AIDS, social sciences, and health education: a personal perspective.

The acquired immunodeficiency syndrome (AIDS) epidemic has raised numerous ethical issues. Above all, it has served to highlight the fact that individual liberty always exists in a precarious balance with public interest. The invasion of privacy, loss of confidentiality, and coercive approaches proposed for testing and disclosure of infected individuals threaten to turn this into and underground epidemic. Health education is the only feasible strategy for containing the AIDS epidemic at this time, yet such efforts have been hindered by the government's reluctance to issue explicitly written materials dealing with homosexual sex practices. The need to convey accurate information is important not only to preventing further infection in the gay community, but also in limiting the likelihood of reinfection should repeated exposure to the AIDS virus prove to be of pathogenic significance. Despite government prudery, the dramatic decrease in rates of rectal gonorrhea in New York and San Francisco indicate that homosexuals are listening to appeals to practice "safe sex." In addition, self-reports on the number of sexual partners among gay men suggest that AIDS has had a chilling effect on life-style. Resolution is needed of the non-health-related problems--including confidentiality and the possible loss of job, insurance, and friends--that make it difficult or unwise to advocate widespread screening for antibody to the AIDS virus at this point.