Schools May Be Kept in Dark About AIDS : Board Learns Law Prevents Giving Names of Those Who Have Been Exposed to Virus

School board officials considering a proposal to allow AIDS victims to remain in San Diego city schools were informed Tuesday that there is no guarantee that school officials would know of students or employees who had contracted AIDS or had been exposed to the AIDS virus.

While one state law requires doctors to report cases of AIDS--acquired immune deficiency syndrome--to county and state health officials, another bars revealing cases of proven exposure to the virus that can lead to the disease. Health officials say people with the virus may be more contagious than those who have the disease.

“I think the general principle is that confidentiality should be maintained,” even after a case is reported to the county, said Dr. James Chin of the state Department of Health Services. “I don’t know how we would recommend that the health department respond if the parent did not agree to informing at least the principal.”

The issue surfaced Tuesday as the San Diego Unified School District’s board of education continued discussing its proposed AIDS policy, which is based on medical evidence that the syndrome cannot be transmitted through the kind of casual contact that occurs in schools.

The board intends to vote on the proposal after a final public hearing Oct. 8. But on Tuesday, Trustee Kay Davis said she had decided to vote against the policy after talking to doctors and hearing several doctors testify against it at a hearing last week.

“I don’t feel personally we should risk the rights of the whole for the rights of one AIDS student,” Davis told the rest of the board. She characterized the policy as “avant garde and on the cutting edge” and said she did not feel comfortable with it.

The proposed policy, based on federal recommendations and prepared by specialists in pediatrics and infectious disease, would bar from the school system only preschool children and others who might bite or be incontinent. The district would consider all other cases individually, in consultation with school district and personal doctors.

So far, there are no reported cases of AIDS in the city schools. About 200 cases, or less than 2% of all AIDS cases reported in the United States, have been children. Officials say they received the infection by being born to mothers with AIDS or by receiving transfusions of contaminated blood.

Transmitted through sexual contact and blood products, AIDS has mostly affected homosexual and bisexual men and recipients of contaminated blood. Although tests can detect people exposed to the virus that causes AIDS, doctors say the tests are not completely reliable, and many people exposed to the virus have not come down with the full syndrome.

On Tuesday, health and education officials said that although people infected with the virus may be more contagious than those afflicted with the full disease, a state law passed last spring bars anyone from revealing the results of an AIDS virus test without written permission from the patient.

As for the full syndrome, doctors who diagnose it must report the diagnosis to the county and state health departments, doctors said. But Chin and others said in interviews and at the board meeting that the state is not obligated to report the case to school or other officials.

In a telephone interview, Chin, who is chief of the infectious disease branch of the state health department, called the communication issue “a difficult question” in light of the confidentiality normally accorded to patients. He said the state task force on AIDS is likely to consider it this week when it meets to discuss school policy.

At the hearing, Jeffrey Black, the UC San Diego professor who helped draw up the proposed policy for San Diego, acknowledged that it was possible for people exposed to the AIDS virus or infected with the disease to be in the school system without officials knowing.

For that reason, several trustees wondered what type of AIDS policy would be most likely to encourage parents to inform the system if a child had been diagnosed.

“An adamant policy against allowing these children in school might drive the information underground,” said Trustee John Witt. Dorothy Smith suggested that, without any policy, parents would simply send children with AIDS to school and not inform the school about the problem.

Davis said she had initially thought she would support the proposed policy. But she said she now believes that the board should exclude AIDS students, at least until more is known about the disease and the board can reconsider.

Only a handful of people turned out Tuesday to voice their views to the board, just as one week earlier only three people spoke.

Testimony of Dr. Michele Ginsberg, a San Diego County health department epidemiologist who has studied AIDS since 1981, contrasted with that of several doctors who said last week that the epidemiology of the disease has been consistent since it was discovered.

She said the virus has been transmitted only through exchange of blood or in sexual intimacy. “Casual contact such as that which would take place in a shared workplace or classroom is not sufficient to transmit this virus,” she said.

“In my view, the proposal before you is scientifically sound, consistent with public health positions, and an appropriate guide,” Ginsberg said.

Carol Holeman, who identified herself as the mother of a second-grader in the school system, testified that she objected to the fact that under the proposed policy the school district would not inform parents if there were an AIDS victim in their child’s class.

“By withholding that information from me, you are making arbitrary decisions on my behalf,” she told the board. “ . . . When a decision is made (on the policy), I do insist that I be told if my son is put in that environment.”

Afterward, Holeman said, “My objection is not so much even AIDS. It’s that that information is being withheld from me.”

Asked how she would react if there were an AIDS patient in her child’s class, she said, “To be honest with you, I don’t know what I would do. But the decision should be mine.”