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Why Mandatory Testing Is a Bad Idea
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13130 |
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Section : |
CURRENT ISSUES
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| Issue
Date : |
11 / 1987 |
2,624 Words |
| Author
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Harvey V. Fineberg and Mary E. Wilson Harvey V. Fineberg, M.D., Ph.D., is dean of the Harvard School
of Public Health and was a member of the National Academy of
Science/Institute of Medicine Committee on a National Strategy
for AIDS.
Mary E. Wilson, M.D., is chief of the Division of Infectious
Diseases, Mount Auburn Hospital, Cambridge, Massachusetts. |
The acquired immunodeficiency syndrome (AIDS) scares all of us. First recognized in 1981, AIDS has afflicted more than 40,000 Americans and many thousands more worldwide. No one who has developed AIDS has recovered from it. The disease is caused by a virus called the human immunodeficiency virus (HIV). A recalcitrant and subtle pathogen, the HIV renders the body susceptible to other infections and to some forms of cancer; it can also cause dementia. The HIV is known to be spread by sexual intercourse (genital, anal, and oral) and by blood-to-blood transmission as occurs in the sharing of needles and syringes by intravenous drug users. The virus may also be passed from an infected mother to her infant.
One of the more sinister aspects of the AIDS epidemic is the silent nature of the infection. A person who becomes infected with the HIV is then capable of transmitting it to others, yet may have no symptoms of disease for five years or even longer. The number of asymptomatic carriers of the HIV is believed to be many times the number of patients with clinical AIDS, leading to estimates of between one and two million infected persons in the United States. These symptom-free carriers are most likely concentrated in the same groups that comprise most current AIDS patients - men (and in much smaller numbers, women) exposed sexually to infected men, and drug users who share needles. While every state has reported some cases of AIDS, the largest numbers are located in the urban areas of California and New York.
The presence of infection, whether symptomatic or not, may be detected by blood tests for antibodies to the HIV. These antibodies found in blood are proteins produced in response to the antigens (which are also proteins)
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