LEAD: The New York City Board of Health reached a consensus yesterday to ask the state to require that the names of people infected with the AIDS virus be reported to the health authorities. The purpose would be to trace the people they have had sex with or shared needles with.
The New York City Board of Health reached a consensus yesterday to ask the state to require that the names of people infected with the AIDS virus be reported to the health authorities. The purpose would be to trace the people they have had sex with or shared needles with.
The proposal by the departing Health Commissioner, Dr. Stephen C. Joseph, was identical to one he has been advocating in the face of criticism from AIDS organizations, gay-rights groups and Mayor-elect David N. Dinkins.
The critics contend that recording names and tracing sex and drug partners would violate the privacy rights of AIDS patients and discourage people from being tested for AIDS. Health officials are pressing to trace partners because research shows that beginning medication even before symptoms appear may prolong patients' lives.
The Board of Health proposal would allow centers that offer anonymous testing to continue to safeguard anonymity. People who are screened through their physicians, hospitals or clinics and who test positive for the virus would be required to give the names of their sex and drug partners.
Reaction by Axelrod
The State Health Department reserved comment until officials had seen the proposal, a spokesman, Peter Slocum, said. State Health Commissioner David Axelrod was cool to the proposal when Dr. Joseph broached it in June at an AIDS conference in Montreal. Dr. Axelrod said the rule might discourage people from being tested. But he did not rule it out forever, and evidence that early medication may help has grown stronger.
The action by the Board of Health adds weight to the move for reporting. "It's something I feel very strongly about," Dr. Joseph said.
The opposition remains strong. Timothy Sweeney, deputy director of the Gay Men's Health Crisis, the largest AIDS organization in the city, said:
"Our problem with his proposal is it's not going to bring people into the health system, but will in fact drive them away. Dr. Axelrod has been opposed to it, and Mayor-elect Dinkins has been opposed. It is inappropriate that during a transition that this issue be brought up."
The director of the AIDS project of the American Civil Liberties Union, Nan D. Hunter, said: "People go to doctors and clinics for treatment. And if you can't get treated without having your name reported, it becomes an enormous disincentive for treatment."
Dr. Joseph's proposal did not address how cooperation might be required. In tracing other sexually transmitted diseases like syphillis, patients are asked for the names of their sex partners. If they refuse, legal sanctions can be imposed. But they are rarely, if ever, used, because health workers prefer to seek cooperation.
Dr. Joseph, chairman of the Board of Health, announced on Monday that he would resign on Dec. 31. The board members have staggered terms.
Series of Warm Endorsements
The session yesterday was the last scheduled meeting for the year, and Dr. Joseph broached the proposal as the final item. He suggested that a resolution or letter be drafted to Dr. Axelrod, the State Public Health Council or both.
Although the board members did not vote, they endorsed Dr. Joseph's idea warmly. He said in an interview that they would work out the details in a private meeting.
One member, Dr. Saul J. Farber, said:
"Well done. I agree. It is our responsibility to track this important and disastrous public-health problem and to try to control the epidemic."
No Breaches Reported
"I think we all agree it's an important and needed step," another board member, Dr. Kevin M. Cahill, said. He urged, however, that the proposal be written to avoid adversarial relationships.
Dr. Joseph said there had never been a breach of confidentiality in the city's recording of its 22,000 AIDS cases.
The Centers for Disease Control require the confidential listing of people who have developed AIDS, but not of those who just test positive for infection with the virus. Some states require the recording of the names of those infected.
When Dr. Joseph called in the past for recording the names, many experts on AIDS and organizations opposed him. Mayor Edward I. Koch called opponents to a meeting at Gracie Mansion and said he would not adopt the proposal.
Dr. Joseph has continued to speak out and sent physicians letters encouraging them to trace contacts voluntarily. Mr. Koch said Dr. Joseph had told him of his intentions before the Board of Health meeting, but the Mayor did not say what he thought of the proposal, adding that he would see how the state reacted.