Between 1918 and 1920, in response to public fears over the spread of venereal diseases, especially concern for the health of the soldiers and sailors conscripted to fight in World War I, the government of the United States promoted and paid for the detention of more than 18,000 women suspected of prostitution (Brandt 1985). Under an act of Congress directing the creation of a “civilian quarantine and isolation fund,” women were held against their will in state-run “reformatories” until it could be determined that they were not infectious. The government's program, while startling in size, is hardly unique in the history of American public health. When cholera struck New York City in 1832, officials rounded up alcoholics, especially poor Irishmen, in the belief that the illness arose in part from intemperance. During New York City's polio epidemic of 1916, health officials routinely conducted house-to-house searches and forcibly removed and quarantined children thought to have the disease (Risse 1988).

With AIDS the official response has been remarkably different. So far, the few serious proposals for mass quarantines have failed. The most vocal and visible public health officials, including the former surgeon general of the United States, have championed voluntary measures over coercive ones (Koop 1986). They have generally argued for greater compassion for those afflicted, and for heightened legal protections against discrimination.