Why mandatory HIV antibody screening cannot work

In 1985 this country introduced the first serologic screening test [enzyme immunoassays (EIAs)] designed to detect antibodies to the human immunodeficiency virus (HIV), the pathogen of acquired immunodeficiency syndrome (AIDS). Some people now suggest use of this test to identify people within the general population who are infected with the virus. This article will review technical and administrative problems pertaining to the use of EIAs to screen the general population for antibodies to HIV, and will explain why optometrists can provide safe and comprehensive care to all patients without knowledge of a patient's HIV antibody status. Prior knowledge by the optometrist of the patient's serological status is unnecessary if the practitioner 1) adheres to established guidelines pertaining to infection control, and 2) is aware of the various ocular manifestations of HIV disease. It concludes that mandatory HIV screening programs should not be adopted until the benefits to society have been more clearly elucidated and associated technical, administrative, and ethical problems have been resolved.