The failure to institute traditional disease control measures for HIV infection indicates the disorganization of the American public health system. Even public health professionals became caught up in the rhetoric that since HIV is untreatable, there is no justification for using proved disease control techniques to control its spread. The rationale was that since carriers could not be cured and their contacts could not be immunized, there was no reason to report infected persons and to trace the contacts of these persons. This rationale ignores the success in controlling tuberculosis before it was treatable and the current efforts to control incurable viral illnesses.

Control of HIV has been unique in providing a common political ground for homosexual activists and the religious right. Homosexual activists fought efforts to control the spread of HIV because they did not want restrictions on their sexuality. The religious right fought disease control efforts because they saw AIDS as an expression of God’s wrath about homosexual practices. The result was to paralyze the public health establishment for the critical first years of the epidemic. The same paralysis now extends to the conflict between Draconian laws against illicit drug use and public health measures to limit the spread of bloodborne pathogens among intravenous drug users.