A recent AIDS screening project conducted by the Utah Department of Health - which involved the testing of more than 24,000 Utah babies, abortion recipients and small random sampling of the general hospital population without their knowledge - has ignited controversy over unauthorized testing.
Some officials have decried the anonymous testing as an invasion of privacy. Others contend the practice doesn't protect the public's health because infected individuals are not subject to contact tracing.State epidemiologist Craig Nichols said the federally funded program, which was approved by the Legislature's Health Committee, provided for AIDS testing of every baby born and a sample of women who had abortions from October 1988 to June 1989.
The testing of mothers and abortion recipients, he said, was done in conjunction with other AIDS screening in Utah involving blood donors, inmates, military personnel and tuberculosis sufferers.
Like tests conducted on a random sample of hospitalized patients, Nichols said the birth and abortion tests were done without the patients' knowledge but that the tests were "blind."
"We do not have names. They (blood samples) come only with a code number, and they are not traceable back to the patients whose blood was taken," he said. "We wanted a total sample so we would reliably know how many of the heterosexual people in the state were infected.
"If we were to ask people for consent, it would have been expensive and time-consuming. The fact is we don't know who they are, and we can never reveal any information about the individuals," Nichols said.
Because of the success of the state program, the national Centers for Disease Control has given more money to Utah to test additional blind samples, most of which will be done on hospitalized patients.
Nichols said the hospitalized patients will also be tested without their knowledge "on blood samples where all routine testing has been completed and after the name has been removed."
The lack of identification concerns a lot of people who want AIDS carriers and their contacts identified and closely monitored.
Nichols believes this is already being done.
"Those individuals who were found to be positive through this study were likely already found through other methods," he said. "Because the sample is blind, we don't know if that's true, but we believe that parallel testing systems allow women ample opportunity to be tested.
"We do know through our health department testing and testing by private physicians of a larger number of pregnant women who are infected."
By law, contract tracing is being done in Utah on infected women identified through clinics and physicians.
Different procedures are followed in federally funded test.
Nichols said in the "blind" test, blood was taken from newborns' heels _ a procedure already used by doctors in conjunction with the health department to test for congenital disorders.
Because of the prenatal blood exchange between mothers and fetuses, the tests actually "reflect the infection status of the mother, rather than the baby," he explained.
The tests revealed three positive results for the AIDS virus.
At the State Health Laboratory, officials also tested the blood from 2,000 abortion recipients (about half of Utah women who had abortions last year), using routine screening samples taken in conjunction with the procedure.
None of the women tested positive for the virus, Nichols said.
The epidemiologist said the data is extremely good news.
The sampling revealed that Utah has _ when the sampling is projected to a full year estimate _ an AIDS virus incidence rate of 1.4 per 10,000, one of the nation's lowest. The results place the Beehive State into the Centers for Disease Control's lowest, 0-9 per 10,000, category.
By comparison, in New York, 40 women tested positive for the virus per 10,000, Nichols said.
"The advantage of being able to do the study is that it's statewide and not only does it reflect the infection rates in babies and their mothers, but indirectly it tells us about male sexual partners of these women," he said.
Nichols said the "blind" testing, "which will continue the next three to five years," was part of a two-year-old federal AIDS prevalence study involving 29 other sites across the nation. Utah was one of the first states to be funded statewide for newborn testing.
The health department's protocol for protecting privacy, he said, has been used as a model by the Centers for Disease Control and adopted by other states.