Military health experts, concerned about the threat that acquired immune deficiency syndrome (AIDS) could present to the armed forces, said yesterday that widespread blood screening of military personnel should be considered, particularly among recruits or those who may face combat or travel to disease-ridden areas.
At a meeting of the Armed Forces Epidemiological Board, a 12-member scientific advisory group asked by the Defense Department to consider the AIDS problem, Col. Edmund C. Tramont, chief of microbiology for Walter Reed Army Institute of Research, said that testing for signs of the AIDS virus may help protect the health of military personnel and assure military readiness.
But Jeffrey Levi, speaking for the National Gay Task Force, raised concerns about the potentially discriminatory impact of such "mass" testing, warning that it could "unduly stigmatize and frighten individuals." He also noted the lack of confidentiality of military medical records, saying they could be used for nonmedical purposes.
"We fear that individuals may be singled out as homosexual or IV [intravenous] drug users [two groups prone to contracting AIDS] based solely on this test result," Levi said.
The unusual public meeting at the Walter Reed institute did not result in formal recommendations.
Board Chairman Dr. Theodore Woodward, a professor emeritus at the University of Maryland, said the group was gathering information before passing on its advice to the Pentagon, which will make any final decisions.
One source said it was likely that the advisory group would recommend some blood testing, at least for military recruits. There are about 1.8 million active-duty enlisted personnel in the United States and about 320,000 recruits annually.
At issue is a test that measures the presence in the blood of antibodies to a virus, HTLV III, that is the primary cause of AIDS. But it is not a test for AIDS. A positive result on the blood test suggests that the person has had the virus at some point, but cannot predict if he will contract AIDS.
Estimates suggest that about 10 percent of those with positive test results may contract the severe and deadly form of AIDS, while 30 percent or so may show lesser symptoms, ranging from swollen lymph glands to reduced energy, weight loss, fever or diarrhea.
Others may not have symptoms but may pass on the virus through sexual contact, blood transfusions or sharing hypodermic needles.
Tramont said that the antibody test should be considered for recruits because people with the AIDS virus may have impaired immune systems, making them vulnerable to live-virus immunizations, which are routinely administered in the military. He cited a case last year of a recruit who appeared healthy but who later came down with severe smallpox complications and was found to have AIDS.
Tramont questioned whether those with hidden immunity problems might be more vulnerable if sent to areas with diseases such as malaria. He also noted that the AIDS virus might unknowingly be passed on during transfusions in the field during combat.
Like their civilian counterparts, military blood banks have implemented the AIDS antibody test for screening donations. Contaminated blood is discarded and, if found positive on confirmatory tests, the name of the donor is provided to the "respective service military health agency responsible for medical evaluation and counseling," Lt. Col. Tony Polk said.
More than 120 cases of AIDS have been reported in the Army, Navy and Air Force. Tramont said that over the next year, about 1,000 cases of antibody-positive individuals are expected in the Army alone, including about 200 cases of illness. He said the care involved "has the potential to bankrupt our system."
Military medical personnel said yesterday that they were taking precautions to assure confidentiality of the results from the AIDS antibody test, but Tramont acknowledged that medical confidentiality in the military lags behind that in the civilian sector. Those who choose to put on a uniform give up "some of those freedoms," he said.