In the early years of the AIDS epidemic, there was a broad consensus that HIV antibody testing should be conducted only with the informed voluntary and specific consent of the individual. However, research showing the efficacy of early intervention in preventing the occurrence of pneumocystis carinii pneumonia, and the belief that early intervention could also improve the prognosis for infants at high risk of HIV infection, has forged a new alliance of physicians favoring routine screening of pregnant women and mandatory testing of high-risk infants. These factors have also eroded the opposition to reporting requirements and mandatory contact tracing. The preventive effort in the U.S. has centered on educational campaigns and counseling programs; this author contends that one area that has been dismally ignored is drug abuse treatment. The Ryan White Comprehensive AIDS Resources Emergency Act of 1990 provided for a major infusion of Federal money to the cities and States most severely struck by AIDS; however, Congress slashed funds authorized under the bill, and it is unclear what allocations will be made in the future. Prevention and care must be joined if public health officials are to intervene effectively in the AIDS epidemic's course. 30 notes