LETTER
Mandatory HIV Testing
Ward B. Buckingham, MD
15 August 1994 | Volume 121 Issue 4 | Pages 309-310
TO THE EDITOR:
Your position paper on HIV infection [1] prompted the following response:
You noted that "when discrimination against persons infected with HIV has been eliminated ... then HIV testing can be treated more like other noninvasive diagnostic tests." What kind of public health approach is that to the only common infectious disease with a guaranteed 100% fatal outcome?
Your statement that "sound public health policies should be based on scientific data, not on unwarranted fear and anxiety" is the best argument for requiring HIV testing of all physicians and health care personnel. Knowledge of HIV status eliminates fear generated by uncertainty of HIV status—our patients deserve to know! What better way to improve AIDS education than to identify HIV-positive persons so that they can choose behavior that protects their patients, families, sexual partners, and others. Reminding us to practice universal precautions to minimize risk of transmitting HIV to our patients is admirable. But we physicians are a stiff-necked, independent sort, and we certainly are not perfect. Why not identify the few HIV-positive caregivers and instruct those continuing in their caregiver role in rigorous practice of universal precautions?
Why reassure the public about something about which so much uncertainty exists? Your addendum about the cases of child-to-child HIV transmission without identifiable risk factors highlights how little we know about HIV contagion.
1. American College of Physicians and Infectious Diseases Society of America. Human immunodeficiency virus (HIV) infection. Ann Intern Med. 1994; 120:310-9.
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