At any time since World War II, with a small united effort, we could have virtually eliminated Gonorrhea and Syphilus. Instead we treated them gently, allowing time for resistant strains to develop and proliferate so that we had to invent new antibiotics to stop them. It's great for the pharmaceutical industry but it's not good for poly-intimate people to be dependent on an unstable political and economic environment to supply them with antibiotics. The Japanese are said to have quickly brought Gonnorhea and Syphilus under control through strict measures. I suspect they will also be far ahead of us in AIDS control. But gentler measures could also be effective.
Lets extrapolate from the past to the future. Assume that no matter how much money we throw at AIDS we don't find a vaccine; that everyone who catches the virus will develop AIDS symptoms and die within ten to fifteen years; that infected mothers usually pass the virus on to their babies; that we take no large-scale restrictive action beyond recommending safe sex and monogamy, which are never fully practiced; and that we make full use of drugs such as AZT which only treats the symptoms, and at considerable cost.
It seems we can look forward to increasing numbers of deaths and expenses due to AIDS over hundreds of generations, until we evolve resistance, or more repressive lifestyles, by natural selection. ("Natural" because we will be living by our instincts, as animals, rather than using foresight and control.) This means until all those who are genetically and culturally susceptible have died. The good side is that we will have postponed the (excess) population problem, because safe sex (with everyone?) is also an excellent contraceptive plan.
Though safe sex is obviously important, there is no total safety. There is no way to be totally sure that AIDS isn't transmitted by kissing or other contact. There are no doubt many cases where the mode of transmission isn't clearly identified.
Monogamy is not a total solution since it still requires one "new" sexual contact (per lifetime) in order to reproduce. Since we mate outside of our own families, AIDS can thus still be spread throughout the population.
Groups of uninfected people who isolate themselves from the general population must do so for several generations, until the infected population all dies, or indefinitely if it turns out that a few people can carry the virus but resist its effects permanently.
Our present AIDS policies are playing nicely into the hands of those who would repress sexuality, gay or straight. The active gay community could have saved itself by accepting external and/or self-regulation but failed to do so, and no doubt straights will follow. I'm not ashamed to say that the uninhibited atmosphere of gay bathhouses was once an important part of my life. But I knew when to give it up. I took the AIDS antibody test (which was negative) shortly after it came out. It's rather important to me to try to control any threat to sexual freedom. Sometimes we must give up a little rather than giving up a lot. We tend to be much more concerned with the civil rights of a few who we can identify now than with the lives of the many potential victims in years to come.
The authoritarian approach might be repeated mandatory testing of everyone, and persecution, tattooing, quarantine, exile or execution of HIV positives. I'm definitely not recommending this, but if we had chosen one of these paths when the antibody test was first available, wouldn't we have saved lives in the long run, especially in the gay community, and pretty much eliminated AIDS by now? Isn't that our goal? I can't find a valid reason to not follow such a procedure, even now, except for the hope that there is a better way, that we will find a vaccine, that safe sex, monogamy or less drastic action will stop the spread of the virus. But I think there's another, better compromise, with a minimum of oppression.
The card holder could tear the card up and throw it away if he wanted to, but soon, people with up-to-date cards with many tabs might become more popular, thereby encouraging more people to take the test. Card holders would of course feel safer with other card holders, which would have a positive feedback effect for all card holders. Those who wanted to cheat and not tear off each other's tabs would also not be very popular. How many has he cheated with since he took the test?
Not having a card would obviously not identify a person as having AIDS. He might not have taken the test, or he might be opposed to carrying such a card. People who are afraid of having their picture taken in connection with the test would also be afraid of hidden cameras. Today, taking the test certainly doesn't identify one as being gay, only reasonably intelligent, and/or possibly sexually free - which hopefully includes quite a few people today.
Of course this system isn't perfect, partly because the test isn't perfect. It will miss recent infections and possibly others. No card would be completely up-to-date even as a person walked out of the clinic. (It would help though, if the card indicated the date of the last TWO tests.) The cards would no doubt be susceptible to counterfeiting. But the system is inexpensive, and a person with a card is less likely to be infected than a person without one. The card would help to make intelligent discrimination possible, not by authoritarians, but by the people who are most directly involved, and who care.