The sickness of HIV profiling.

Although we have now passed the quarter-century milepost of the AIDS epidemic, the animus toward people with HIV/AIDS has not abated in the United States. At the same time that government funding for effective prevention programs is shrinking, many of the public health authorities and agencies that hold the purse strings are requiring physicians to report to the government the names and personal details of all HIV-positive patients. That leaves many health care providers in the compromising position of having to choose between government funding and the traditional confidentiality of the clinician-client relationship. This is nothing more than conservative politics and moral intolerance dictating health care policy.

In my home state of Massachusetts, for example, the Department of Public Health could lose $9 million a year and the Boston Public Health Commission $6 million if they refuse to rat out their patients-money that is used for such things as medication, meals, and home health care.

Proponents of name-based reporting call it a proven tool in targeting the specific people and communities at risk for infection. I call it HIV profiling. This impulse is not new. In 1986 conservative commentator William F. Buckley Jr. suggested tattooing people with HIV on their buttocks and forearms, a proposal reminiscent of both American slavery and the Holocaust.

The people who suffer most from this government intrusion are at society's margins: LGBT people, IV drug users, and people of African descent--all of them already the moral whipping board for a morally intolerant society in denial about how the epidemic continues to explode.

Names-based reporting not only violates patients' confidentiality, the Fourth Amendment prohibition against unreasonable searches, and the constitutional right to privacy, it also threatens to expand rather than control the AIDS/HIV epidemic by scaring away people who most need medical care--all under the banner of restoring so-called traditional family values.

The Bush administration is not interested in scientifically credible tactics to combat HIV/AIDS infection. Its abstinence-only ideology takes monies from proven disease prevention initiatives, denounces the long-established effectiveness of condoms, and refuses to fund lifesaving needle exchange programs.

Under the direction of a government that continues to believe that HIV/AIDS is a direct and divine consequence of engaging in a lifestyle fraught with disease and sin, names-based HIV testing simply erects virtual colonies for diseased and rejected "lepers." It's a policy that establishes its supposed moral high ground by riding on the backs of our society's most vulnerable members. This policy is not only an act of inhospitality and moral intolerance. It's the symptom of a sick society that tests negative for compassion.