Chicago Tribune (CT) - SUNDAY June 21, 1987 By: Edition: FINAL EDITION Section: NEWS Page: 3 Word Count: 899
Ronald Kotulak, Science Writer

"Since there is no cure for AIDS and no protection beyond avoiding or making safer intimate contact with infected individuals, those infected with the virus must be sexually isolated from uninfected persons," the report said.

Condoms cannot be relied on to provide complete protection, it said. Avoidance of both sexual contact and the use of shared needles by drug addicts are the only sure protection, said the report.

"Those who are infected must be identified so that they will not unknowingly transmit the disease to others," the report continued. "Many who are not infected will need to change their behavior substantially to minimize their risk of infection by the AIDS virus."

AIDS (acquired immune deficiency syndrome) destroys a victim's immune defense system, opening the way to infectious diseases.

The virus is primarily spread through sexual intercourse, or the sharing of hypodermic needles contaminated with infected blood.

Most victims so far have been in high-risk groups, such as homosexuals, bisexusals, intravenous drug users and persons who have sex with them.

The report calls for wider testing to identify people who are infected with the AIDS virus, but it does not support broad mandatory testing such as President Reagan's suggestion that tests be given to couples applying for marriage license applicants and hospital patients.

However, the trustees did support mandatory testing in a number of situations, such as for donors of blood, organs and semen, military applicants, immigrants and federal and state prisoners.

The trustees said laws are needed to guard the confidentiality of patients and to protect them from discrimination, but they also said legislation was needed to impose penalties on people who knowingly infect others and to enable doctors to inform people that their sex partners are infected.

"The person who is afflicted with the disease needs compassionate treatment, and both those who have the disease and those who have been infected with the virus should not be subjected to irrational discrimination based on fear, prejudice or stereotype," said the report.

"And of critical importance, the uninfected must be protected; those individuals who are not infected with the AIDS virus must have every opportunity to avoid transmission of the disese to them."

The report was prepared for the AMA's 406-member House of Delegates, which begins its annual meeting Sunday in the Hilton Hotel.

The recommendations will be debated in committee meetings Monday and the full House of Delegates will vote on accepting the report, with possible changes, on Tuesday.

The AMA has 271,000 physician members.

"We do not want to overreact to the point of hysteria," said Dr. Ramond Scalettar, a trustee from Washington, D.C. "We think that if the public gets the proper message and understands what is happening in the presence of this serious disease, we can start begging to have a rational approach that balances the public health with the individual's rights and privacy."

A key recommendation of the report is the formation of a commission modeled after the panel that made recommendations in the early 1980s on the problems of financing Social Security.

The commission should be made up of representatives of the Executive Branch of the federal government, the Congress, state and local government and the private sector, and it should develop an overall plan of dealing with the AIDS epidemic, which already has afflicted more than 36,000 Americans and killed more than 22,000.

The trustees also called for an immediate conference involving the AMA, other physician organizations and public health officials at all levels of government to determine what needs to be done to adequately train and educate the AIDS counselors who will be needed for a greatly expanded testing program.

AIDS testing should be readily available for anyone who wishes to be tested, and it should be provided free to those who can't afford it, said the report.

Regular testing, on a voluntary basis, should be provided to patients at sexually transmitted disease clinics and drug abuse clinics, and in high-risk areas to pregnant women, people seeking family planning services and patients needing surgical or other invasive procedures, said the trustees.

Health care workers in high-risk areas also should be regularly tested, as well as couples in those areas applying for marriage licenses, they said.

"Testing for the HIV (AIDS) virus in America will require substantially more resources than are currently being made available," said the trustees. "Since AIDS is the terminal and fatal stage of HIV-infection, it represents only the tip of the huge HIV-infection iceberg."

The number of Americans estimated to be infected with the AIDS virus varies from 300,000 to 1.5 million.

Antidiscrimination laws, which now apply to people diagnosed with AIDS or ARC (AIDS-related complex), should be extended to those found to have antibodies to the virus, but who are not sick, said the report.

"An HIV-seropositive individual who might live five years or much longer with no overt health problems, once identified in a community, may be subject to many and varied discriminations--by family and loved ones, by neighbors and friends, by employers and fellow employes and by other providers of services," said the report.

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