Top-level business executives believe that AIDS is one of the most important problems facing the nation today, but are often confused about their role in dealing with employees who have the deadly disease, according to a new national survey.

Results of the survey -- the first to poll the attitudes of high-echelon American executives about AIDS -- show the misunderstanding and ambivalence that grip business leaders over the growing epidemic and point to the need for greater efforts within the business community to combat AIDS.

The executives said, for example, that employees should not be tested routinely for the AIDS virus. If employees are tested, however, the executives believe that the results should be shared with employers.

Some 623 randomly selected executives, 80 percent of them vice presidents or higher, participated in the survey, which was cosponsored by Fortune magazine and Allstate Insurance Co. Results of the survey were released yesterday at a daylong conference on AIDS and the role of corporate America in dealing with the epidemic.

The majority of executives polled felt that insurance companies -- not the federal government -- should bear the brunt of the financial burden for AIDS patients. About half of these executives believe that insurance premiums will rise significantly because of AIDS-related health care costs.

"American business knows that it should be concerned about AIDS in the workplace," said Herbert E. Lister, chairman of Allstate. "Yet it hasn't done much about it."

Among the executives polled, AIDS ranked as the third most important problem facing the nation today -- behind only the federal deficit and drug abuse.

Yet the survey found that few companies have taken steps to help those with the disease or to educate their employees about preventing the spread of AIDS.

The majority of executives -- some 70 percent -- reported that their companies "neither have nor are planning to develop any policy about AIDS," the survey found. Only three of every 10 company executives surveyed report that their companies have or are developing a policy for dealing with employees who contract the deadly disease.

Only 10 percent of companies had some sort of written policy, while 8 percent have an unwritten policy about AIDS. An additional 11 percent of executives polled said that their companies are in the process of developing a policy on AIDS.

As of Monday, 51,361 Americans have contracted AIDS, according to the federal Centers for Disease Control, and 28,683 people in the United States have died of the disease.

"The total treatment for life of a person with AIDS is estimated to cost about $50,000," Otis R. Bowen, secretary of health and human services, told the conference. Those costs will rise, Bowen said, "as we develop ways of keeping people with the disease alive longer."

Exactly who will pay the rising health care costs of AIDS is still being debated.

This year, about 40 percent of AIDS patients will have their care paid for by federal and state funds through Medicaid at a cost of some $600 million. By 1992, those costs will soar to an estimated $2.5 billion.

But the majority of AIDS patients must turn to private charity, personal funds or private health insurance to pay for their treatment. "And that's where you come in," Bowen told participants at the conference.

If private companies have to take over the primary financial burden for AIDS patients, most of those polled expect insurance costs to rise significantly.

"What this suggests is that insurance companies are going to have trouble with their images down the road," said Merle Sprinzen, director of market research for Fortune magazine.

The survey also found that:

High-level executives generally report that they have a fairly good understanding about what AIDS is and how people contract the disease. Yet, when it comes to dealing with employees who have AIDS, the survey also found that many high-level executives misunderstand what steps they can take. Slightly more than a quarter of the executives indicated that they would be very unsupportive. Some in this group said that AIDS patients should be isolated from other workers. Others indicated that AIDS patients are socially undesirable people and that "they got what they deserved."

Almost half of the executives would give AIDS patients time off for treatment, the survey found. About one-third of those polled said they would offer counseling, and slightly more than a quarter would make some type of work adjustment to allow people with AIDS to work as long as possible. But 16 percent would try to get the employee to quit and 6 percent would fire a person with AIDS. "Some of the actions the executives say their companies would take are, in fact, illegal," Sprinzen said.

Half of the executives reported that their companies would face an image problem if the public were to find out that someone in their company had AIDS. Executives with smaller companies, those with less than 100 employees, believed they would face the most difficulty if the public knew an employee had AIDS, and executives with service-related companies said they faced a greater problem than industrial businesses.

The majority of executives -- some 60 percent -- believe that employees should not be tested for exposure to HIV -- the virus that causes AIDS.

But when employees are tested for exposure to the disease, the test results should be shared with the employer, the executives said -- a policy that many critics fear will result in discrimination against those who test positive for the HIV virus.

"We need you to set the example for being fair and objective and for not succumbing to groundless hysteria," Surgeon General C. Everett Koop told the conference. "We need you to be informed about AIDS, to inform your employees about AIDS and to encourage your employees to exercise appropriate preventive measures."

As part of the conference, Allstate also released a 100-page report designed to help companies deal with the current AIDS epidemic.

Called "AIDS: Corporate America Responds," the report was written in conjunction with a consortium of companies and nonprofit organizations to help businesses cope with the growing AIDS problem.