Mandatory AIDS testing is back as a ballot issue in California. Although defeated overwhelmingly last November, Proposition 64, which would have required mandatory AIDS testing for some Californians and possible quarantines for AIDS patients, will be on the June 3 state primary ballot.
The revived measure is being pushed, as before, by supporters of Lyndon LaRouche, the right-wing presidential candidate who has been indicted on credit card fraud charges.
The new version qualified for the ballot this week and does not have a number yet. It drew immediate fire from state public-health officials and homosexual-rights groups, who worked to defeat Proposition 64 last year.
``The concern [of the initiative] is not really public health. It's to advance the name of Lyndon LaRouche,'' says Benjamin Schatz, director of the AIDS civil rights project for National Gay Rights Advocates.
``Unfortunately,'' says Mr. Schatz, ``it means that once again a lot of time and energy must be spent fighting bad policy rather than fighting AIDS.''
Last November's vote on Proposition 64 was closely watched by policymakers in other states who were wondering how to respond to public concern about Acquired Immune Deficiency Syndrome.
Since then, about 550 AIDS-related bills have been proposed in 48 states.
But none has been as restrictive of AIDS patients as Proposition 64 would have been, says Kate Farrell, a research analyst for the National Conference of State Legislatures.
Much of the proposed legislation across the nation, however, raises some of the same questions that surfaced during California's debate on Proposition 64.
Such issues include voluntary vs. mandatory testing, confidentiality vs. public reporting of test results, housing and employment rights, public schooling, and AIDS funding.
Of all the AIDS-related bills considered by states this year, only about 50 have become law. ``It could be that states are deciding legislation may not be the way to go,'' Ms. Farrell says. ``Conditions [in regard to the disease] are changing so rapidly.''
As states weigh how best to protect the public health, many are recognizing that existing laws give state health officials authority to quarantine, if needed, patients diagnosed as having communicable or sexually transmitted diseases.
``Yes, many states have reaffirmed their right to isolate or quarantine an individual with a communicable disease [in response to AIDS],'' says Dick Merritt, director of the Intergovernmental Health Policy Project at George Washington University. ``But they have also added something that wasn't there before - language giving respect to due process and civil liberties of such patients.''
In general, such laws require the state to shoulder the burden of proof showing such a patient is a danger to the public health. Most of the laws also provide for education, counsel, a fair hearing, and assurances that ``the least-restrictive antidotes'' are used to monitor the movement of the patient, he says, adding that no state has exercised its power of quarantine.
Civil libertarians and gay-rights groups are not entirely pleased with such state laws, noting that expert after expert has testified the AIDS virus is not transmitted through casual contact with a patient.
Most agree state restrictions on AIDS patients should apply only to those few who, despite extensive education and counseling, continue to engage in behavior that endangers the public health. Even then, they warn, due process must be followed.
With AIDS resources already stretched to the limit, the prospect of possibly spending another $2 million to again fend off the anti-AIDS measure in California raises the ire of gay activists and public-health workers here.
Still, Proposition 64 represented an opportunity to educate Californians about AIDS - and the new measure will do so again, gay activists say.
``The overwhelming defeat of Proposition 64 demonstrated that the American public could be educated about AIDS, and that fear would not dominate American public policy,'' Mr. Schatz says.