HIV NAMES-BASED REPORTING: No ‘Specific Health Benefits’?
Names-based HIV reporting "does not seem to affect how quickly patients seek medical care, or how many partners they notify of their HIV status," according to a study published in Monday's issue of the Annals of Internal Medicine, WebMD/CNN.com reports. Lead author Dennis Osmond of the University of California-San Francisco's Center for AIDS Prevention Studies, said, "The bottom line is that within the realm of public issues about partner notification and getting people into care earlier, name reporting did not help public health departments" (Westphal, WebMD/CNN.com, 11/15). Researchers from UCSF and UC-Berkeley surveyed nearly 2,000 HIV-positive people diagnosed during 1995-96. Participants came from five states with HIV names-based reporting requirements (AZ, CO, MS, MO and NC) and three without such requirements (TX, OR and NM). New Mexico has since adopted a names-based surveillance law. Among the study's main findings:
- Only 9% of people who delayed medical care after learning their HIV status cited "concern about being reported by name" as a reason. None of the participants gave it as the main reason (UCSF release, 11/15). Most said their main reason for not seeking care was that "they felt healthy or did not want to think about HIV."
- People contacted by health departments after their names were reported were no more likely than those not contacted to seek care within three to six months of a positive HIV test. And within two months of diagnosis, the percentage of people seeking care was virtually identical in names-based reporting states (66%) as in non-names-based states (67%).
- As for partner notification, people who had been diagnosed confidentially versus those whose names were reported to the health department said they had notified the same number of sex partners of their HIV status -- an average of 3.8 partners.
- The study did find, however, that in states with names-based requirements, "more gay men delayed testing for fear of having their names revealed."
Fuel to the Fire
Jeffrey Levi of George Washington University's School of Public Health said the findings are disturbing and "should be read as something of a wake-up call to health departments" (WebMD/CNN, 11/15). But Osmond said that "separating the issues about surveillance itself from the issues about the use of surveillance ... would help focus the debate" (UCSF release, 11/15). Fred Dillon, state policy director for the San Francisco AIDS Foundation, said, "People have not understood how different HIV is, how great the stigma is, how scared people are." The group is fighting against a names-based HIV reporting system in California (CNN/WebMD, 11/15). All states require that full-blown AIDS cases be reported by name. Only 31 states require HIV reporting by name, as opposed to recording of confidential unique patient identifiers. The study was funded by the CDC as part of the Multistate Evaluation of Surveillance for HIV project (UCSF release, 11/15).