Name-Based Reporting for HIV

abstract & commentary

Source: Osmond DH, et al. Ann Intern Med 1999;131: 775-779.

This interesting survey challenges the concept that name-based surveillance of HIV infection will result in improved partner notification and more timely access to health care for infected contacts. The Multistate Evaluation of Surveillance for HIV Study Group surveyed 1913 people with AIDS who tested positive for HIV in five states with name-based surveillance. Surprisingly, just as many sexual and needle contacts were notified by HIV-infected persons who were tested anonymously as those identified through the confidential testing sites and tracked through the health department (3.85 vs 3.80 partners). Furthermore, both types of contacts sought medical care with a similar frequency and within a similar time-frame. In general, about two-thirds of infected contacts began medical care within two months irrespective of the means of notification. About 6% of patients had not sought medical care within three years of receiving a positive HIV test.

Most patients who delayed seeking care indicated that they either felt well or were not yet ready to deal with their HIV. Other common reasons for delaying care was uncertainty about where to go and concerns regarding the affordability of care.

comment by carol kemper, md

Only 8.6% of patients expressed concern that they would be identified to the health department. Contrary to current thought, named-based surveillance reporting for HIV may not increase identification of infected contacts nor does it appear to facilitate their access to medical care. Improved counseling at anonymous test sites with better information about health care options is needed. (Dr. Kemper is Clinical Associate Professor of Medicine, Stanford University, Division of Infectious Diseases, Santa Clara Valley Medical Center.)