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Wednesday, May 22, 2024
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State Requiring Clinics to Report New HIV Cases

State Requiring Clinics to Report New HIV Cases

Health Care: Switch Will Ensure Better Tracking of The Spread of the Disease

BY MARION WEBB

Senior Staff Writer

The California Department of Health Services is requiring doctors and clinics to report new HIV cases in an effort to better track shifts of newly infected cases and ensure adequate federal funding for prevention and treatment.

The new system, which the Legislature authorized in 2000, is raising concerns of confidentiality and security issues among health advocacy groups.

The reporting of HIV is a departure from the practice of tracking only cases of AIDS, which meant the state often didn’t learn until many years later when an HIV infection occurred.

In San Diego County, there are 11,300 residents reported to be living with AIDS, according to statistics by the county’s Health and Human Services Agency Office of Public Health Community Epidemiology Division.

More than half of reported cases, or 65 percent, are white adults; 20 percent are Hispanic; 12 percent are black; and two percent are Asian.

Michael Montgomery, chief of the office of AIDS Prevention Services at the California Department of Health Services, said recent statistics suggest a rise of AIDS cases among blacks.

He said tracking HIV cases will allow health officials to better target prevention campaigns.

The federal government will allocate funds to states based on HIV reporting as early as 2005 and no later than 2007, he said.

California will need to compete for federal dollars with other states already tracking HIV infection rates, he said.

Some states track HIV cases by name, others use a code-based system.

Coded Database

In California, HIV tracking will be done using a person’s gender, date of birth, the last four digits of a Social Security number and a four-digit alphanumeric code of the last name, Montgomery said.

Under the system, the testing lab is required to create the alphanumeric code for each positive HIV test result and then report it to the county health department and health provider, he said.

The health provider must add the four-digits of the person’s social security number to the form and submit it to the county.

The county then reports the result either electronically or via mail to the state department, he said.

“All of the information is stored in a secure system on a private network and in a closed system,” Montgomery said. “Only authorized people gain access to the database.”

Thus far, the AIDS registry has never had a security breach and will be the backbone for tracking new HIV cases, he added.

Mark Mischan, former chair of the San Diego-based HIV Consumer Council, which depends on federal dollars to provide services to local HIV patients, is critical of coded reporting.

“You can’t rule out mistakes,” Mischan said.

Mischan, a longtime activist for HIV-symptomatic patients, said the disease is still stigmatized and people rightfully fear discrimination from co-workers, employers, health insurers and society at large.

“In the past I have been opposed of name reporting (in favor) of anonymous testing,” he said.

Now he’s torn between name reporting, which makes patients vulnerable to discrimination and tracking HIV using codes, where infected people don’t know who has access to the database and how the information is being used.

Privacy Concerns

The new system has the potential for unlawful entry by computer hackers and raises issues of confidentiality. Both issues could deter people from getting tested, he said.

Among his other concerns are duplication of records on the same individual, and errors in record-keeping. That is discounting the standing practice in helping the state in notifying sexual partners of individuals that test positive for HIV and certain other sexually transmitted diseases, he said.

The state health department received $128 million in federal funding under the Ryan White Care Act to provide assistance for HIV and AIDS patients, Montgomery said.

According to Terry Cunningham, chief of San Diego County’s Office of AIDS Coordination, the agency received $11.5 million in federal funds and $12 million from the state in AIDS Drug Assistance Program funds to treat AIDS patients.

No one from the local agency was available to comment on the new regulation.

Mischan said he’s hopeful that by tracking new HIV cases, more government dollars will become available for HIV-symptomatic patients, which he finds should be separate from money set aside for AIDS patients.

Individuals who opt for anonymous HIV testing where they don’t provide names, are excluded from the new regulation.

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