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Mandatory HIV test/vaccination


In the United States all medical information is generally considered confidential


and protected under law. Because of the sensitivity of HIV-related information, many


states have adopted laws that provide additional protection to HIV-related medical


Help with essay on Ethical philosophy of mandatory HIV vaccination


records. In the wake of the HIV epidemic many research and prevention methods are


considered. What are the ethical and legal obligations to involved with mandatory HIV


screening and/or vaccination ? First I will present some facts about what measures have


been taken to research the best methods for prevention of spreading the disease further.


Then, I will offer some views on mandatory HIV tests and/or vaccinations. Last, I will


present my opinion on the subject.


In the 160's the United States began collecting tissue samples at birth to test for


various medical conditions. The tissue and blood samples from these tests are taken and


stored without informed consent. These samples are then accessible to multiple


organizations to provide demographic research information (1). The allowance for these


tissue samples set the groundwork for anonymous HIV seroprevalence studies which


began in 187. The U.S. Center for Disease Control (CDC) performs these tests on


uninformed patients at 40 hospitals, 10 state prisons, 15 colleges, and many clinics. The


tissue samples taken at birth from about 4.1 million infants a year are also subjected to


HIV seroprevalence tests ().


1. Loretta M. Kopelman, "Informed Consent and anonymous tissue samples The case of HIV Seroprevalence Studies" The Journal of Medicine and Philosophy Vol. 1 No. 6 December 14, p 55.


. Kopelman, p 50


The claim by the researcher is that anonymous testing provides valuable


demographic information without causing harm to the subject. Only basic information


such as gender, age, race, sexual practices, drug use, and place and date of screening may


be attached to the sample (). The protection of people's rights and welfare comes by


means of confidentiality and universal education, such as counseling about safe practices


and about who should be tested (4).


But, how anonymous are these tests? With the scientific advances in DNA


research a person is easily identified by the DNA strands found in their tissue sample.


This DNA fingerprint along with the accompanying geographic information allows any


sample in the tissue bank to be matched 100% to the donor. Whether this DNA match


will be pursued is not the case. The researcher guaranteed the privacy of the subject as


leeway for uninformed consent. The fact that the samples can be identified creates an


ethical dilemma.


What is privacy? One of the most accepted definitions of privacy is that of Louis


Brandeis and Samuel Warren. They conclude that privacy is "the right to be let alone."


To be let alone is to be anonymous and to have solitude, perhaps from others or just


protection from unwanted intrusions (5). Privacy is a core human value that goes to the


very heart of preserving human dignity and autonomy. We are persuaded that privacy is


fundamental to a free society. But, most people assume that they have greater rights to


. Kopelman, p 5


4. Kopelman, p 58


5. Mark Tunick, "Does Privacy Undermine Community," The Journal of Value Inquiry Vol. 5 No. 4, December 001, p 51


privacy than the law actually provides. States have the authority to impose mandatory


health measures under what is called their "police power." This power is reserved to


states in the Tenth Amendment. This allows states to take any steps necessary to ensure


the public health and welfare, to foster prosperity, and to maintain public order (6).


While many states actions seek to promote the public health by creating a safer


environment, states have also relied on their power to intervene directly in the private


lives of their citizens.


In Connecticut, a law was passed in October of 1 requiring prenatal testing of


mothers, or post delivery testing of newborns. This has led to almost universal testing for


a pregnant woman's HIV status. A study at Yale found that before the law went into


effect only 40 percent of women underwent testing and now more than 5 percent of


women allowed themselves to be tested. A religious conflict is grounds to refuse the test.


In one study of more than ,00 children born between October 1 and July 000,


mandatory testing found seven HIV positive pregnant women. These women were


previously unaware of their status and were started on antiretroviral therapy. All seven of


the babies are HIV negative today. Many others have been discovered and placed on


therapy (7).


There is a legal argument related to the mandatory prenatal HIV testing. The


United States Supreme Court has recognized a "zone of privacy," encompassed in the


Constitution, protects an individual against unwarranted governmental intrusions.


6. American University Law Review Vol. 45, Book 4


7. "Mandatory AIDS Test Law Does Work," May , 001, Newsmax.com


4


This "zone" includes the disclosure of personal information. Screening newborns for HIV


compromises the privacy of both the mother and the child because it reveals the HIV


status of the mother. Privacy protection for HIV-related information is particularly


necessary. But, the right to privacy is always in question. There must be a legitimate


states interest to infringe on an individuals right to privacy. The states interest in


mandatory testing of newborns is the protection of public health and the protection of the


health of the newborn. Because prenatal testing only reveals the presence of HIV


antibodies in the newborn and not the virus, only the status of the mother is confirmed.


Therefore, a mandatory screening policy would not adequately address these interests.


The government's interest in testing newborns for HIV must be weighed against the


privacy interests and consequences of testing on the newborn and the mother. It is also an


infringement on our Fourth Amendment right. This amendment is meant to protect


people from unreasonable governmental searches and seizures (8).


Do the benefits of this infringement outweigh the right of privacy? Some dismiss


the erosion of their rights to privacy with the dangerously false pretense that only people


with something to hide should be concerned with the loss of privacy. H.W. Arndt views


privacy as a recourse of the guilty rather than a safe haven for potential victims. He


argues that a tax evader or person with venereal disease wants privacy. And, this shows


how "the cult of privacy seems specifically designed as a defense mechanism for the


protection of anti-social behavior "(). For someone with this view the infringement on


8. American University Law Journal Vol. 45 Book 4


. Tunick, p 55


5


the right to privacy is not an infringement at all because only those with something to


hide value their privacy. Privacy can be seen in this way by those with nothing to hide. A


person who is socially responsible would not object to an infringement of their right to


privacy. Because a concern for privacy undercuts the goal of having people work together


toward common goals (10).


Why might a socially responsible person truly have a need for privacy? Mark


Tunick states, "When people respect my privacy they are respecting and recognizing me


as a person, a bearer of rights, as someone entitled to some degree of self- determination.


In leaving me alone, they are putting their trust in me that I can act responsibly (11)".


Charles Fried agrees by saying, "A man cannot know he is trusted until he has a right to


act without constant surveillance so that he knows he can betray the trust. Privacy confers


that essential right (1)". An invasion of privacy can undercut autonomy and affront our


dignity (1).


A communitarian would view mandatory HIV screening as beneficial.


Communitarians evaluate acts based on their consequences for the community. The


communitarian is in favor of many types of screening (14). The community benefits in


several ways from mandatory screening. The mother is placed on antiretroviral therapy


and the baby's probability of infection is decreased


10. Tunick, p 55


11. Tunick, p 57


1. Tunick, p 57


1. Tunick, p 57


14. Tunick, p 5


6


One-fifth of all perinatally infected infants die by eighteen months of age (15). An HIV


positive pregnant woman given zidovudine(ZDV) during pregnancy reduces mother to


child transmission by 67.5 percent (16). Also, knowing that they are infected with HIV,


those individuals could abstain from activities which could lead to further transmission of


the disease. Therefore, the health and welfare of the community is improved. But, the


communitarian also recognizes the need for privacy. There must be a compelling need for


the intrusion, the intrusion should be minimized, there should be no less intrusive


alternatives, and side affects of the intrusion should be minimized (17).


What negative side affects with mandatory prenatal HIV screening become


involved?HIV testing as a routine part of prenatal care raises several concerns. First, it


is unknown whether such testing would be acceptable to pregnant women. Second, there


is danger that, if HIV testing becomes routine, it will become so habitual or mechanical


that pregnant women may not realize that they have the option to decline testing.


Pregnant women are among those recognized by United States federal regulations as a


vulnerable population (18) and therefore more susceptible to this affect. Third, caregivers


and patients may forget that HIV testing entails much greater psychosocial risks than


other blood tests. Fourth, by foregoing opportunities for education and counseling,


routine testing may undermine prevention efforts. Finally, routine HIV testing in the


prenatal context may affect adherence to the norms of pretest counseling and informed


15. Human Immunodeficiency Virus Screening. Pediatrics July 1 No.104 p 18


16. Kopelman, p 51


17. Tunick, p 5


18. American Law Journal


7


consent for HIV testing in other contexts.


There is a proposal of a mandatory AIDS vaccination. The vaccine is to be


administered to 11 to 1 year olds and military. Massive resistance has been received


(1). How should our government officials make such a controversial decision? How


would most people make this decision? One way to approach this would be to weigh the


options on the basis of the expected effect. We would favor options that we expect to


produce the most favorable results. Because the results will surely produce some negative


results there are alternate ways of approaching the decision. Instead, various moral


intuitions are involved. We often consider the harm caused by our actions to be more


serious and more to be avoided than harm caused by our omissions. As a result of this


intuition some people avoid taking protective measures that might cause harm, even


though the same measures are more likely to prevent harm. When a vaccine, such as the


AIDS vaccine, can cause side effects or death people want to avoid these effects, even


though the vaccine can prevent a disease that is more likely and equally serious and


deadly. Therefore, government officials might resist requiring the vaccine. It is not


because the government officials are wise but capitulate to public demands. They have


the same moral intuition that influences their judgment. This intuition is, "do no harm." It


is a widely advocated. In a case like a vaccination this rule is potentially harmful. It leads


us to neglect things we could easily prevent, like disease and death. After the AIDS


vaccine has been properly tested there will still be a risk of becoming infected with HIV


at the time of vaccination. But, this is the risk with any vaccine. Some parents will resist


1. Wes Vernon, "Reports indicate Massive resistance to Mandatory AIDS Vaccine" June 1, 001 Gannett News Service, Newsmax .com


8


the vaccine for their children even though they know the total risk is lower with the


vaccine than without it. Even though the risk may not be to that detrimental point today


without a cure the risk continues to increase. Most people do not want to see themselves


as the cause of harm to their children. It is better that the harm come from some force out


of their control. Then it is easier to shun a guilty conscience, even though they could have


prevented it. This do no harm view also affects the decisions of judges and juries, when


people sue the makers of the vaccines for its side effects. These side effects are awful, but


so are the consequences of not making the vaccine at all. Even though drug companies do


not get sued for the injuries caused by their failure to make a product, they take these law


suits into consideration when deciding to invest research and development resources into


more possibly risky vaccines versus another drug that lowers cholesterol. In a utilitarian


society people would favor a government policy for a mandatory AIDS vaccination that


will help many while hurting a few.


In some states we allow the testing of infants for HIV pre-birth. Why can we not


implement mandatory HIV test for all people? This would improve the welfare of the


community. Like screening newborns the privacy of the individual will be compromised.


The harm caused by the compromise may inflict mental and/or physical harm on the


person who is found to have the disease. This will in fact hurt the person involved. If in


the U.S., they will be placed on antiretroviral therapy. The lifestyle of that person will


change. But, this is for the good of the whole. If those with the disease are made aware of


their infection they are less likely to continue spreading the disease to others. The privacy


issues explored in relation to mandatory testing of infants apply here as well. But, they do


not outweigh the benefits that would be achieved from mandatory testing. How is it that


we have come so far as a society and mandatory testing is not enforced? The people who


are found to be HIV positive are the people who benefit the most. Even though they will


be subjected to a dramatic lifestyle change, they had the disease anyway. The fact that the


disease is in their system does not change whether or not they are tested. The benefit they


receive is earlier treatment of the disease. It is common knowledge that the earlier this


disease is treated a better quality of life is received.


So, why is mandatory testing not enforced? Why do people claim infringement of


privacy? People are afraid. People are afraid that they will have the disease. Because if


they have the disease they know that their mate probably has the disease. They know that


they have a long road ahead of them with treatment and sickness. They know that it is a


death sentence. They know they will feel shameful and dirty. They know they will


experience rejection. So, is it ethically wrong to mandate HIV testing? Why would it be


wrong, because someone will be upset if they are positive? No that is ridiculous. What is


unethical is for people to reject the test. It is socially irresponsible for people to have sex


with multiple people and not get tested. But, people are selfish and become more and


more selfish as they evolve.


Even though mandatory testing will not become a reality in my generation, I


believe it is the best method of prevention. People with HIV and AIDS need to be kept


isolated form the population that is not infected. There needs to be a system that will


allow people to know who is infected. Or more so, people need to know if they are


10


infected so that they can make the necessary changes in their own lives to keep others


safe. This may be a callous approach. But, the spread of HIV has gotten out of hand. And,


I am afraid. I take the precautions that I need to take to protect myself, but I have friends


and family that may not take the same precautions. I understand that a lot of people who


are infected are good people who want to lead normal lives. And, I believe that most


people who know they have the disease are cautious with their lifestyle activities. The


problem is the people who do not know they are infected. Those people who are not


taking the necessary precautions. The methods of controlling this epidemic that have


been in use in our society so far are education and voluntary testing. These methods are


not enough. Not enough people are getting tested or practicing safe sex. The disease is


still spreading.


Vaccination will probably be the next step in this battle against HIV. Even though


there is presently much resistance to the idea, it is a practice already seen in our culture.


Therefore, people will accept vaccination before they will accept mandatory testing. But,


I assume it could go either way. Everyone in the U.S. who attends school is required to


prove vaccination with records. But, a TB test record is also required. Which ever is the


preferred method of control, hopefully, it is sooner than later.


Mandatory HIV test/vaccination


In the United States all medical information is generally considered confidential


and protected under law. Because of the sensitivity of HIV-related information, many


states have adopted laws that provide additional protection to HIV-related medical


records. In the wake of the HIV epidemic many research and prevention methods are


considered. What are the ethical and legal obligations to involved with mandatory HIV


screening and/or vaccination ? First I will present some facts about what measures have


been taken to research the best methods for prevention of spreading the disease further.


Then, I will offer some views on mandatory HIV tests and/or vaccinations. Last, I will


present my opinion on the subject.


In the 160's the United States began collecting tissue samples at birth to test for


various medical conditions. The tissue and blood samples from these tests are taken and


stored without informed consent. These samples are then accessible to multiple


organizations to provide demographic research information (1). The allowance for these


tissue samples set the groundwork for anonymous HIV seroprevalence studies which


began in 187. The U.S. Center for Disease Control (CDC) performs these tests on


uninformed patients at 40 hospitals, 10 state prisons, 15 colleges, and many clinics. The


tissue samples taken at birth from about 4.1 million infants a year are also subjected to


HIV seroprevalence tests ().


1. Loretta M. Kopelman, "Informed Consent and anonymous tissue samples The case of HIV Seroprevalence Studies" The Journal of Medicine and Philosophy Vol. 1 No. 6 December 14, p 55.


. Kopelman, p 50


The claim by the researcher is that anonymous testing provides valuable


demographic information without causing harm to the subject. Only basic information


such as gender, age, race, sexual practices, drug use, and place and date of screening may


be attached to the sample (). The protection of people's rights and welfare comes by


means of confidentiality and universal education, such as counseling about safe practices


and about who should be tested (4).


But, how anonymous are these tests? With the scientific advances in DNA


research a person is easily identified by the DNA strands found in their tissue sample.


This DNA fingerprint along with the accompanying geographic information allows any


sample in the tissue bank to be matched 100% to the donor. Whether this DNA match


will be pursued is not the case. The researcher guaranteed the privacy of the subject as


leeway for uninformed consent. The fact that the samples can be identified creates an


ethical dilemma.


What is privacy? One of the most accepted definitions of privacy is that of Louis


Brandeis and Samuel Warren. They conclude that privacy is "the right to be let alone."


To be let alone is to be anonymous and to have solitude, perhaps from others or just


protection from unwanted intrusions (5). Privacy is a core human value that goes to the


very heart of preserving human dignity and autonomy. We are persuaded that privacy is


fundamental to a free society. But, most people assume that they have greater rights to


. Kopelman, p 5


4. Kopelman, p 58


5. Mark Tunick, "Does Privacy Undermine Community," The Journal of Value Inquiry Vol. 5 No. 4, December 001, p 51


privacy than the law actually provides. States have the authority to impose mandatory


health measures under what is called their "police power." This power is reserved to


states in the Tenth Amendment. This allows states to take any steps necessary to ensure


the public health and welfare, to foster prosperity, and to maintain public order (6).


While many states actions seek to promote the public health by creating a safer


environment, states have also relied on their power to intervene directly in the private


lives of their citizens.


In Connecticut, a law was passed in October of 1 requiring prenatal testing of


mothers, or post delivery testing of newborns. This has led to almost universal testing for


a pregnant woman's HIV status. A study at Yale found that before the law went into


effect only 40 percent of women underwent testing and now more than 5 percent of


women allowed themselves to be tested. A religious conflict is grounds to refuse the test.


In one study of more than ,00 children born between October 1 and July 000,


mandatory testing found seven HIV positive pregnant women. These women were


previously unaware of their status and were started on antiretroviral therapy. All seven of


the babies are HIV negative today. Many others have been discovered and placed on


therapy (7).


There is a legal argument related to the mandatory prenatal HIV testing. The


United States Supreme Court has recognized a "zone of privacy," encompassed in the


Constitution, protects an individual against unwarranted governmental intrusions.


6. American University Law Review Vol. 45, Book 4


7. "Mandatory AIDS Test Law Does Work," May , 001, Newsmax.com


4


This "zone" includes the disclosure of personal information. Screening newborns for HIV


compromises the privacy of both the mother and the child because it reveals the HIV


status of the mother. Privacy protection for HIV-related information is particularly


necessary. But, the right to privacy is always in question. There must be a legitimate


states interest to infringe on an individuals right to privacy. The states interest in


mandatory testing of newborns is the protection of public health and the protection of the


health of the newborn. Because prenatal testing only reveals the presence of HIV


antibodies in the newborn and not the virus, only the status of the mother is confirmed.


Therefore, a mandatory screening policy would not adequately address these interests.


The government's interest in testing newborns for HIV must be weighed against the


privacy interests and consequences of testing on the newborn and the mother. It is also an


infringement on our Fourth Amendment right. This amendment is meant to protect


people from unreasonable governmental searches and seizures (8).


Do the benefits of this infringement outweigh the right of privacy? Some dismiss


the erosion of their rights to privacy with the dangerously false pretense that only people


with something to hide should be concerned with the loss of privacy. H.W. Arndt views


privacy as a recourse of the guilty rather than a safe haven for potential victims. He


argues that a tax evader or person with venereal disease wants privacy. And, this shows


how "the cult of privacy seems specifically designed as a defense mechanism for the


protection of anti-social behavior "(). For someone with this view the infringement on


8. American University Law Journal Vol. 45 Book 4


. Tunick, p 55


5


the right to privacy is not an infringement at all because only those with something to


hide value their privacy. Privacy can be seen in this way by those with nothing to hide. A


person who is socially responsible would not object to an infringement of their right to


privacy. Because a concern for privacy undercuts the goal of having people work together


toward common goals (10).


Why might a socially responsible person truly have a need for privacy? Mark


Tunick states, "When people respect my privacy they are respecting and recognizing me


as a person, a bearer of rights, as someone entitled to some degree of self- determination.


In leaving me alone, they are putting their trust in me that I can act responsibly (11)".


Charles Fried agrees by saying, "A man cannot know he is trusted until he has a right to


act without constant surveillance so that he knows he can betray the trust. Privacy confers


that essential right (1)". An invasion of privacy can undercut autonomy and affront our


dignity (1).


A communitarian would view mandatory HIV screening as beneficial.


Communitarians evaluate acts based on their consequences for the community. The


communitarian is in favor of many types of screening (14). The community benefits in


several ways from mandatory screening. The mother is placed on antiretroviral therapy


and the baby's probability of infection is decreased


10. Tunick, p 55


11. Tunick, p 57


1. Tunick, p 57


1. Tunick, p 57


14. Tunick, p 5


6


One-fifth of all perinatally infected infants die by eighteen months of age (15). An HIV


positive pregnant woman given zidovudine(ZDV) during pregnancy reduces mother to


child transmission by 67.5 percent (16). Also, knowing that they are infected with HIV,


those individuals could abstain from activities which could lead to further transmission of


the disease. Therefore, the health and welfare of the community is improved. But, the


communitarian also recognizes the need for privacy. There must be a compelling need for


the intrusion, the intrusion should be minimized, there should be no less intrusive


alternatives, and side affects of the intrusion should be minimized (17).


What negative side affects with mandatory prenatal HIV screening become


involved?HIV testing as a routine part of prenatal care raises several concerns. First, it


is unknown whether such testing would be acceptable to pregnant women. Second, there


is danger that, if HIV testing becomes routine, it will become so habitual or mechanical


that pregnant women may not realize that they have the option to decline testing.


Pregnant women are among those recognized by United States federal regulations as a


vulnerable population (18) and therefore more susceptible to this affect. Third, caregivers


and patients may forget that HIV testing entails much greater psychosocial risks than


other blood tests. Fourth, by foregoing opportunities for education and counseling,


routine testing may undermine prevention efforts. Finally, routine HIV testing in the


prenatal context may affect adherence to the norms of pretest counseling and informed


15. Human Immunodeficiency Virus Screening. Pediatrics July 1 No.104 p 18


16. Kopelman, p 51


17. Tunick, p 5


18. American Law Journal


7


consent for HIV testing in other contexts.


There is a proposal of a mandatory AIDS vaccination. The vaccine is to be


administered to 11 to 1 year olds and military. Massive resistance has been received


(1). How should our government officials make such a controversial decision? How


would most people make this decision? One way to approach this would be to weigh the


options on the basis of the expected effect. We would favor options that we expect to


produce the most favorable results. Because the results will surely produce some negative


results there are alternate ways of approaching the decision. Instead, various moral


intuitions are involved. We often consider the harm caused by our actions to be more


serious and more to be avoided than harm caused by our omissions. As a result of this


intuition some people avoid taking protective measures that might cause harm, even


though the same measures are more likely to prevent harm. When a vaccine, such as the


AIDS vaccine, can cause side effects or death people want to avoid these effects, even


though the vaccine can prevent a disease that is more likely and equally serious and


deadly. Therefore, government officials might resist requiring the vaccine. It is not


because the government officials are wise but capitulate to public demands. They have


the same moral intuition that influences their judgment. This intuition is, "do no harm." It


is a widely advocated. In a case like a vaccination this rule is potentially harmful. It leads


us to neglect things we could easily prevent, like disease and death. After the AIDS


vaccine has been properly tested there will still be a risk of becoming infected with HIV


at the time of vaccination. But, this is the risk with any vaccine. Some parents will resist


1. Wes Vernon, "Reports indicate Massive resistance to Mandatory AIDS Vaccine" June 1, 001 Gannett News Service, Newsmax .com


8


the vaccine for their children even though they know the total risk is lower with the


vaccine than without it. Even though the risk may not be to that detrimental point today


without a cure the risk continues to increase. Most people do not want to see themselves


as the cause of harm to their children. It is better that the harm come from some force out


of their control. Then it is easier to shun a guilty conscience, even though they could have


prevented it. This do no harm view also affects the decisions of judges and juries, when


people sue the makers of the vaccines for its side effects. These side effects are awful, but


so are the consequences of not making the vaccine at all. Even though drug companies do


not get sued for the injuries caused by their failure to make a product, they take these law


suits into consideration when deciding to invest research and development resources into


more possibly risky vaccines versus another drug that lowers cholesterol. In a utilitarian


society people would favor a government policy for a mandatory AIDS vaccination that


will help many while hurting a few.


In some states we allow the testing of infants for HIV pre-birth. Why can we not


implement mandatory HIV test for all people? This would improve the welfare of the


community. Like screening newborns the privacy of the individual will be compromised.


The harm caused by the compromise may inflict mental and/or physical harm on the


person who is found to have the disease. This will in fact hurt the person involved. If in


the U.S., they will be placed on antiretroviral therapy. The lifestyle of that person will


change. But, this is for the good of the whole. If those with the disease are made aware of


their infection they are less likely to continue spreading the disease to others. The privacy


issues explored in relation to mandatory testing of infants apply here as well. But, they do


not outweigh the benefits that would be achieved from mandatory testing. How is it that


we have come so far as a society and mandatory testing is not enforced? The people who


are found to be HIV positive are the people who benefit the most. Even though they will


be subjected to a dramatic lifestyle change, they had the disease anyway. The fact that the


disease is in their system does not change whether or not they are tested. The benefit they


receive is earlier treatment of the disease. It is common knowledge that the earlier this


disease is treated a better quality of life is received.


So, why is mandatory testing not enforced? Why do people claim infringement of


privacy? People are afraid. People are afraid that they will have the disease. Because if


they have the disease they know that their mate probably has the disease. They know that


they have a long road ahead of them with treatment and sickness. They know that it is a


death sentence. They know they will feel shameful and dirty. They know they will


experience rejection. So, is it ethically wrong to mandate HIV testing? Why would it be


wrong, because someone will be upset if they are positive? No that is ridiculous. What is


unethical is for people to reject the test. It is socially irresponsible for people to have sex


with multiple people and not get tested. But, people are selfish and become more and


more selfish as they evolve.


Even though mandatory testing will not become a reality in my generation, I


believe it is the best method of prevention. People with HIV and AIDS need to be kept


isolated form the population that is not infected. There needs to be a system that will


allow people to know who is infected. Or more so, people need to know if they are


10


infected so that they can make the necessary changes in their own lives to keep others


safe. This may be a callous approach. But, the spread of HIV has gotten out of hand. And,


I am afraid. I take the precautions that I need to take to protect myself, but I have friends


and family that may not take the same precautions. I understand that a lot of people who


are infected are good people who want to lead normal lives. And, I believe that most


people who know they have the disease are cautious with their lifestyle activities. The


problem is the people who do not know they are infected. Those people who are not


taking the necessary precautions. The methods of controlling this epidemic that have


been in use in our society so far are education and voluntary testing. These methods are


not enough. Not enough people are getting tested or practicing safe sex. The disease is


still spreading.


Vaccination will probably be the next step in this battle against HIV. Even though


there is presently much resistance to the idea, it is a practice already seen in our culture.


Therefore, people will accept vaccination before they will accept mandatory testing. But,


I assume it could go either way. Everyone in the U.S. who attends school is required to


prove vaccination with records. But, a TB test record is also required. Which ever is the


preferred method of control, hopefully, it is sooner than later.


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