State to mandate anonymous HIV reporting

By Beverly Creamer
Advertiser Staff Writer

Reporting of HIV-positive cases without naming the individuals tested will begin Oct. 1 as the State Health Department sets a more aggressive course in tracking changes in the AIDS epidemic in Hawai'i.

"We need to know who is being infected, and what interventions will be important in the future to reduce the numbers of transmission," said Dr. Peter Whiticar, chief of the STD/AIDS Branch of the Health Department.

"This system will provide the necessary public health and epidemiological information and, at the same time, safeguard confidentiality."

Health Director Bruce Anderson was in agreement: "HIV case reporting will help provide a much clearer picture of the spread of the epidemic in Hawai'i."

HIV, the human immunodeficiency virus, can lead to AIDS. As doctors, laboratories and other health-care providers gear up to report cases of HIV-positive test readings, Hawai'i joins a majority of states in now requiring HIV reporting. The reporting of diagnosed AIDS cases has been required for many years.

Unlike the practice in many Mainland states, HIV cases will be gathered using an Unnamed Test Code to protect patient privacy.

A committee of health officials, providers and those living with HIV spent three years working out a compromise to find the best way to get new data about HIV infection levels while protecting privacy.

"Death from AIDS is dropping dramatically, and the number of cases reported," said Whiticar. "But at the same time the number of HIV cases continues to grow. And we don't know very much about this group. We need to know about this population, both for their care and for prevention, and so that they're getting appropriate services."

Whiticar said that with the new medications available for HIV, "many people are going on to live better lives and a longer time with HIV without developing an AIDS diagnosis."

The state's successful needle-exchange program kept the rates of AIDS infection low in Hawai'i, said Whiticar. But in other parts of the country the patterns of infection are changing, and they may well be changing in Hawai'i, too.

"What we're looking at is California where there has been a fairly dramatic increase in risk-taking among young gay men," he said. "There's a resurgence of syphilis in this population and HIV.."

There has also been an increase in the virus among young people in ethnic minorities — and "that's always a concern in Hawai'i," said Whiticar.

Even with the rules change, the state will continue to offer the same anonymous, free HIV testing it has for many years.

About 10,000 people annually undergo anonymous HIV testing throughout the state. When the test reading is positive for exposure to HIV, the individuals are counseled and offered appropriate services.

The compromise position of going with unnamed reporting has generally found high praise in Hawai'i's AIDS community. When the agreement was reached last year, Maui AIDS Foundation president Jon Berliner said the decision would protect people from the continuing "stigma" of the disease.

As well, Berliner said that only with unnamed reporting would people still be willing to come in for testing.