Across the country, in city councils, state legislatures, and the halls of Congress, dozens of laws and regulations have been proposed or adopted in response to rising public concern over AIDS, Acquired Immune Deficiency Syndrome. The new proposals and regulations ostensibly seek to provide a medically rational approach to one of the most politically charged public-health issues today.
More than 20 states have considered AIDS-related legislation in the past year, and more action is expected when state legislatures return to sessions in 1986.
``It is a simple question of taking action needed to protect the health of people,'' says Rep. William E. Dannemeyer (R), of California. Last week he introduced legislation, that would, among other things, keep children diagnosed as having AIDS out of public schools.
But many proposals and new laws face plenty of critics. They say certain proposals, if adopted, could unfairly stigmatize large numbers of physically healthy people, because tests may show certain people having the AIDS virus who in fact do not actually have AIDS. There is also concern that some measures could ``drive the disease underground'' -- that is, cause some AIDS victims to purposefully avoid state health authorities, and thus present a danger to themselves and others. Critics also b elieve some proposed laws use AIDS as an excuse to discriminate against homosexuals.
Among the latest developments:
In New York State, local officials have now been empowered to close homosexual establishments, such as bathhouses, where risk of spreading the disease is high.
Last week, Massachusetts officials established the first state-wide guidelines for people with AIDS whose work involves handling food. The guidelines allow them to work as food handlers, but under certain prescribed conditions.
Last Wednesday, Colorado became the first state in the nation to require that names and addresses of those found to have the AIDS virus be turned over to the state health department.
Also on Wednesday, Representative Dannemeyer introduced five bills in Congress. They would: make it a felony for an individual from a high-risk group to donate blood; prohibit anyone with AIDS from working as a health-care professional in institutions receiving federal funds; deny federal funds to cities that do not close bathhouses frequented by homosexuals; keep children with AIDS from attending public schools; and allow health-care workers to wear special protective clothing around AIDS
patients without interference from hospital officials.
Critics of the Dannemeyer bills say that many of its provisions are crafted for dramatic effect and would have little impact in controlling the spread of the disease. For example, they say, the felony bill is unnecessary because blood donations are now routinely screened for the AIDS virus anyway.
Many observers charge that some legislative initiatives pander to public fears about AIDS as much as they shield the public from any potential health threat. ``We're basically dealing with two epidemics right now: AIDS and fear of AIDS,'' says Mervyn Silverman, former San Francisco health commissioner.
Public fear, however, is only one impetus behind legislative action. Because the spread of AIDS has been closely linked with homosexual activity, many analysts see the policy debate over the disease charged by issues of lifestyle and personal morality.
That concerns many civil libertarians, who see new laws appearing on the horizon which are tailored to play well with anti-homosexual voters.
``This tragic, terrible disease is being used to further a right-wing political agenda,'' says Rep. Henry A. Waxman (D), of California. Of future AIDS-related legislation, he says: ``If we're not careful we can have a hysterical reaction not only by the general public but by members of Congress as well.''
In fact, analysts say, the debate over AIDS has set back efforts around the country to adopt legislation designed to prohibit discrimination on the basis of sexual preference.
Last month, the Massachusetts House of Representatives struck down such legislation, despite the fact that a similar bill had passed handily in 1982. ``A lot of members who voted for the bill last time turned against it now because of the AIDS situation,'' says Royall H. Switzler, a Republican who led both attempts to defeat the bill. Many of the legislative actions emphasize noncontroversial AIDS public-information and education campaigns. Others, however, stress more restrictive measures, such as qu arantining AIDS victims; banning bathhouses; and requiring some workers to be tested for the virus under the supervision of state health authorities.
Medical experts oppose many of these ``restrictive'' initiatives. The best way to halt the spread of AIDS, they say, is alter sexual behavior among so-called high-risk groups; carefully monitor the nation's blood supply; and stop intravenous drug users from using contaminated needles. They stress that no known AIDS case has ever been communicated through casual social contact.
``What happens if word gets out that we quarantine [AIDS victims]? The disease goes underground,'' says Bailus Walker Jr., commissioner of the Massachusetts Department of Public Health.
Yet, many of the solutions targeted by medical experts as counterproductive are being seriously considered. For Rep. Don Gilmore, a Republican state representative in Ohio, public pressure prompted him to introduce an AIDS-quarantine bill.
``I'm shocked, I'm getting support from all over the US,'' he says of his proposal that all the AIDS victims in Ohio be quarantined in their homes. He says the bill has strong support among his colleagues in the legislature. He does not expect it to pass, however, because, he predicts, state health authorities will adopt other AIDS-related measures to syphon support from the bill.
But restrictive measures are by no means the only response by local officials to AIDS. Many states have joined the federal government in increasing funds for AIDS research and education. And Los Angeles and West Hollywood, Calif., recently became the first municipalities in the country to pass a law protecting those with AIDS from discrimination in employment, housing, and public accomodations. A similar bill is under consideration by the San Francisco Board of Supervisors.
California and Wisconsin recently passed legislation making it unlawful to use blood tests to exclude people from insurance coverage or employment (although Wisconsin amended its legislation to allow insurers access to AIDS-virus tests for individual policies). Advocates of homosexual rights fear employers could use test results to discriminate. An American Council of Life Insurance spokesman says similar bills could soon be introduced in Massachusetts, New York, Ohio, and Texas.
In addition, says Thomas Stoddard, legislative director for the New York chapter of the American Civil Liberties Union, every state except Arizona and Delaware has a law to prevent employment descrimination against the handicapped. Many of the laws are relatively new and have not been fully interpreted in court, so future rulings could extend these laws to include AIDS victims.