Physicians have been urged to explore and divulge their human immunodeficiency virus (HIV) status to their colleagues and patients. The obverse has not been emphasized—that HIV-infected patients accept their moral responsibility by revealing their health status to their providers, who are admonished not to refuse care to such persons.

The position paper by the American College of Physicians and the Infectious Diseases Society of America [1] enumerates reasons for HIV testing but does not support universal, mandatory evaluation. Faced with a uniformly fatal epidemic, why is the acquired immunodeficiency syndrome (AIDS) exempted from epidemiologic efforts that helped to conquer other infectious diseases? Without obligatory HIV testing, how can incidence be accurately determined?

A ubiquitous reservoir of HIV-infected patients is sequestered from public health scrutiny by concerns for social problems of ostracism, loss of employment, and housing. Meanwhile, innocent sexual partners continue to be infected by recalcitrant or unknowing persons with AIDS, and infected children continue to be born of such liaisons. Early treatment of patients with HIV is recommended, but how are they to be found without mandatory evaluation?

As noted by Cohen and colleagues [2], we can interdict persecution of patients with AIDS by forthright education of all citizens, including politicians, in epidemiology, protective devices, and treatment. Control guidelines may require legal mandates to confine recalcitrant patients (as has been done in tuberculosis control). Priority for prevention cannot be rendered, however, unless persons with the disease are identified.