Politicians wrestle with AIDS crisis. Confidentiality issue stymies federal bill; California initiative would mandate stiff reporting

Voters in California, which has 22 percent of America's 75,000 AIDS patients, could have a profound impact on the entire nation's AIDS policies. In a month they will decide whether their state should continue, or perhaps reverse, the direction that other states have been taking this year toward the disease - one of confidentiality. The proposed bill would require AIDS victims to disclose the names of their sexual partners.

Another issue is being debated in Washington and among people afflicted with AIDS, their families and friends, and gay-rights activists. That is: Is the federal government, as represented by the Food and Drug Administration, moving quickly enough to let people with the disease have medication that is not fully tested?

The government says it is moving as fast as it can. Gay-rights activists say it isn't, and they held a protest demonstration Tuesday at FDA headquarters in the Washington suburb of Rockville, Md.

Even as Californians prepare to vote on their proposal, Congress seems to be preparing not to vote on a bill of its own. So far this year both houses of Congress have passed several AIDS proposals. Efforts have been under way to blend these measures into one that both houses can agree on. Thus far, they cannot. A major sticking point is the confidentiality assurances provided in a counseling and testing proposal that only the House has approved.

Although efforts at reaching agreement continue, as of this writing it appears the bill is not likely to become law. Congress adjourns this week.

But a number of bills have become law in state capitals in 1988. Some 32 states have approved nearly 100 new laws that relate to AIDS.

``A lot of laws [deal with] confidentiality provisions,'' says Mona Rowe, co-director of the AIDS policy center at George Washington University. Most contain major provisions to protect the confidentiality of test results and counseling accorded to people who have tested positive for the virus. (Voter-registration drive boosts `gay rights' bill in Chicago, below.)

The differences in these state laws regarding confidentiality lie primarily ``in the amounts and degree of exceptions,'' Ms. Rowe says.

What Californians are voting on is formally called Proposition 102. Its sponsors are Paul Gann, author of the trend-setting past initiative to cut taxes, and United States Rep. William Dannenmeyer. Mr. Dannenmeyer, a Republican, says that society must be able to know who has AIDS and must be able to inform their sexual partners in order to protect itself from the spread of the disease.

The California proposal is hotly controversial, largely because its provisions might reverse the nationwide trend toward protecting the confidentiality of people who have AIDS or the virus that physicians say precedes the illness. Passage of the referendum ``would argue to politicians that they should'' reverse course and pursue the California example, says Thomas Stoddard, executive director of the Lambda Legal Defense and Education Fund, a gay-rights advocacy organization.

Proposition 102 would require physicians and health clinics who have ``a reasonable cause to believe a person is infected'' with the virus to report him (or her) to local health officials. The referendum then would require that sexual partners be notified. Further, it would allow employers to test their employees for the virus.

People who track AIDS legislation say the California proposal is the only one on any state's ballot this fall.