THE EVOLUTION OF A PUBLIC-HEALTH POLICY - HEALTH-CARE PROVIDERS AND THE TRANSMISSION OF HIV

The single known instance of transmission of HIV from a health care pr ovider to a patient raised issues concerning the responsibility of cli nicians to their patients, and sparked debate over policies to prevent the spread of HIV in health care facilities. The intensity and politi cization of the debate were reflected in revision of the Centers for D isease Control guidelines to control the spread of infection at health care facilities, and in legislation proposed in Congress. The guideli nes and proposed legislation provoked responses by public health and m edical organizations, several of which considered the measures to be u nnecessarily restrictive and too costly in terms of potential benefits . This article describes the events and responses that took place duri ng 1991-1992 after the public was made aware of the case involving tra nsmission from provider to patient. The author examines the situation in the context of public health efforts to control the spread of HIV.