Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
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San Francisco Examiner, January 23, 1999
Mark Helm, Examiner Washington Bureau
"This is no longer about how to treat the dying; it's about how to treat the living," said John Kane, senior judge of the U.S. District Court in Colorado, at a conference here Friday on the future of public policy toward AIDS and HIV, the virus that causes the deadly disease.
Kane said the growing effectiveness of drugs in delaying the onset of AIDS in HIV-positive people means that those taking the medicines can live for years before becoming sick.
Since most of them will choose to continue their normal lives, society must learn to deal with this "new minority," Kane said. He added, "We need to make sure that people infected with HIV are not just allowed to work but that they are treated equally and fairly."
Last spring the Supreme Court ruled that HIV infection constitutes a physical impairment under the Americans with Disabilities Act, which prevents unjust discrimination against people with disabilities. However, Kane said legislatures need to enact laws that will clarify how employers should treat workers with HIV or AIDS and what kinds of accommodations must be made for them.
Through the end of 1997, more than 647,000 cases of AIDS had been reported in the United States, according to the Centers for Disease Control and Prevention in Atlanta. As many as 900,000 more Americans have the virus, and it infects about 40,000 people a year.
Ronald Bayer, a professor at Columbia University's School of Public Health, said the country also needs to change its image of who is being infected by the virus. He said that while gays are still at risk, the main growth in HIV infection is among heterosexual drug users, minorities and women.
Bayer said the changing demographics of infection means public health policy must develop new ways to fight its spread. "How we educate and whom we educate must reflect the new populations at risk," he said.
Don Des Jarlais, a professor at the Albert Einstein College of Medicine in New York City, said that with the growing number of drug users contracting HIV, the government should reconsider its opposition to needle exchange programs.
"These programs are cheap and simple and can save thousands of lives, so why not use them?" he asked. Des Jarlais pointed out that in Britain, needle exchange programs have nearly eliminated HIV infection among intravenous drug users.
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