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Afraid of AIDS? Think Before You Test

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To the editors:

As the AIDS epidemic continues to spread from high risk groups into the general public, a wide range of medical, legal, and ethical questions regarding AIDS antibody testing remain to be answered. Most important are three critical issues: who is to be tested, what manner of counseling, if any, should be offered, and once obtained, should such test results be made and kept confidential.

In spite of the legal uncertainty surrounding testing, counseling and confidentiality, a variety of social organizations and medical clinics are advertising in the Reader, hoping to appeal to people nervous about contracting AIDS. In offering a variety of services, from confidential blood-screening to members-only social events, these facilities are considered to take some of the risk out of meeting prospective partners by determining and tracking one's antibody status.

Although many organizations and clinics advertise protection from AIDS by certifying that individuals have been tested HIV-antibody negative, no amount of testing, regardless of how rigorous or periodic, can in and of itself insure that a person will not become HIV-antibody positive.

Consequently, to avoid potential lawsuits most social clubs, contrary to their advertising, are quick to inform their applicants that they cannot eliminate the risk of contagion or guarantee their members are free of the AIDS virus. In light of recent Supreme Court decisions protecting individuals with transmissible diseases from discrimination, so-called AIDS-free clubs may soon find it difficult to retain that distinction.

Further, anyone seeking an organization offering confidential testing may be surprised to know that in light of the growing number of people infected with the virus, some medical associations are adopting resolutions challenging state laws guaranteeing confidentiality. Also, test results may be subpoenaed. To prevent such legal action, states must enact special laws. To date, no state has passed such legislation,

Although no claim of safety is made by these clubs or clinics, nor do they advocate high risk behavior, the inference that an HIV-negative partner is a safer partner, or participating in less than cautious behavior because of such an inference, could prove fatal.

Granted, these organizations may advertise a legitimate service, but the critical nature of HIV-antibody testing, counseling, and confidentiality demands that any facility attempting to provide such services conduct itself within accepted standards of public safety and in accordance with what is accurately known about AIDS. Unfortunately, no specific regulations currently exist to monitor or enforce the conduct of these organizations.

Consequently, the Chicago Board of Health has recently passed a resolution which would allow it to pursue an investigative role into the various organizations advertising antibody testing. The scope of their investigation will include whether the testing process is accompanied by educational counseling and the testing facility is utilizing recommended procedures of confidentiality.

But until such time as clear and enforceable AIDS legislation is enacted, as relates to members-only clubs and testing clinics, it remains the lonely responsibility of the individual to determine if his or her rights are being protected when the price of admission is paid. It may well be a price one cannot afford to pay.

David Welsh

W. Fargo

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