Two statements in your Jan. 6 editorial "Fighting AIDS" apply to all countries: "People know about AIDS but still do not change their behavior," and "people will not admit to having the disease and so will continue to spread it."
In the United States, voluminous privacy laws assiduously protect the anonymity of HIV carriers so that they can continue to spread it. Those not infected have been deprived of their right to know who is infected so they may avoid intimate contact.
Identification of the infected carrier and separation from the healthy have been the essence of effective public health policy for all other diseases. But this disease has been exempt from the scientific approach because of politics.
Privacy laws obstruct routine efficient testing for HIV at the physician's discretion by requiring written consent plus counseling before testing. It is estimated that incidence of HIV is two or three times greater than the reported numbers. These laws also prevent routine notification of those exposed to an HIV carrier by requiring the patient's signed consent or a court order.
Virginia does permit spousal notification without consent. Virginia also permits mandatory testing of indicted rapists and notification of victims; some states require conviction before testing the rapist without his consent.
We could almost eliminate AIDS in infants by unencumbered routine testing of all pregnant women and all newborn babies followed by treatment of those who test positive. After a 13-year struggle, New Jersey has instituted mandatory testing and treatment of newborns with excellent results.
--M. Gregory Carbone