Gay Groups, Officials Oject to ID Verifying Results of AIDS Test

A company operating out of a Van Nuys medical office is advertising and performing a test for exposure to the AIDS virus and offering clients “a photo ID verifying negative test results.” But AIDS researchers say this test can be unreliable, sometimes generating false positives or false negatives and possibly encouraging AIDS carriers to infect others.

The company’s president, Brian Hymes, said he is “doing a service to the community.”

AIDS researchers and spokesmen for organizations representing AIDS victims and the homosexual community say test results can easily be misinterpreted, leading either to a false sense of security or a false sense of impending doom.

“We are very concerned about how this sort of an operation is represented,” said Peter Scott, a spokesman for AIDS Project Los Angeles, a counseling, lobbying and assistance service for AIDS victims.

“The danger is that it confuses people . . . into believing that a carrier of such a card has status that he or she doesn’t have,” he said. “Having that card is no assurance that they weren’t infected already and certainly they could become infected once they have the card.”

If someone is told that the test has shown exposure to the AIDS virus, that can be dangerously unsettling, he said. “You’re dealing with a disease now that’s incurable and mostly fatal,” Scott said. “It creates enormous emotional stress.”

Previous Effort Stymied

The last attempt by a company to market a card verifying negative results on a test for the AIDS virus began in January but ground to a halt after the Los Angeles City Council, led by Councilmen Zev Yaroslavsky and Joel Wachs, ordered investigations of a West Los Angeles firm called National Assn. for AIDS Awareness.

At the time, Wachs called the idea of marketing such cards “disgusting and misleading.”

The company “never got off the ground,” a spokesperson said last week.

Hymes said his company is different. “We don’t tell anyone how to use the card,” he said. “The card gives someone a fresh start at a given point in time,” he said. “It’s meant to give someone . . . a new beginning.”

Hymes said he contacted Wachs’ office in search of support several months ago. “They were mostly concerned with the way you advertise,” he said. “It’s such a delicate subject. I’m not pushing the hell out of it. My ads are responsible.”

A spokesman for Wachs said no one in the office knew Hymes had actually gone into business.

The business has been in operation since Hymes had the idea for the testing program in January, but has only recently started promoting itself, “actually advertising and advertising the card,” Hymes said.

Ads Placed in Periodicals

Medical Screening Services, which is based in a small medical office at 7554 Woodley Ave., is advertising in L. A. Weekly; the Free Press, which caters to heterosexuals who engage in recreational sex, and Frontiers, a biweekly homosexual-oriented magazine.

Customers “are not beating the doors down,” Hymes said. An employee at the office said Medical Screening was testing one person every three or four days.

The full-page advertisement Hymes ran inside the front cover of Frontiers has not generated a single customer, Hymes said, probably because of fear. “The higher the risk group, the more they seem to be turned off to being tested,” Hymes said.

Hymes said he wrote to AIDS Project in January, seeking an endorsement, but got no response. Groups promoting homosexual rights “don’t want anyone else getting into the act,” he said. “They say it’s our disease.”

According to Hymes, AIDS is everyone’s concern. “Who is in a high-risk group?” Hymes asked. “Anyone who considers themselves sexually active.” A number of heterosexuals have sought the service, he said. He described one patient “whose girlfriend pushed him to come here.”

Exam, Blood Tests

For $100, Medical Screening gives its customers a complete physical examination and performs tests for several sexually transmitted diseases. These include the HTLV-III Elisa test, which detects antibodies in the blood that show whether a person has been exposed to the AIDS virus--called HTLV-III or HIV in the United States.

The Elisa test, developed to screen the nation’s blood supply, is “overly sensitive” and apt to produce many false positives, said Charles Schable, chief of the AIDS diagnostic laboratory at the federal Centers for Disease Control in Atlanta.

Moreover, a negative result doesn’t guarantee that a person cannot pass on the AIDS virus, he said. If the person was exposed to the virus not long before the test was taken, telltale antibodies may not have developed yet. Also, the person could be exposed to the virus the day after he took the test, Schable said.

“AIDS is just not one of those things where you can take a test and get a card in the mail that says you got it or you don’t,” Schable said.

Expensive Follow-Up Test

If Medical Screening performs an Elisa test and it comes back positive, Hymes said, “we automatically rerun the test.” He would not say, however, how many tests have produced positive results.

If the second one is positive, Hymes said he meets with the patient, gives him or her brochures on sexually transmitted diseases, including a Public Health Service leaflet called Facts About AIDS, and recommends a final, confirmatory test called the “Western Blot.”

The Western Blot test is more expensive--in the neighborhood of $100 contrasted to the $10 laboratory cost of the other test--but is far more accurate, rarely producing false positives.

Hymes also recommends that the person get psychological counseling. “I talk to them about protecting themselves and protecting society,” he said. But, he added, “We’re not a counseling service.”

Hymes said he wears a white laboratory coat when he meets with patients to discuss test results. He has no medical degree, but he has a bachelor’s degree in clinical psychology, he said, and “I have done my homework on this.”

If the client tests negative for the various diseases, he or she is offered a small green card, topped with the word Healthcheck, that bears the message: “The person whose name and photograph appear on this HEALTHCHECK was examined by a physician on (date) and on that date tested NEGATIVE to the following laboratory procedures.”

The list includes tests for syphilis, gonorrhea and chlamydia as well as the Elisa test. There is a note marked “caution” at the bottom of the card. “The significance of the laboratory test results as set forth on this card must be explained by your physician,” it reads.

‘Give an Individual License’

“The whole problem here is that the company is giving the wrong message on the subject,” said Dr. Martin Finn, medical director of the AIDS Program Office of the Los Angeles County Department of Health Services. “The right one is this is the time to be cautious, to be responsible. These cards almost give an individual license to be other than responsible,” he said.

“The possibility of having a negative test and being out there being communicable exists,” he said.

Finn said Hymes called him early this year to propose a program to test restaurant employees for sexually transmitted diseases. “I told him over the phone that I would not approve nor give it my support,” Finn said.

“We are absolutely opposed to any kind of use of the antibody test that suggests that a negative test indicates freedom from infection with the virus,” said Dr. Neil Schram, chairman of the Los Angeles City-County AIDS Task Force. “It is extremely dangerous of anybody to assume that a negative test indicates freedom from infection,” he said.

It’s not just the AIDS test that makes such a card a controversial item, Finn said. “A card can give a real sense of false security,” he said. “That person could have been incubating syphilis on the day he got the test. He could go out and feel he can do anything sexually. . . . That’s the way small epidemics get started.”

Laws Not Violated

Inquiries at state, county and city agencies indicate that this type of AIDS testing program, including the issuance of a card, violates no law. A spokesman for the AIDS section of the state Department of Health Services said the only required license--other than the license for the physician performing the checkup--is for the laboratory doing the AIDS test.

Physicians Reference Laboratory in Huntington Beach analyzes the Elisa test for Medical Screening. The laboratory is properly licensed, the state health spokesman said.

“Medical entrepreneurs can offer what they will as long as they’re clinically correct in what they’re doing,” Finn said. “But socially it’s an unacceptable strategy in terms of protecting the public health,” he said.

For those who want to be tested for AIDS exposure but do not want an identity card, according to AIDS Project’s Scott, there are several centers “where people can have the same test free of charge and results are anonymous.” There are two in the Los Angeles area: the Gay and Lesbian Community Services Center in Hollywood and The Center in Long Beach, he said.

Along with the challenges Hymes has faced in trying to establish Medical Screening Services as a legitimate business, he has also had trouble with the day-to-day operation of his firm, he said.

Dr. Filiberto Zadini, who had been performing examinations and providing office space for Medical Screening Services at the walk-in medical center he was running on Woodley Avenue, is leaving that facility. Zadini said he had a disagreement with Valley Health Medical Group, which owns the company that holds the lease on the property. Zadini is moving to another medical office.

Hymes said he has a contract with Valley Health Medical Group that allows him to remain in the office. He has found three doctors, each paid under contract on a case-by-case basis, who will examine patients, he said. “We’re still in business,” he said.