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AMA Urges AIDS Reporting System : Would Tell Carriers' Partners; Endorses Mandatory Tests

June 20, 1987|ALLAN PARACHINI | Times Staff Writer

The American Medical Assn. board of trustees Friday endorsed mandatory AIDS testing for blood donors, prisoners and military personnel and urged creation of a reporting system in which the sexual partners of carriers of the AIDS virus could be identified and warned by health officials.

A spokesman said it was the AMA's first report making coordinated national AIDS policy recommendations.

The AMA trustees also urged that, in addition to the names of persons actually suffering from AIDS, the identities of people who are carrying the virus but are not sick, and of those with the less serious AIDS related complex, be provided to local public health departments.

Opposition Expected

Dr. Lonnie R. Bristow, an AMA trustee, said he expects homosexual organizations to oppose expanded reporting of people infected with the AIDS virus. But he said public health agencies historically have been able to protect the confidentiality of victims of a wide variety of routinely reported disorders, including syphilis, gonorrhea and cancer.

However, he conceded that the AMA board has "concern" about what might happen to such information if it "gets outside the medical care loop" and comes into possession of law enforcement or other civil agencies.

The report, released in Chicago at an AMA convention, was to be turned over to the association's policy-making house of delegates for adoption.

The AMA trustees also recommended that:

--Mandatory testing programs be carefully separated from voluntary ones, with testing required only for a few classes of people, including immigrants, blood and organ donors and persons giving sperm for artificial insemination or eggs for in vitro fertilization; military personnel, and state and federal prisoners.

High-Risk Areas Targeted

--Voluntary testing programs should include patients at sexually transmitted disease clinics, patients in drug abuse treatment and first trimester pregnant women in areas where AIDS is prevalent. Testing would be offered to residents of high-risk areas when they seek family planning services, as well as to patients contemplating surgery in such areas. Doctors should "encourage" testing among applicants for marriage licenses, hospital patients on admission and health care workers.

--Persons who test positive for the AIDS virus should be reported to local public health agencies, either anonymously or by name under confidential circumstances. However, reporting programs should make it possible to find and notify the sexual partners of an AIDS or ARC victim, or anyone carrying the virus.

--"Serious consideration" should be given to sanctions to control the conduct of people infected with the virus who, knowing they are carrying the virus, fail to warn sexual partners. Bristow said the AMA board deliberately did not spell out the nature of such sanctions, saying they should be decided by state and local authorities. But he conceded that sanctions could include confinement or imprisonment, criminal charges or civil lawsuits.

--Anti-discrimination laws be extended nationwide to apply to AIDS victims and people carrying the virus. "The disease, not its victims, is the threat from which society must be protected," the position paper concluded.

The AMA board also urged establishment of a national AIDS commission--a step already taken by the federal government. It called for a campaign of television public service spots to increase AIDS awareness and education.

'Must Be Sexually Isolated'

"Since there is no cure for AIDS and no protection beyond avoiding or making safer intimate contact with infected individuals, those infected with the virus must be sexually isolated from uninfected persons," the AMA board report said. "A condom barrier offers some but not complete protection. Avoidance of sexual contact and (of) use of shared needles are the only sure protections."

Bristow acknowledged that the AMA board's positions on mandatory testing are somewhat at odds with those of President Reagan, who has endorsed "routine" testing of marriage license applicants and patients at drug programs and venereal disease clinics. The Administration has also urged mandatory testing for a wider range of individuals.

"I think there are areas where we do have disagreements" with Reagan, Bristow said. "One example would be in the area of what we would call preemptive sanctions." Under such programs, which have been widely advocated in recent months, authorities might even be empowered to take action against people thought likely to engage in conduct that could spread AIDS.

However, the AMA board carefully noted that while it recommended exploration of sanctions against AIDS victims and carriers who know they have been exposed to the disease but knowingly ignore health precautions, "preemptive sanctions are not being endorsed."

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