The state of Colorado is refusing to pay part of El Paso County Health Department's annual $40,000 grant, because the department refuses to destroy records of people who have tested negative for HIV.
The department's director, Dr. John Muth, argues that HIV test results, like the negative and positive results of other tests, should be kept. He rightly claims that the records could be useful to testees at some point in the future, and that they are also useful to the state in tracking the course of the infection in the population.
But the manager of the state's HIV program, Mary Kay Myers, counters that destroying negative results helps reassure people who might otherwise be nervous about being tested.
While I don't know anything personally about Dr. Muth, I don't think his argument is necessarily a cover for AIDS-phobia. To someone who looks at disease from the "public health" angle, it looks like a terrible mistake to be throwing away any negative test results, when those results could be used later to narrow down the time when some individual first contracted HIV. If they tested negative in June, and positive in December, that negative test might be crucial data in tracking the spread of the disease.
But the way a public health official looks at disease might be different from the way an individual looks at it. Whether you test positive or negative for HIV, that data, and your health, become part of the public health bureaucracy, and you can hope and pray, and maybe vote and lobby, for a wise use of the information. But everyone's idea of "wise use" is different, so some people are bound to be dissatisfied with their treatment.
I don't think there is a universal right answer to the question of whether to keep negative test results or not. It's a judgement call based on one's appraisal of how trustworthy the political process is and how much mileage health officials will get out of the data. Dr. Muth should take notice of the number of people who use pseudonyms when getting tested as an indicator of just how controversial that judgement is.
Instead of a financial tug-of-war between El Paso and the State, Myers and Muth should ask the people in question -- each person being tested -- what they want done with their test results. People who do not want their results, positive or negative, to be part of the public record ought to have that right. But I think at least some people, when told about the benefits of carefully controlled public records, will agree to help the fight against AIDS by taking that risk with their right to privacy.
Individual medical and privacy decisions should be considered more important than the decisions of public health officials. The weighing of risk, longevity, quality of life, privacy, and other factors is crucial and intensely personal. We can not allow a single agency to make cookie-cutter decisions for millions of people that have different moral, religious, and personal feelings about life and death.