HIV: NEJM SUPPORTS MANDATORY HIV REPORTING
"The distinguished New England Journal of Medicine is urgingThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
mandatory reporting of HIV infections to state health departments
to increase the chances people will get early treatment,"
AP/Arizona Daily Star reports. Dr. Robert Steinbrook, the
journal's deputy editor, writes in today's issue that HIV
infections should be reported "just like tuberculosis and many
sexually transmitted illnesses" because new treatments started
soon after infection may improve outcomes (9/11). San Francisco
Chronicle reports that the recommendation is "a sign of sifting
attitudes toward AIDS." Reporting of HIV infections was highly
controversial in the early years of the epidemic because of
privacy fears, San Francisco Chronicle notes (Petit, 9/10).
THE TIME IS NOW
In the editorial, Steinbrook argues that "[t]he availability
of better therapies and our rapidly expanding knowledge of the
molecular biology of HIV creates new opportunities to control the
AIDS epidemic." He notes that of the "estimated 650,000 to
900,000 HIV-infected people in the United States, many do not
know that they are infected," and that some states with the
highest rate of infection, such as New York and California, don't
require reporting of HIV infection. Steinbrook calls for a "more
comprehensive and coordinated approach to HIV infection" with
four main components: "a national standard for HIV reporting,
greater access to effective medications, improved access to
physicians experienced in treating the disease and protection of
patients from violations of privacy and discrimination." He
notes that "[p]eople with HIV infection need strong guarantees
that their privacy will be maintained and that they will not face
discrimination in employment, insurance or elsewhere," and that
mandatory reporting of HIV infection will only succeed "as part
of an overall strategy that incorporates protection against
discrimination" (New England Journal of Medicine,
9/11 issue).
SPARKING CONTROVERSY
Rep. Nancy Pelosi (D-CA) and several groups "attacked the
newly recommended policy as dangerous." The San Francisco
Chronicle notes that "[w]hile treatments have improved enormously
in recent years, the groups still fear that mandatory reporting
would discourage many people from being tested for the virus."
In addition, critics of mandatory reporting believe that those
infected by HIV would be discriminated against by insurance
companies and employers (9/11)
STATES THAT REPORT
According to AP/Arizona Republic there are 27 states that
require HIV reporting: Alabama, Arizona, Arkansas, Colorado,
Idaho, Indiana, Louisiana, Michigan, Minnesota, Mississippi,
Missouri, Nebraska, Nevada, New Jersey, New Mexico, North
Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South
Dakota, Tennessee, Utah, Virginia, West Virginia, Wisconsin and
Wyoming (9/11).