A Unified Front Against AIDS
which were, if not legally, then at least socially punishable through discrimination and alienation. This difficulty in admission leads to a further, more grave problem: the unreliability of the information from the screenings. If the admission of certain behaviors is recognized as socially unacceptable, the propensity to falsify information greatly increases. Potentially contaminated blood would enter the blood pool, seemingly regardless of screening processes, without a conclusive test for HIV.
In some cases, this fear of contamination from high-risk groups took an extreme form. In January of 1983, a Texas-based group proposed legislation to criminalize homosexual behavior on the grounds that this behavior jeopardized public health. This group also pressured the White House to move to criminalize the donation of contaminated blood. Any donor who’s blood was found to be contaminated with the AIDS virus could be held legally responsible. While this legislation was suggested under the guise of the protection of public health, it seems that its result would have been highly counter-productive. Anyone who might volunteer to donate blood would be seriously dissuaded by the threat of potential legal action in the event that they, even unknowingly, carried the virus. Without any test to detect the presence of the virus, blood donation would present a no-win situation for the donor: he or she would undergo the inconvenient and uncomfortable process of donating blood, and then wait to find out if legal charges would be brought against him or her. Any humanitarian gain is lost in the threat of criminal repercussion. As an aside, it seems difficult to believe that without a test, the presence of the virus could be reliably detected to the point where the identification of an individual donor would be possible, yielding criminal prosecution. This further exposes the Texas group’s position as a proponent of the public good, and reveals their position as a merely a stance against certain behaviors they found unseemly.
Unfortunately, the problems concerning civil rights and privacy did not end with the development of a reliable HIV test. A positive HIV test often carries with it social prejudices concerning the means of contraction of the virus. Issues of fault and blame pervade a positive diagnosis, making the dissemination of knowledge concerning infected individuals a controversial subject. While knowledge and record of infected individuals is necessary for the study and research of the disease, this notion is countered by the myriad social problems an HIV-positive individual may encounter in the future by virtue of being identified as infected.
The greatest impediment to a unified response to the AIDS crisis involved the response of the institutionalized public health system. The two most important groups involved were the Centers for Disease Control (herein CDC) and the National Institutes of Health (herein NIH). The public health system, at its very heart, exists as an uncoordinated entity, structurally unable to present a unified response to any health crisis, let alone one with the complexity of AIDS.
In a health emergency, distinct roles must be defined in order to conserve time and [next page]