Health Officials Reject Forced AIDS Tests

Federal health officials have rejected the idea of mandatory routine AIDS antibody screening of hospital patients and marriage license applicants and intend to recommend that states expand voluntary testing, particularly in clinics that treat individuals likely to be at risk of the disease, sources familiar with the proposals say.

The recommendations, drafted by the federal Centers for Disease Control, were submitted to Dr. Robert E. Windom, assistant secretary for health, on Thursday and reflect the consensus expressed by public health officials at a two-day meeting in Atlanta last February.

The proposals emphasize that comprehensive pre- and post-test counseling and informed consent should accompany all testing, and they urge that additional statutory protections be enacted to prohibit discrimination against infected individuals, sources said.

Privacy Held Critical

Further, the recommendations stress that “confidentiality (of test results) is critical,” said Kristine Gebbie, administrator of the Oregon state health division who heads the AIDS committee for the Assn. of State and Territorial Health Officials.

The proposals endorse wider voluntary use of the test in such settings as drug abuse clinics and clinics that treat sexually transmitted diseases and pregnant women.

“These recommendations are really a solid reinforcement of the core of what the public health community has been trying to get across: Don’t get into mandatory testing; it doesn’t seem productive with this disease. Deal with the discrimination and confidentiality issues, and include counseling with all testing,” Gebbie said.

Traditionally, it is the province of state legislatures and public health departments, rather than the federal government, to implement such measures, although the state actions are often influenced by guidelines from the federal Public Health Service.

Voluntary Tests Urged

Windom said through a press spokesman that “we are going to continue to ask people to undergo voluntary testing” and “no matter what, there must always be protection of the individual’s rights. You must--underline must--have confidentiality.”

However, the proposals will be debated by members of the White House Domestic Policy Council--an interagency advisory group headed by Atty. Gen. Edwin Meese III--where sentiment is uncertain.

Gary Bauer, President Reagan’s domestic policy adviser, said Thursday that “it’s too early to say” whether the White House will endorse the CDC proposals. But he said he favors a more hard-line approach, including required testing of those applying for marriage licenses.

“If we’re dealing with something that is the equivalent of the black plague, then entirely too little testing has been done,” Bauer said.

Education Secretary William J. Bennett, who serves on the Domestic Policy Council, said Thursday in a speech that he supports mandatory testing for marriages, prisoners and routine hospital admissions.

Test Shows Exposure

The test determines only that an individual has been exposed to the virus that causes AIDS and does not indicate whether he or she will contract the deadly disease. However, someone who tests positive is presumed to be infected and infectious to others. There is no medical treatment for infection.

Many medical and public health personnel and gay rights and civil liberties groups have feared that test results, unless kept anonymous or confidential, would result in stigmatization and be used to discriminate in such areas as employment and insurance.

Most public health officials oppose mandatory testing of any kind in favor of increased education, saying that enforced testing would drive individuals “underground” and result in large amounts of money being spent unnecessarily to test individuals who were not at risk. An estimated million to 2 million Americans are believed to be infected.

Rep. Henry A. Waxman (D-Los Angeles), chairman of the House Energy and Commerce subcommittee on health, is drafting legislation that would expand federal programs for voluntary testing and provide federal protections for confidentiality and non-discrimination. He has scheduled hearings today on the subject.

AIDS, or acquired immune deficiency syndrome, destroys the body’s immune system, leaving it powerless against certain cancers and otherwise rare infections. It is commonly transmitted through anal and vaginal sexual intercourse, through the sharing of unsterilized hypodermic needles, and by woman to fetus during pregnancy.

In this country, AIDS primarily has afflicted homosexual and bisexual men, intravenous drug users and their sexual partners.