California to Introduce New HIV-Reporting System Based on Codes, Not Names
California health officials announced on Friday that beginning July 1, doctors and laboratories will be required to report newly diagnosed cases of HIV to state public health officials, the Los Angeles Times reports. Unlike 33 other states that "track patients by name confidentially," California's system will be based on numerical codes that correspond to HIV-positive individuals. The issue of HIV reporting in California has been the focus of "vigorous debate" since Gov. Pete Wilson (R) in 1998 vetoed a bill to create a similar code-based reporting system, the Times reports. Regulations first proposed by the state Office of AIDS more than a year ago were approved by California's Office of Administrative Law on Thursday, paving the way for their implementation in July. Under the system, HIV testing laboratories will assign an individual a code -- based on birth date, gender and consonants in his or her last name -- each time a test turns up positive. The individual's physician will then add the last four digits of the patient's Social Security number to the code and report it to a local health agency. Individuals who are tested anonymously at sites that do not record names will not be included in the reporting system. The Times reports that the system "will put health officials in a better position to distribute money for HIV and AIDS treatments, services, education and prevention programs," as funding is currently "largely based upon anecdotal information and AIDS statistics."
Pros and Cons of Code System
California's decision to use a code-based HIV reporting system rather than the name-based system used by the state for 80 other diseases, including AIDS, has drawn both praise and criticism. Proponents of the new system, including several HIV/AIDS advocacy groups, said that it will help the state track HIV cases more effectively without compromising patient privacy or discouraging testing. "We really feel that people still have fears of disclosure," Rebecca Isaacs, managing director of the Los Angeles Gay and Lesbian Center, said, adding, "There's still stigma around HIV." But opponents said that the code-based system will prove "unwieldy and confusing" and will inhibit efforts to trace and notify partners of individuals who test positive for HIV, thereby limiting state health officials' ability to prevent new infections. "We think that the inability of health departments to get in touch with and work with the people who are infected misses a great opportunity to prevent further transmission," Dr. Ron Hattis, secretary-treasurer of Physicians for HIV Control, said. In 1998, the CDC asked states to create HIV-reporting systems and urged the use of name-based systems, although it permitted code-based systems as well. Only Hawaii, Illinois, Kentucky, Maryland, Massachusetts, Vermont and Puerto Rico currently use a code-based system, while Maine, Oregon and Washington "have systems in which the names of HIV-positive patients are initially reported but later replaced with codes," the Times reports (Ornstein, Los Angeles Times, 5/4).