Name-based surveillance and public health interventions for persons with HIV infection. Multistate Evaluation of Surveillance for HIV Study Group.
Name-based surveillance of HIV infection is the law in 31 U.S. states but remains controversial. This policy can be advocated solely to support surveillance of the epidemic, but a frequent argument is that it also provides a public health benefit by allowing follow-up of HIV-infected persons. These persons can then receive timely medical care and can be assisted with notifying sex and needle-sharing partners. Few comparative data are available to evaluate the outcomes of these interventions. In five states with name-based surveillance of HIV infection, the Multistate Evaluation of Surveillance for HIV Study Group surveyed a cross-sectional probability sample of persons with AIDS who tested positive for HIV before the date of their AIDS diagnosis. Health department follow-up of a reported HIV infection was not associated with more timely receipt of medical care after a positive HIV test result. Only 8.6% of persons who delayed medical care after their first positive HIV test result gave concern about being reported by name as a reason; no person gave it as the main reason. Persons who were tested anonymously and those who were tested confidentially did not differ in the mean number of sex and needle-sharing partners notified: Those tested anonymously reported personally notifying 3.85 sex and needle-sharing partners, and those tested confidentially reported notifying-personally and through the health department-3.80 partners. Many researchers and policymakers believe that name-based surveillance of HIV infection will have positive or negative effects on partner notification and access to health care. These results suggest that the potential for such effects has been exaggerated.
Osmond
D H
DH
Department of Epidemiology and Biostatistics, University of California, San Francisco 94143, USA. dosmond@psg.ucsf.edu
Bindman
A B
AB
Vranizan
K
K
Lehman
J S
JS
Hecht
F M
FM
Keane
D
D
Reingold
A
A
D035041:Anonymous Testing; D003219:Confidentiality; D016358:Contact Tracing; D018563:Disease Notification; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D011159:Population Surveillance / Q000379:methods*; D015397:Program Evaluation; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology