Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
Newsday - June 24, 1988
Laurie Garrett
The Journal report said that such contact tracing is "an effective means of controlling the AIDS epidemic."
But due to the controversial nature of the findings, the Journal also carried an editorial rebuttal from scientists who say such detective work is too expensive and dangerously imperils privacy rights.
The study reported the case of a young homosexual man who came into a State Department of Health HIV testing center in rural South Carolina last year; he tested positive for infection with the HIV virus that causes AIDS and, when interviewed, named 19 sexual partners.
From these men, health officials gained the names of another 71 men and women who had been their sexual partners. Most of them were located, tested and given AIDS counseling. Twelve men tested positive for acquired immune deficiency syndrome.
The total cost of the tracking in the 18-month tracing effort was $6,500.
By comparison, the cost of treating a single case of AIDS is estimated at $40,000 to $100,000, Dr. Randolph E. Wykoff, one of the project researchers, wrote in the article. "If you prevent even one case of AIDS you're still saving $40,000 to $100,000 in AIDS medical costs," he said.
But in an accompanying editorial Drs. George Rutherford and Jean Woo of the San Francisco Department of Health, sharply disagreed.
Woo and Rutherford said contact tracing is generally ineffective in cases involving intravenous drug abuse. Addicts are rarely willing to reveal the names of people with whom they have shared contaminated needles, they said.
And the critics said the nation's public health departments would have to spend more than $97 million to trace the sexual contacts of the estimated 1.5 million Americans with the virus.
Woo and Rutherford also took issue with the researchers' methodology, saying the rural South Carolina county was unusual in that few of the traced individuals had moved during the study time - unlike most Americans, who are far more mobile and difficult to track down.
Perhaps more troubling, Wood and Rutherfood said, serious issues regarding privacy rights are raised by large-scale efforts to question people about their sex lives.
Wykoff, however, said that possible violations of confidentiality can be minimized. Moreover, he said, such contact tracing is worth the risk. Many people contacted by his department changed their sexual behaviors after they learned of their exposure to the HIV virus. Condom use jumped from zero percent to 80 percent after the men learned they were infected with the HIV virus, he said.
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