Pennsylvania to Rule on Reporting HIV Cases

A state panel will decide Thursday whether to approve a controversial plan for confidential reporting of the names of people with HIV. Pennsylvania already requires doctors to use patients' names in reporting AIDS cases to county and state health officials. But unlike most other states, Pennsylvania has no system for reporting HIV. All sides agree that HIV reporting is needed to help track and combat the infection. But AIDS activists and some state legislators oppose the use of names, arguing it would discourage people from getting tested for fear of breaches of confidentiality. Activists want a coded system that would assign each person a "unique identifier."

About 13,000 Pennsylvanians have AIDS, and more than 30,000 are estimated to have HIV. The Independent Regulatory Review Commission -- a five-member panel appointed by legislative leaders and the governor -- must approve all new regulations in Pennsylvania. Although the Senate, House and governor can jointly overrule commission approval, that rarely happens. Thirty-four states, including New York and New Jersey, have name-based reporting -- the method recommended by the CDC. Seven states, including Maryland and Massachusetts, use a code-based system.

The Pennsylvania Health Department, while insisting on a name-based system, has promised that anonymous HIV testing still will be available at 130 sites for people who request it. There is debate about whether name-based HIV reporting has deterred testing in some states, and which system poses greater security and technical challenges. State health officials say concerns about confidentiality breaches should be allayed by the state's unblemished 20-year record of name-based AIDS reporting. Each reporting system has pitfalls. With unique identifiers, a person who gets repeated tests may obtain several identifiers. With name reporting, people may give false personal information. Pennsylvania's proposed plan has been the subject of hearings and debate for more than five years.

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