Prop. 102 Is Powerless as a Shield Against AIDS : It Isn’t ‘Like Other Communicable Diseases,’ and Tracking All Contacts Is Impossible

Proposition 102 is a sham--a cruel hoax on the people of California. It will not slow the spread of AIDS. It will not protect people from infection with the virus. It will dismantle programs that have dramatically slowed the spread of the virus. And it will create a logistical and fiscal nightmare for public-health officials and the people of this state.

Proposition 102 would require--as laws in a few other states now do--the reporting of the names of all people who test positive for HIV, the human immunodeficiency virus. Unlike any other state, California then would require the tracing of all sexual and intravenous-drug-use contacts that those people had had for the past 10 years. This is where Proposition 102 becomes a scam: a measure that may sound sensible but that has no possibility of achieving any results other than chaos.

Contact tracing has been shown to be effective on a small scale to reach people who might not suspect that they were exposed to the virus--for example, in San Francisco, among heterosexual partners of people with AIDS.

But contact tracing is expensive and labor-intensive: It takes 6 to 12 months to train someone to do it, and each professional can reach only about 20 contacts a month. This is because informing people that they may have been exposed, and advising them on low-risk behavior, must be done in person and privately.

The contact tracing that would be needed as a result of Proposition 102 would be massive. An estimated 300,000 Californians are infected with the HIV virus. If each person testing positive named 20 contacts (that’s not a lot for a 10-year span), and each of them named 20 contacts, and those 400 named 20 contacts, and so on . . . . Imagine the number of contact tracers who would have to be employed. Imagine how much money would be taken first from other health programs and then from non-health programs to pay for them. Imagine trying to identify and locate all the people who’d had sex or shared needles with just one IV drug user over the past 10 years. Imagine, beyond the sheer numbers, the obstacles of finding former acquaintances in a mobile society like ours.

In Los Angeles County, contact tracing on sexually transmitted diseases is already understaffed, with fewer than 100 full- and part-time tracers. If HIV tracing were required, obviously thousands more would have to be hired and trained--and that’s just for Los Angeles.

Nevertheless, many Californians might support this if it protected their loved ones from AIDS. But it will not. The supporters of Proposition 102 who say that voluntary testing, education and counseling don’t work (AIDS experts all disagree) cannot tell us how the initiative will stop people from having unprotected sexual intercourse or sharing drug equipment. Instead, they fall back on the line that Gov. George Deukmejian used when he announced his support for Proposition 102: “Stop its spread by treating AIDS like other communicable diseases.” Syphilis is the most common example given.

To control syphilis in the early 1940s, when there was no readily available cure, health authorities tried contact tracing and incarceration of thousands of prostitutes. As Dr. Allan Brandt detailed in his book, “No Magic Bullet,” these measures did no good whatsoever; the spread of syphilis was not curtailed until a cure was found.

In contact tracing for syphilis today, only about 50% of the people named can be located after six months. (Syphilis tracing involves contacts only as far back as 6 or 12 months.) And this year we learned that in spite of the usual public-health measures and penicillin, syphilis is out of control in Los Angeles County. Thus, to say that AIDS will be controlled like syphilis is absurd.

So the big lie of Proposition 102 is that it will protect people from AIDS. It will not. It will close the anonymous testing and counseling programs, which have slowed the spread of the virus. It will further discourage voluntary testing by repealing a law that protects HIV-positive people from losing their jobs. And it will create the impossible nightmare of mandatory tracing of people as many as 10 years after their contact with someone who has just been identified as carrying the virus.

What is very disturbing is that the numerous opponents of this initiative--including the California Medical Assn., the California Nurses Assn., the Health Officers Assn. of California, etc.--have not exposed Proposition 102 for the fraud that it is. Too often they have focused on its insidious components without fully explaining the most important reason they oppose it--because it won’t work.

The discussion about Proposition 102 should not be whether its associated evils are a reasonable trade-off for controlling AIDS. The real question is whether the voters, through a lack of understanding, will choose to dismantle programs that are working and replace them with chaos of unimaginable dimensions.