THIS WEEK, the California Medical Association is drafting a
reporting law that would dramatically shift the way state
officials track and report HIV disease.
In addition, the U.S. Centers for Disease Control and
Prevention is expected to release within the next several
months HIV reporting recommendations to states. Those
recommendations, if adopted, could tie compliance to federal
funding, according to the Los Angeles Times.
Bills also are pending in Congress to make HIV surveillance
mandatory. New York, Illinois, Pennsylvania, Georgia and
Massachusetts - all states heavily affected by HIV - have
reporting legislation pending or in the process of being
The goal is to identify those in the earlier stages of HIV
infection, not just those exhibiting full-blown symptoms of
About 30 states keep track of cases of human immunodeficiency
virus infection, even if it has not progressed to AIDS. But
some of the areas most heavily affected by the epidemic,
including California, have clung to a policy of tracking AIDS
cases only - a practice largely in response to AIDS advocacy
groups that urged a balance between disease control measures
and a person's privacy.
In recent months, however, major advocacy organizations have
come to a remarkable consensus with public health officials
that AIDS-only surveillance puts states at risk of losing track
of the changing epidemic. "This lack of information is
endangering lives and undermining our efforts to fight the
epidemic," said the Gay Men's Health Crisis of New York, the
nation's largest AIDS organization, in a position paper last
The debate rather quickly shifted from whether HIV should be
tracked to how it should be tracked - by name or by codes to
protect people's identities? On this point, medical
traditionalists and AIDS advocacy groups clash mightily.
With more patients staying healthy longer, many advocates and
disease detectives agree AIDS cases are no longer a good tip by
which to measure the HIV iceberg. Nor can research and
prevention dollars be appropriately allocated based on AIDS
Nationwide counting of HIV cases could reveal some surprises,
even reconfigure the official map of the epidemic. One
Mississippi health officer predicted it would alert officials
to growing rural pockets of HIV and perhaps draw more federal
dollars to his state.
The nation has recorded 612,000 AIDS cases since 1981 - a third
of them in California and New York. The HIV-infected population
is estimated at anywhere from 650,000 to 900,000, according to
The greatest wrangling now, however, is over whether the
government - local, regional or state health departments -
ought to track HIV cases by name or by codes.
The California Medical Association, the American Medical
Association and various public health groups support name-based
reporting, often insisting on strong confidentiality
The California Medical Association also insists that anonymous
testing sites be maintained. These are places where people who
do not want to be identified by name can find out their HIV
status. Under this complex system, such patients would only be
reported by name when they sought medical treatment for HIV.
Legislation backed by the state group is expected to be
introduced this year.
The San Francisco AIDS Foundation endorses HIV surveillance
only if it is done through a "unique identifier" system that
would identify and track patients by codes. It opposes
But the CDC - which dispenses federal funding for AIDS tracking
- has indicated it will favor name-based systems. One key study
published in the agency's Morbidity and Mortality Weekly Report
in January was highly critical of experimental identifier
systems in Texas and Maryland, concluding the records were too
* "CMV Disease in the Era of Antiretroviral Therapy" will be
discussed today at 6 p.m. by Drs. Lawrence Drew and Jay
Lalezari of the Community Consortium at the Mission Center
Building, Room 126, 1855 Folsom St. at 15th., in San Francisco.
*The AIDS Emergency Fund is holding an open town meeting on
Thursday at 7 p.m., 131 Gough St., for people to voice their
opinions, ideas and concerns to the group's Board of Directors.
Call (415) 558-6999.
*Thinking about returning to work? Learn about the legal,
financial, social and emotional issues at a workshop by AIDS
Health Project and AIDS Benefit Counselors on Saturday. Call
*The Ansel Adams Center for Photography will be visited by the
HIV Positive Social Program of the AIDS Health Project on March
24 at 2 p.m. Free. Call (415) 476-6448.
*Three prominent AIDS-treating physicians will conduct a
national dialogue, via a free national telephone conference
call, called "Choosing the Right HIV Treatment Strategy," on
March 25 at noon. Anyone who wants to participate in the call,
organized by the San Francisco AIDS Foundation, can reserve a
place by calling 800-707-BETA.
*The Tenth National AIDS Update Conference will be held in San
Francisco's Civic Auditorium March 24-27. Scholarships are
available for people with HIV / AIDS. Call (415) 255-1295.
* "Positive Choices: A treatment workshop for women living with
HIV," sponsored by Community Prescription Service, will be held
March 28 from 10 a.m. to 3 p.m. at the Oakland YWCA, Julia
Morgan Tea Room, 1515 Webster St. in Oakland. Free. Lunch and
child care provided. Call 800-842-0502.
* "Mansex 101," a series of 15 discussion groups held this
spring, tackles such topics as love, sex, power, dating and
disease. For more information, call STOP AIDS at (415)
621-7177, ext. 235.
Billy Ray Blasinger, 55, a graduate of East Texas State
University, vice president at Bank of America, and a
competitive tennis player . . . Kevin G. Toney, 45, a long-term
survivor of HIV who was a native of Tonawanda, N.Y., a computer
programmer and employee of VISA.
. . . . . .Date . . . . . .reported. . Cases. . Deaths S.F.. .
. .3/1 . . . . 25,148. .17,049 Calif.. . .3/1 . . . .105,121 .
66,450 U.S.. . . .3/1 . . . .612,078 .379,258 WHO(rprtd) 3/1 .
. .8,400,000 6,400,000
Figures are cumulative since June 1981. Government officials
now compile and release statistics quarterly, not monthly. To
contribute to AIDSweek, call (415) 777-7867. AIDSweek columns
are available on the Internet at