I have cared for AIDS patients every day of my professional life since 1984. As a physician, it's easy for me to know how to vote on the LaRouche initiative, Proposition 64 on the November ballot. I know what the disease is and how it is spread. I also know that because most AIDS patients are homosexual men, AIDS--acquired immune deficiency syndrome--carries much excess moral and political baggage; this has made it easy for bigots to play on public fears to the detriment of sound public policy-making. I am saddened to see energy and money having to be spent for the "No on 64" campaign that could better be invested elsewhere in the battle against AIDS.
What does Proposition 64 say? It reads innocuously enough; If passed, it would require the state health authorities to take "all appropriate measures" to protect the public from AIDS. (The implication is that the state health authorities have not been doing their job and have willfully allowed the public's well-being to be jeopardized.) It would further require all people with a positive test for antibodies to the AIDS virus to be reported to the state, and that such people be prohibited from certain kinds of employment (namely, work involving contact with other people). A consideration of the facts about the disease should make it clear that Proposition 64 is unneeded, and in fact, would result in the opposite of its stated aims.
AIDS is caused by a virus that can attack and destroy the body's immune system. When the immune system becomes seriously damaged, a person becomes defenseless before an onslaught of otherwise harmless microbes and eventually succumbs. The AIDS virus is spread by intimate sexual contact and by exposure to infected blood and blood products. AIDS is not spread by casual contact: Despite intensive scrutiny, there has not been a single proven case of transmission of the virus occurring via ordinary social and workplace interactions. Insects and saliva don't spread the disease. AIDS is unusual; it takes a complex series of voluntary acts to become infected. Unlike the common cold virus which can sneak up on the victim, the AIDS virus needs very special circumstances to be successfully transmitted from one person to another. AIDS is hard to get.
Proposition 64 is sponsored by Lyndon LaRouche and his National Democratic Policy Committee of Leesburg, Va., a group that would also have us believe Queen Elizabeth II is a kingpin (queenpin?) of the international narcotics trade and that Henry A. Kissinger is a communist agent. LaRouche represents a virulent strain of American thought that has been around a long time: As Richard Hofstadter pointed out in "The Paranoid Style in American Politics," extremist groups from the Know-Nothings of the 1850s through the White Citizens' Councils of the more recent South have sought to appeal to people who felt disenfranchised, fearful, and alienated from the rest of society. LaRouche and his supporters are the Know-Nothings' spiritual heirs. It is a serious mistake to underestimate the potential of these extremists for wreaking political and social havoc: in the '20s, the Ku Klux Klan controlled the state government of Indiana and almost caused parochial schools to be declared illegal in Oregon.
At first glance Proposition 64 would appear to be an example of what happens when LaRouche zealots apply to medical science the same keen analytic techniques they use in the world of politics; but in reality they have shrewdly hit on an issue likely to appeal to many voters who ordinarily wouldn't think of associating with them. The link of AIDS to homosexuality has created a climate allowing people who disapprove of homosexuality (and polls show most do) to camouflage their sentiments by saying, "I'm not against gays, I just don't want to get AIDS at a restaurant or in the workplace, so I'll vote for Proposition 64."
Most of Proposition 64 reinvents the wheel. State and local public health authorities already have the power to impose whatever means they judge necessary to protect public health from AIDS, including quarantine. They have not imposed quarantine for the simple reason that they are bright enough to understand it wouldn't work--not because they have been thwarted by the conspiracies of "male homosexual lobby" or by a drug-peddling English monarch. For a quarantine to have any prayer of working, all AIDS-virus carriers would have to be rigorously excluded from the rest of society; we lack the scientific ability to identify all such carriers, we lack the economic ability to cope with the massive social dislocations a quarantine would produce--and I hope we lack the cruelty and ignorance necessary even to think of enacting such a quarantine.
The only addition, albeit significant, that Proposition 64 makes to existing law would be to require that all people who test positive for antibodies to the AIDS virus be reported to state public health authorities. The pro-64 ballot argument suggests that this would lead to "contact tracing," as is done with other venereal diseases such as syphilis and gonorrhea. Yet the only reason to perform contact tracing for those diseases is that they are curable; AIDS has no cure, and thus AIDS contact tracing would have no positive value, and indeed would have real potential for abuse: Thousands of Californians could find themselves excluded from employment for no other reason than blind prejudice. It is likely that people infected with the AIDS virus would actively avoid medical care just so that they would not lose their jobs.
Considering the facts about AIDS transmission, Proposition 64 won't do anything to protect the public. It will cause needless anxiety and has a real potential for hurting many innocent people. We have to realize that the real defense against AIDS is not going to be provided by the government, but must instead come from each one of us through education and understanding.
What is needed is medical progress, public education and responsible political leadership. Republican Gov. George Deukmejian and Sen. Alan Cranston, a Democrat, hardly agree on anything, but both have come out against 64. So have the Roman Catholic bishops. So has every medical scientist with a shred of credibility. What is not needed are appeals to the dark side in all of us. Bluntly, LaRouche and company count on voter ignorance. They had some success recently in Illinois, much to the dismay of the Democratic Party. Happily, polls indicate that they'll be proved wrong in California.