Public health officials in New York City recently encountered what appears to be a rapid-onset AIDS strain. Whereas the typical cycle has been about a decade between infection with the virus and the onset of full-blown AIDS, this patient went from infection to presenting the symptoms of the full-blown disease in a matter of a few months. As well, the strain is resistant so far to most of the medications that have been helpful in some measure to AIDS patients.

The New York City patient is potentially a one-man trigger of a major outbreak, for he claims to have had unprotected sex with 100 men in the past few months. The possibilities for an immediate epidemic are staggering, if this truly is a new rapid-onset strain.

However, many doctors and scientists working with AIDS, including researcher Richard Gallo (who was one of the first to identify HIV), say that the NYC Health Department went public much too quickly with their suspicions. Not enough is known about the patient, the critics claim, to say with certainty that he indeed has a rapid-onset strain of HIV-AIDS. And, the figure of a decade between HIV infection and full-blown AIDS is only an average. There have always been a few people on the high end of the curve, whose cycle is rapid in comparison to the average.

Regardless of what else happens, there is a sweeping cry for routine HIV testing, something some health experts have been recommending already. Two large federally funded studies concluded recently that the cost of routine testing of virtually every adult for HIV/AIDS would be offset by a reduction in new infections. Also, it would mean that people infected with HIV could be started on a treatment program early, when drugs work best.

Adding this testing to basic wellness checkups would be costly to an already struggling health-care industry. Treatment is also expensive—running about $15,000 a year.

As it is, the Centers for Disease Control (CDC) requires routine HIV screening in areas where the rate of infection is greater than 1 percent of the population. The UN now recommends routine HIV/AIDS testing in the developing world, where 90 percent of the people with AIDS do not know that they have it.