Three years ago when Idaho became the last state in the nation to report its first case of AIDS, public health officials took a no-nonsense approach to "corral the virus."
With little debate and no opposition, Gem State physicians began treating it much like any other communicable disease. Anonymous testing was barred and doctors, hospitals and laboratories were required to report the name and address of anyone who tested positively. Counselors were permitted to ask people to voluntarily identify their sexual partners so they, too, could be urged to be tested.The state's policies were simple and straightforward, designed to halt AIDS at the border. But were they realistic?
Some say "yes." In fact, many conservatives think Idaho's uncomplicated procedures should serve as a model for states that have badly bungled the job of controlling AIDS, a disease that has already infected 62,740 Americans and killed 35,188.
But in Utah, another conservative state with a relatively low incidence of AIDS, concerns about civil liberties, ethics and privacy seem to be weighed equally with the aggressive protection of public health.
This was evident in 1988 when Gov. Norm Bangerter vetoed two controversial AIDS bills that had been heavily debated and passed by the Legislature.
Since then, extensive revisions have been made to HB220 ("AIDS Testing and Reporting for Protection of Emergency Medical Service Providers"), and SB113 ("Confidentiality of Communicable Disease In-formation").
Both revised bills, hashed over by medical specialists, law enforcement officers, emergency responders, attorneys, insurance agents and citizens for the past five months, could be discussed in the special session beginning July 5.
Dr. Brett Lazar, director of the Division of Community Health Services of the Utah Department of Health, thinks the objectionable issues have been resolved. But he can't predict how the bills will be received by the Legislature.
"AIDS is such an emotional issue that it is hard to anticipate where objections might arise," he said. "I am hopeful they will pass, particularly the confidentiality issue."
Lazar said the emergency medical provider bill is not one that the health department is actively promoting, "in the sense that it is `our' bill' " It is being promoted by emergency medical providers.
"But I think we have answered the concerns as the governor has asked us to do, and we have a bill that responds to the needs of the emergency providers, while protecting individual rights."
The revised bill, Lazar said, has two primary components. One is the voluntary testing of patients who have been transported by emergency responders where there's been a significant exposure to the responder. Upon admittance to a hospital, the patient will be asked if his/her blood can be tested for hepatitis or AIDS.
The second part of the bill provides a mechanism for workman's compensation should a responder become HIV positive as a result of a work-related exposure.
Lazar said the confidentiality bill basically sets up a series of protections to ensure that patient information is guarded by all holders of that information - whether the holder is a public health agency, hospital, physician or other provider.
Consideration - and even passage - of these two AIDS bills during the special session, won't mean the end of AIDS legislation in Utah. Other issues, such as mandatory testing and discrimination, remain unsettled.