AIDS TREATMENT NEWS Confidentiality Policy -- and HIV Healthcare Hysteria

AIDS TREATMENT NEWS never has and never will sell or share its subscriber list with any other organization. We restate this policy for two reasons:

* In our last issue, when we added the masthead on page 2, we inadvertently left out the confidentiality statement. The original text is back in this issue, and of course there never was a policy change.

* The growing hysteria over HIV-infected healthcare workers is increasingly threatening medical practice. Persons with AIDS are wondering who will treat them, if HIV-positive physicians are driven out of medicine, and others become more reluctant to treat AIDS.

At a recent medical conference, some physicians noticeably avoided the AIDS TREATMENT NEWS table -- something we had not seen before. Most or all of them were undoubtedly HIV-negative, with no reason to fear having their HIV status exposed, but in the present climate of fear, they did not want to be seen as associated with AIDS.

This situation has arisen because of the understandable fear patients may have in any major medical situation -- in a hospital or doctor's office surrounded by unfamiliar technology, and often facing unknown or serious illness. This normal fear and vulnerability is being exploited by right-wing politicians in pursuit of their own advancement, to the detriment of the entire medical system, not only in regard to AIDS. For example, a new bill to impose 10-year prison sentences on doctors who know they are HIV-positive and do not tell their patients -- introduced by Jesse Helms (Republican, North Carolina) and passed by the Senate -- would also set a precedent for direct Federal regulation of physicians' practices. According to a report in The New York Times, (July 19, page 1) the bill would create a new category of U. S. criminal law.

Undue focus on the negligible risk of HIV infection from a surgeon -- estimated to be comparable to the risk of death by traffic accident during the trip to the hospital, less than the risk of death by lightning, and 500 times less than the risk of death from anesthesia -- distracts attention from the far greater danger of patient-to- patient disease transmission if proper infection-control procedures are not followed.

Perhaps the most serious effect of policies such as the Helms bill, or the U. S. travel ban on foreign visitors and immigrants, is that they give everyone in the world an incentive not to know their HIV status, not to be tested, not to interact with the medical system. Most persons with HIV do not know that they are infected, and therefore do not take precautions to avoid transmission; as a result, they are more likely to spread the virus than those who do know their status. The crucial trust upon which cooperation depends must not be destroyed by self- serving politicians.

A way must be found to reassure the public about the safety of medical care, without spending tens of millions of dollars on unnecessary testing, driving thousands of health-care workers out of medicine, making HIV care harder to obtain, and threatening all the public-health efforts which employ voluntary cooperation in AIDS prevention.