When James Dorsey, an unemployed teenager from Detroit, packed his bags to go to Dayton last summer, he looked forward to a promising new beginning. He enrolled in classes at a U.S. Job Corps residential training center, hoping to qualify for a clerical job. But Dorsey had hardly started classes when he was summoned to the program's medical office for an unpleasant surprise. He was informed that he had tested positive for AIDS antibodies during his required physical exam, then dropped from the program. "The world was pulled out from under me," recalls Dorsey, who has no symptoms of AIDS. Last month he filed suit in federal court in Washington demanding reinstatement.
Dorsey, who is mounting the latest major challenge to the use of AIDS testing, is one of an estimated 1.5 million individuals known as "healthy seropositives." These are people whose blood indicates infection with the AIDS virus but who have not developed the debilitating disease that has now attacked 71,171 nationwide. His situation places him among a growing group of Americans who often have difficulty finding work, housing and even medical care solely because of their test results. Reports abound of individuals who have been forced to resign from jobs, threatened with loss of a lease, or rejected for health or life insurance.
Safety is usually the cited reason for setting apart those who test positive. Job Corps Director Peter Rell explains that his agency's exclusionary policy is meant to secure "as healthy and disease-free an environment as possible." All 36,000 participants in the agency's residential programs are warned of the test on enrollment forms, he says, and are provided with counseling if they are rejected because of the results. The high costs of treating AIDS patients is an actuarial problem for insurers, who routinely reject seropositives seeking life or medical coverage. "Once we sign on, we're there for the duration," says Emily Crandall, vice president of the Guardian Life Insurance Co. of America.
Victims of these practices counter that testing positive does not necessarily mean a person will develop AIDS. Nor does the presence of carriers, or even those who have come down with AIDS, endanger the workplace, critics insist, because medical evidence indicates that the virus cannot be transmitted by casual contact. Discrimination on the basis of the blood tests may actually harm public health, they warn. "If you fear you are going to lose your job and just about everything else in your life," says Katherine Franke of the New York City Human Rights Commission, "there is no incentive to take the test and get information about safe sex and needle use." Last week, reacting to concerns about confidentiality, the Centers for Disease Control announced that starting next year it would routinely survey one-third of the nation's newborns for AIDS antibodies, but no names will be attached to the blood samples analyzed.