From many people I have talked to about this, there seems to be a general feeling that the problem could be solved if you knew who to avoid. This comes up time and time again. If only we could find the threat and we avoided that threat, we would be safe. The fact that people's behaviour would only be somewhat modified leads me to believe that simply having that information provides you with a sense of false security because, really, just by knowing that one or two people definitely have the HIV infection, is no guarantee that two or three other people you may be involved with do not have it. It is simply that you know for sure these two or three people who are infected should be avoided and then you would be safe, in the sense, at least you are not being infected by those two or three people. There is no guarantee you would not get it from someone else. I am convinced that we are going up the wrong path, if we think we can solve the problem just by knowing who to avoid.
My question is, from your knowledge -- and I have lived in several small communities -- is it not likely that in those communities that most people would know who the problem cases are? Even though we have confidentiality and all the ethical considerations looked after, it is very difficult in my experience in a small community to hide anything. It is almost impossible. In reality, in communities where there are people who are HIV infected, what is the judgement of the department? Do people locally know who is infected, or is it a secret which is kept so carefully and closely guarded it would be impossible for the community to find out?