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Mandatory HIV Testing
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•Type with double-spacing
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IN RESPONSE:
A common theme in the comments of Drs. Weissman and Buckingham is the need for mandatory testing of entire populations to identify HIV-infected persons and to control the AIDS pandemic. This is an opinion shared not only by many other physicians but also by many laypersons and their elected representatives. The reasons we have not adopted such an approach are adequately delineated in the position paper [1] and are briefly summarized here.
First, the discrimination encountered at all levels of society by persons known to be infected with HIV has been abundantly documented during the first decade of the AIDS epidemic. Public education and legislative actions have improved the situation, but there is still a long way to go before discrimination against HIV-infected persons ceases to be an issue. Second, mandatory population testing programs are extraordinarily resource-intensive and would add a huge incremental cost to our already constrained health care bill. Testing the 260 million persons in the United States would cost at least $10 billion each time it was done!
Finally, no evidence exists to suggest that even a single case of AIDS would be prevented by such an approach. It is significant that calls for universal testing are being heard from some quarters but not from those charged with protecting the public health.
The editorial by Cohen and colleagues [2] that accompanied the position paper does not indicate that we can interdict persecution of persons with AIDS by education of all citizens, as Dr. Weissman suggests. That is an important goal, to be sure, as we have stated [1]. Note in the editorial [2] that universal testing is not a component of the three-pronged prevention program advocated by the Global Program on AIDS and the U. S. Agency for International Development.
Theodore C. Eickhoff, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
