A Pentagon advisory board is examining ways to combat the threat of acquired immune deficiency syndrome (AIDS) in the military, including the possibility of screening the blood of 2.4 million military personnel and recruits for signs of the AIDS virus.
The 11-member Armed Forces Epidemiological Board is conducting a full review of the impact of AIDS on the military. Among the questions it is examining is whether to recommend discharging military personnel found to be carrying antibodies to the disease.
The board, whose members are medical specialists from universities and hospitals, was asked to undertake the review June 12 by Dr. Clinton Jarrett, deputy assistant secretary of defense for health affairs. The board specifically was asked to evaluate the blood test, which can detect an antibody to AIDS, and to consider other surveillance issues.
The test can detect an antibody in a person's blood, which indicates only that he has been exposed to the AIDS virus or a similar virus at some time in his life. It does not mean that the person either has ever had or can transmit AIDS.
The military use of the controversial blood test has raised fears that the tests will be used to stigmatize those at high risk of contracting AIDS, and not for the limited medical purpose of ensuring a safe blood supply.
Before any action would be taken to impose blood tests, or other screening, on the 2.1 million active-duty personnel or on the approximately 328,000 recruits who enlist yearly, the proposals would have to be approved by the Pentagon's Health Affairs Office and the secretary of defense.
"They'll be looking at screening at military induction centers so as not to let those with antibodies in," said the director of a services-wide health program directly involved in AIDS surveillance. "We already check blood for hepatitis and syphilis. If it can be worked out what this test means, it will be added to the annual physical exams."
Dave Newhall, an assistant to Dr. William Mayer, assistant secretary for health affairs, said, "If the AFEB should come forward and strongly recommend it, we would strongly consider it, but it's a premature report that this is going to happen."
Homosexual activist groups have asked to appear before the board to protest any use of the blood test as a screening device, saying that it is unreliable and will be used to discriminate against homosexuals.
The newly developed test has a high rate of false positives, but has been used by military and civilian blood banks since March to screen out blood that may have been contaminated. Doctors say it is a useless test for screening people rather than blood, however; it cannot detect AIDS directly.
Base medical commanders are now told the names of soldiers who donate to military blood banks and whose blood is positive for AIDS antibodies, said Lt. Col. Tony Polk, director of the Army blood programs, but there is no set military policy on what happens to the soldiers.
"There's no medical reason for the test to be given by the military unless a person is going to donate blood," said Jeff Levi, political director of the National Gay Task Force. "I have very little faith that this is being done to protect the general health of the military population . . . . They're using this as a guise for discrimination."
Julian Barber, a spokesman for the Office of Health Affairs, disagreed. "We're aware of some allegations that this is a witch hunt designed to identify homosexuals in the military . . . . It's strictly on medical reasons."
The Pentagon tried earlier this summer to require civilian blood banks that conduct blood drives on military bases to inform military doctors of those soldiers whose blood tests positive for the AIDS antibody.
But protests by the American Red Cross -- which, along with the Community Council of Blood Centers and the American Association of Blood Banks, collects about 5 percent of its blood from military donors -- prompted the Pentagon to delay its order "indefinitely."
"It is a source of controversy and Dr. Mayer issued an indefinite moratorium on that order," said Barber.
Jane Starkey, acting executive director of the Community Council of Blood Centers, said a meeting is scheduled in mid-August with Pentagon officials to discuss the requirement.
Polk said that the military's blood centers process 200,000 units of blood each year and that many units are shared with civilian blood banks. The military hospital system, like its civilian counterpart, has had several cases of AIDS caused by contaminated blood transfusions, he said.
The extent of AIDS infection in the military, as in the civilian population, is unknown. A spokesman for the Army surgeon general's office said that about 100 people in the Army have been diagnosed as having AIDS.
"But the Centers for Disease Control is showing 2.5 people per thousand are turning up with antibodies in their blood," he said. "I'm sure we have that same tremendous number of people walking around infected. There are real questions about what this means for the military that we need answered."