bills introduced into the legislatures have been highly controversial in nature, says Richard Merritt, executive director of George Washington University's Intergovernmental Health Policy Project. Relatively few of these proposals, however, have been enacted. In the next few weeks the project will release a comprehensive report on how states have been dealing with the AIDS problem.
Examples of frequent proposals include requirements for mandatory testing, isolation of people with the AIDS virus, or required tracing of the sexual contacts of those who have the illness, Mr. Merritt says.
Most of the new laws that state legislatures have enacted, he says, have been quite different in thrust: ``Most of the attention at the state level has been in supporting education and prevention measures,'' either in the public schools or among people at high risk. Alaska and Massachusetts, for example, are planning to mail copies of the US surgeon general's report on AIDS to every state household. Connecticut has offered to finance any community deciding to undertake such a mailing.
During the past few years, some 15 states have passed what Merritt calls ``very strong confidentiality'' laws, either by enacting new legislation or amending existing laws. In Massachusetts and California, which have the stiffest confidentiality laws, the fact that an individual has tested positive for the AIDS virus cannot be disclosed to anyone without the patient's consent. In Wisconsin, on the other hand, disclosure is permitted in a limited number of cases, such as to a physician or a blood bank, although confidentiality otherwise is upheld.
In most case, after legislatures have considered the issues involved, they have failed to approve restrictive proposals.
For example, Merritt says, ``the largest majority'' - 85 bills - of the mandatory-testing proposals would have required premarital testing. ``But only three of these bills were enacted,'' in Illinois, Louisiana, and Texas. And in Texas, the requirement would take effect only if the number of Texans believed to have contracted the AIDS virus, which can develop into the disease itself, reaches a level higher than most experts think is likely.
Seven states have passed new laws, or amended old ones, so as to provide due process of law to people who have AIDS, but at the same time enable society to protect itself from those of the afflicted who behave irresponsibly. The measures would seek to persuade such people to change their behavior through counseling. But if all else failed, Merritt says, the bills contain the authority to quarantine.
All states require that the names of people diagnosed as having the disease be reported to health authorities; 12 states have the same requirement for people who test positive for the AIDS virus.
``Only two states that we know of,'' Merritt says, are actively seeking out the sexual contacts of people diagnosed as having the disease and who provide the names of their sexual contacts - California and Idaho.
In four states - California, South Dakota, Nevada, and Ohio - people coming into the prison systems ``are being routinely screened'' for the AIDS virus.
In many states, bills were introduced that would have provided criminal penalties of various kinds to sexually active people who knew they had tested positive for the AIDS virus. ``But only a handful of states have enacted any laws,'' Merritt found. Louisiana has the stiffest penalty: Any person convicted of ``knowingly'' behaving in a way to infect a sexual partner is subject to a $5,000 fine and up to 10 years in prison.
In Texas, Merritt says, a person indicted for sexual assault must undergo a blood test to check for the presence of the AIDS virus.
The article of October 28 on state actions regarding the disease AIDS should have said that Colorado, not California, is among states that trace sexual contacts of AIDS victims, and that routinely test incoming prisoners for the AID virus.