After years of debate surrounding patient privacy issues, California three years ago began reporting HIV cases to the federal government using alphanumeric codes that incorporate a patient's birthdate, gender and elements of their last name. Under the system, laboratories and doctors report to their county's health department the codes for anyone who tests HIV-positive, and the information is sent to the state, which then reports the information to the federal government. However, the Los Angeles Times last month reported that the system is failing, as many cases are believed to be lost because doctors and laboratories often send incorrect or incomplete codes or fail to keep required patient data. As a result, state health authorities are having difficulty gauging the HIV epidemic in the state and allocating appropriate funding to counties. Code-based reporting also has complicated the state's elimination of duplicative reports, the association of HIV cases with reports of other diseases, follow-up with patients and the notification of sexual partners of those who test HIV-positive. CDC does not consider code-based HIV reporting to be accurate, and federal officials have said they soon will withhold funds from states that use code-based reporting rather than confidential names-based reporting, which the state uses when reporting its AIDS cases. California -- which is one of only seven states and the District of Columbia that uses codes for reporting HIV cases -- could lose as much as $50 million annually in federal HIV/AIDS funds if it does not switch systems (Kaiser Daily HIV/AIDS Report, 7/26). Several newspapers recently have written editorials on California's HIV reporting system, two of which are summarized below.

• Bakersfield Californian: The fear of patient confidentiality breaches that surfaced early in the HIV/AIDS epidemic were "unfounded," and the "[s]enseless" policy of reporting HIV cases using codes that resulted from such fear "should have been abandoned long ago," a Californian editorial says. The state Legislature should approve a measure (SB 945) that would abandon the code-based reporting for names-based reporting, and the governor should sign it, the editorial says, concluding, "Better late than never; do it now" (Bakersfield Californian, 7/28).
  
  
• Sacramento Bee: "The same activist groups and legislators who backed this disaster of a reporting system" should be the first to back legislation changing the system to names-based reporting, a Bee editorial says. The code-based reporting system has prevented physicians and public health officials from contacting those who have had sexual contact or shared needles with HIV-positive people, and the system "has proven to be such a disaster that it now threatens federal funds to fight HIV" in the state, according to the Bee. "Without a change, this misguided effort at cloaking each HIV case may prove not only costly but also downright deadly," the editorial concludes (Sacramento Bee, 7/29).
  

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