AIDS panic from yesteryear

Chile has been awash in a faux AIDS scandal for weeks now, and the story even reached the New York papers, as in this Daily News headline over an AP account: ‘Hundreds in Chile not told of positive HIV tests’.

The first line of the report gives away the store: ‘Chile is scrambling to reach people who could be unknowingly spreading AIDS’.

The breathless tale is about how Chilean laboratories did not tell some 2,000 people that they had come up positive for the HIV infection.

The health minister had to resign over the revelation, and her replacement, one Alvaro Erazo, solemnly told Chile’s Congress: ‘There is no justification for that.’

Except that, um, there is, and it’s called a public health rationale. People go get tested for HIV under guarantees of privacy and autonomy, and in the old system still in use in Chile involving a blood sample, you have to go back for the results. No one could force you to because the anonymity of the test kept your data out of official hands.

If you later decided you didn’t really want to know, that was your right. Without it, most people wouldn’t go near the damn test in the first place given the wave of insensitive abuses that occurred in the early years.

Guess what? They’re back. The same article notes that a guy in southern Chile had two Nurse Ratchets show up at his job in an ambulance recently to tell him he was HIV-positive. Goodbye job, girlfriend and pretty much life as he knew it. That will certainly encourage more people to get tested.

The fact that an incident of this sort can happen two decades into the AIDS epidemic shows how fragile the gains of the early years still are. I was personally involved in those fights in which we patiently explained to providers that the best way to promote testing was to treat people with respect as sentient beings rather than as ‘vectors of infection’ as their epidemiology textbooks suggested.

The AP language is a throwback to the years of panic in which ‘those people’ were seen to be running around spreading HIV and needed to be grabbed and made to stop. ‘Those people’ being gays, drug users, Haitians and women in the sex trade—NOT you and me and our precious children, of course, and not AP reporters either, all of whom could also be ‘unknowingly spreading AIDS’.

I’ve got news for Minister Erazo and the Associated Press: a whole lot more than 2,000 people in Chile and every other country in the world are unaware of their HIV infection. The estimate in the U.S. alone is around 200,000. We try to encourage people to find out as a double benefit, to them and to their eventual partners, but not with media-driven Sex Panics.

The fact that someone in a laboratory got hold of an HIV+ blood sample changes nothing and means nothing, but in the Chilean case it has stimulated bad public policy and a lot of irresponsible news reporting, too.

If Chile wants to take the strong-arm approach, why not give everyone in the country an HIV test and force them into care? That’s the logic of this reactionary witchhunt, a policy that would last just long enough for the first government official, police captain or rich teenager to get caught up in the dragnet and have his business spilled into the neighborhood gossip circuit.

It says something, too, about the weakness of Chile’s nonprofit AIDS sector that, after wallowing in millions of Global AIDS Fund dollars for a decade, can’t mobilize a coherent response to this gigantic step backwards.