LEAD: The New York City Board of Health favors the idea of contact tracing in cases of AIDS. That would mean, if New York State approves, that people infected with the AIDS virus would have their names reported to health authorities. They, in turn, would try to trace and alert the patients' sexual and needle-sharing partners.
The New York City Board of Health favors the idea of contact tracing in cases of AIDS. That would mean, if New York State approves, that people infected with the AIDS virus would have their names reported to health authorities. They, in turn, would try to trace and alert the patients' sexual and needle-sharing partners.
Contact tracing is the standard procedure used for syphilis and other communicable diseases. It's controversial in the case of AIDS because gay men and drug abusers, the chief groups at risk, live in fear of discrimination. They don't want their names on a list, whatever confidentiality may be promised. Though states like Colorado have a successful contact tracing program for AIDS, New York has avoided one because of the fear it would drive away those most in need of treatment.
The city's departing Health Commissioner, Stephen Joseph, argued recently that this social calculation had changed. New drugs like AZT and pentamidine can help those infected to delay the onset of symptoms. Gay men are well informed about these drugs, but contact tracing would help inform inner-city women who have no knowledge of their risks and remedies.
Dr. Joseph has now persuaded the Board of Health, which he heads, to endorse his proposal for contact tracing, although it is likely to be opposed by the city and state. He is right in principle. There are many places where contact tracing will save lives; there will be more as early treatments improve. Whether contact tracing would be effective in New York City is worth discussion.
AIDS is now spreading fastest through needle sharing and anonymous sex in crack houses. Many infected in this way don't know their partners' names. In any case, the city is often unable to provide treatment for the addicts or those infected.
Dr. Joseph, who steps down next month after three years as commissioner, has served the city well. Throughout the vexed and divisive AIDS crisis, he has always put public health first - and has attracted detractors. On all or most issues he has been right, and prescient. Some critics suggest he would have been more effective had he not sought out controversy. Maybe, but even the smoothest official would find it hard to win the battles Dr. Joseph chose.
When historians ask what specific actions by New York City or State helped curb the spread of AIDS, they may find little to report, except that Stephen Joseph raised, and fought for, the right causes.