A court ruling has affirmed California's responsibility to test boxers for HIV infection before allowing them to fight. That's good news for the veteran referee who is suing the state over its negligence to do just that in 2005. It also raises questions about the effectiveness of a policy that focuses on testing rather than prevention or education, and is based more on perception than science.

The Fourth District Court of Appeal in San Bernardino ruled last week that veteran referee Ray Corona Sr. – who made a cameo appearance in the film Million Dollar Baby – and his wife may proceed with their lawsuit against the California Athletic Commission. Corona refereed a 2005 super-featherweight bout between Tommy Perez and Guillermo Ruiz, in which Ruiz knocked out Perez in three rounds. Unknown to Corona at the time, the medical report for Perez submitted to the commission before the bout indicated his HIV status was "inconclusive." A subsequent test came back positive and Corona was sent a letter advising him to get tested because of possible exposure. He went on preventive medication and both he and his wife tested negative, but they sued the commission for negligence, seeking damages for emotional distress. The lawsuit was thrown out in 2007 in superior court, but may now proceed because of the 3-0 reversal on appeal.

The commission said it has tightened its procedures since the 2005 bout to prevent recurrences of that failure.

Before 1996, California and most other states did not mandate HIV testing for boxers, and a few attempts to legislate the requirement had failed in a highly charged debate that largely pitted civil rights versus AIDS hysteria. But the political climate changed in February 1996 when heavyweight boxer Tommy Morrison, best known to moviegoers for his appearance as Tommy Gunn in Rocky V, tested positive just before a heavily hyped fight en route to a likely showdown with Mike Tyson.

Morrison, by the way, has been living a high-profile life of denial in his attempt to return to boxing in the past few years. (See Jock Talk, March 8, 2007.) In his most recent effort to bolster his claim that his original HIV test was a false positive, Morrison earlier this year skirted state boxing commissions by facing Corey Williams in a bout in Wyoming that was billed as a mixed martial arts fight under "modified" rules: No kicking. No grappling. No strikes below the waist. In other words, just boxing. The bout lasted a few seconds. But despite promises to file for a boxing license, he still has not received clearance from any state boxing commission.

Late in 1996, California became the 14th state to require testing in boxing. Under current regulations, boxers must be tested for hepatitis B, hepatitis C, and HIV any time they apply for a boxing license or renewal and also within six months before any scheduled bout.

Awareness and prevention education, however, are not mandated, and education is seen by most HIV/AIDS experts as a more effective means of curtailing infections.

Measures to reduce the risk of transmission were adopted by most sports organizations in the early 1990s after NBA star Magic Johnson revealed he had been infected with HIV. When blood flows in most sports, the bleeding athlete is removed until the bleeding can be made to stop. Trainers and physicians take precautions when treating the athletes.

But the sport of boxing is built on blood, bruise, and bash. When the blood flows, neither the bleeding nor the action is stopped. And a sport that has never really figured out a way to prevent the far more frequent and inherent long-term neurological damage is not terribly likely to figure out a way to stop the bleeding.

Debate continues as to whether the risk of blood-contact transmission of HIV is great or small in boxing, but nobody questions the existence of the risk and the desirability of being able to make an informed choice.

"We generally don't believe in mandatory testing," said Dana Van Gorder, executive director of Project Inform, "but in a circumstance where there is a possibility of transmission is relatively high, it might make sense. This is a little like the debate going on in the porn industry: Should the state require that everyone in the industry be tested before they are in a film or should it be voluntary?"

Outside the ring, boxers – as well as professional wrestlers and the emerging legions are ultimate fighting combat sports – are frequently surrounded by groupies, drug pushers and pressures to inject steroids, all of which can raise their risk of exposure.

"If those industries are not doing education about transmission, they really should," Van Gorder said. "There are plenty of groups ready and willing to help them."