State requires doctors to identify HIV patients

INDEX...AIDS/HIV HOME
LINKS: ....Skin Conditions....Medical Dictionary....Stress Management....Brain Food....Your Memory Enhancer....Brain Facts....Neurotech....Success Tips....Free....World Travel Guide....Boston Tour Guide....Makeup.Fashion....Allergy Info....Bird Flu Alarm
November 15, 2006

Starting Jan. 1, Massachusetts doctors will be required to provide the state with the name of anyone testing positive for HIV, regulators decided yesterday.

Proponents of the move, approved unanimously by the state Public Health Council, say such reporting is a critical component of a national campaign to more precisely chart the AIDS epidemic, so that prevention and treatment efforts can be directed where the need is greatest. Doctors in Massachusetts now use codes rather than names to identify cases.

The state is promising to keep identities confidential in secure computer files, but critics have expressed fear that the new policy will dissuade some people from getting tested for the virus and that no record system is foolproof.

The change, which has been under study for a year and was first reported by the Globe in April, emerges as federal health agencies increase pressure on states to adopt uniform HIV reporting standards, including the collection of names. The stakes for failing to do that could be substantial: The federal government is making financial assistance for HIV patients contingent on the reporting of names, and federal officials said the change is necessary to slow the rate of new infections.

"We could lose as much as $15.1 million in the Commonwealth," said Sally Fogerty, an associate commissioner in the Department of Public Health. "We feel that the regulations incorporate the safeguards to address any concerns around confidentiality."

Only five other states have yet to mandate the reporting of names with HIV test results, Fogerty said, and, like Massachusetts, all five are moving toward such a policy.

Jean McGuire, former chief of the state's HIV-AIDS Bureau, characterized the federal government's arm-twisting as "most unfortunate" and said the state's , system provides sufficient information.

"I felt that if we had the ability to collect good data and not have a name, why not do it that way?" said McGuire, now a visiting professor at Northeastern University. "We proved our ability to do that."

In many respects, the adoption of names-based reporting reflects the changing landscape of HIV in the United States.

Advocates of the policy maintain that the stigma attached to the virus has diminished, as have patients' fears about testing, especially with the passage of laws to shield people with HIV from workplace and housing discrimination. Also, the arrival of potent drug cocktails a decade ago rendered a disease once regarded as almost a death sentence into a treatable chronic condition for US patients.

Proponents of the requirement say that it's important to have a standard practice for tracking HIV cases, rather than a patchwork of state-by-state policies. Standardization allows for speedy recognition of problem areas and fair distribution of federal aid.

The refined tracking system in Massachusetts will keep records about HIV cases within a closed computer network at the state laboratory in Jamaica Plain that cannot be reached through the Internet or via other internal computer systems in the state, said Dr. Alfred DeMaria, state director of communicable disease control.

Massachusetts already requires reporting by name for many other infectious diseases, such as syphilis and gonorrhea.

Those infected with HIV but who do not have AIDS are the lone exception to the infectious-disease reporting requirement. That was a reflection of the earliest days of the epidemic, when AIDS progressed so rapidly that specialists believed that counting AIDS cases was the most telling measure of the disease's movement.



INDEX...AIDS/HIV HOME
LINKS: ....Skin Conditions....Medical Dictionary....Stress Management....Brain Food....Your Memory Enhancer....Brain Facts....Neurotech....Success Tips....Free....World Travel Guide....Boston Tour Guide....Makeup.Fashion....Allergy Info....Bird Flu Alarm