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Surgeon General Seeks AIDS Tests For An Entire U.S. University

January 28, 1988

LONDON (AP) _ U.S. Surgeon General C. Everett Koop said Thursday he wanted to screen every student of a major American university this spring to help determine the incidence of AIDS among young adults.

Koop also proposed similar mass AIDS screening at a few high schools in the United States, but said the government had made no decision on either proposal.

He disclosed the plan Wednesday at a world meeting on AIDS in London and gave details in an interview Thursday with The Associated Press.

The three-day conference, attended by health ministers from 114 countries and senior public-health officials from 34 others, adopted a declaration backing the World Health Organization’s global strategy on AIDS control and prevention.

Proclaiming 1988 the ″Year of Communication and Cooperation About AIDS,″ the 650 summit delegates said they ″can and will″ slow the spread of AIDS, but offered no major new strategies.

Koop’s plan for anonymous screening of students could prove controversial. Civil libertarians have argued that anonymous screening is an invasion of privacy and that screening of a limited population could be the forerunner of mandatory nationwide testing.

The surgeon general said health officials had yet to choose a university, but it would likely be one in a large city with a student body of around 25,000. Plans call for the screening to take place some time this spring, Koop said, and it would likely be part of a one-day open-air campus ″gala″ on AIDS prevention.

″That would give you a pretty good idea of the prevalence (of AIDS) in the age group in an urban setting,″ he added.

The incidence of acquired immune deficiency syndrome is highest among 20- to 24-year-olds, with male homosexuals and drug abusers among those most at risk.

AIDS is caused by a virus that damages the body’s immune system, leaving victims susceptible to infections and cancer. It is spread most often through sexual contact, needles or syringes shared by drug abusers, infected blood or blood products, and from pregnant women to their offspring.

Blood tests can determine the presence of AIDS antibodies, indicating exposure to the virus, but a positive test does not necessarily mean a person will develop symptoms.

Koop said the screening would probably be conducted under the auspices of the Centers for Disease Control in Atlanta or the American Medical Association.

He said anonymity would be guaranteed and those taking part would have no way of knowing the results.

″To me, it’s not an invasion of anyone’s privacy,″ he said. ″It’s an effort to help the public health people make some predictions about prevalence, which we sorely need.″

Koop said he also hoped that such screening could be carried out at a few high schools in diverse parts of the country. As examples of the types of places he had in mind, Koop cited Philadelphia or New York’s South Bronx in the Northeast and Evansville, Ind., in the Midwest.

The CDC earlier dropped a plan for random testing in the United States after determining it would be much more complicated than originally thought.

Koop said he would like to test an entire university student body, and possibly the faculty, but acknowledged that some people might not want to take part, indicating such screening would not be mandatory.

The meeting produced a commitment by health ministers to join an international effort to combat the disease, which has spread to at least 130 countries.

A key point of the summit declaration was its endorsement of the World Health Organization’s global AIDS strategy.

The strategy, which already has been endorsed by the U.N. General Assembly and the World Health Assembly, calls for slowing the spread of AIDS in every country by using educational and scientific means to attack its modes of transmission.

Delegates adopted the declaration after reaching agreement on various amendments to a draft document.

The most significant revision, prompted by Nigeria, added ″population groups″ to those who should be protected from discrimination. The change reflected African resentment over speculation that AIDS originated on that continent and screening programs focused on African students and immigrants.

The declaration emphasized the need ″to protect human rights and human dignity″ in AIDS prevention, saying discrimination and stigmatization ″undermine public health.″

WHO’s global strategy stresses the need for nationwide health-education campaigns against AIDS. It opposes mandatory screening except for donor blood, blood products and semen for artificial insemination, but endorses large-scale voluntary screening.

Dr. Halfdan Mahler, WHO director-general, said he felt ″by far the most important″ result of the summit was that it committed health ministers to the concept that ″information can make a difference in health.″

″Information and communication has to a large extent been stonewalled by the health professionals, including myself,″ Mahler said. ″We now have to relearn that communication is decisive in fighting such a global threat as AIDS.″

During the summit, Dr. Jonathan Mann, director of WHO’s Special Program on AIDS, predicted the number of AIDS cases worldwide would increase from the current estimated 300,000 to 1 million by 1991.

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