' News of the Day #446 - All states to track HIV-positive patients by name

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News of the Day ... In Perspective

6/30/2007

All states to track HIV-positive patients by name

To avoid losing federal money for medications and health services, all 50 states have agreed to begin electronic tracking of HIV-positive patients by the end of the year.

Despite concerns about privacy, AIDS advocates have surrendered. “I still believe code-based reporting is valid and is preferable for HIV reporting,” said Ron Johnson, deputy executive director of AIDS action in Washington, D.C. “It, for all practical purposes, has become a losing battle.”

The Centers for Disease Control and Prevention (CDC) rejected code-based systems after finding they led to double counting and burdens on medical facilities.

HIV numbers are used to calculate funding to cities and states receiving formula grants under the Ryan White CARE Act. More than $1.4 billion is at stake.

In a 2005 security breach in Palm Beach County, Florida, the names of 6,500 HIV and AIDS patients were mailed to 800 county health workers. Other breaches have occurred in California and Kentucky.

According to Dr. Dan Berger, medical director of NorthStar Healthcare in Chicago, many high-profile people do not want to have their names reported. He reportedly told the Associated Press that he has advised some patients not to give him their real names. Health officials say it is impossible to know how many doctors and patients are finding ways to keep names out of databases. Thus, they cannot predict whether HIV case numbers will show any decline that could be connected to name-based reporting (Chicago Sun Times 4/1/07).

Andrew Maniotis, Ph.D., of the University of Illinois at Chicago notes that “viral load is only able to predict progression to disease in 4% to 6% of HIV-positives studied, challenging much of the basis for current AIDS science and treatment policy” (JAMA 2006;296:1498-1506). Moreover, influenza vaccination is a cause of false positive screening tests and indeterminate Western blot tests (NEJM 2006;354:1422-1423).

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