South Carolina: For Advocates, Reporting System Evolved From Prejudice to Protection

AIDS advocates in South Carolina now approve of the state health department's long-standing practice of recording the name and vital statistics of HIV-positive residents. The practice, begun in 1986, has allowed the state to track the course of the epidemic and to plan prevention and treatment efforts.

The confidential reporting system has also helped demonstrate to federal funders the shift of the disease to the Southeast and why money for treatment is needed.

"It may have been based in prejudice, but what it evolved into was one of the best surveillance systems in the United States," said Bambi Gaddist, executive director of the South Carolina HIV/AIDS Council. In 1986, South Carolina was one of only five states to record HIV as well as AIDS cases. Up until then, the state had offered anonymous testing. At the time, the change alarmed advocates who were concerned about privacy issues.

The surveillance system has provided valuable information to public health officials including:

• How the disease has spread, with new diagnoses peaking in 1990 at 1,389 cases.
• Which counties bore the greatest burden, with Richland being consistently at the top.
• How the number of new HIV diagnoses has declined steadily. In 2006, there were 777.

In 2006, the reporting system also helped South Carolina and other Southeastern states support their case for a larger share of federal AIDS funds by giving a more accurate picture of the region's growing epidemic.

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