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Medicine and Public Policy |

Name-Based Surveillance and Public Health Interventions for Persons with HIV Infection

Dennis H. Osmond, PhD; Andrew B. Bindman, MD; Karen Vranizan, MA; J. Stan Lehman, MPH; Frederick M. Hecht, MD; Dennis Keane, MPH; Arthur Reingold, MD, Multistate Evaluation of Surveillance for HIV Study Group*
[+] Article, Author, and Disclosure Information

Requests for Reprints: Dennis H. Osmond, PhD, Box 0866, Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94143; e-mail, dosmond@psg.ucsf.edu. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Current Author Addresses: Dr. Osmond: Box 0866, Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA 94143.

Dr. Bindman, Ms. Vranizan, and Mr. Keane: San Francisco General Hospital, Ward 95, 995 Potrero Avenue, San Francisco, CA 94110.

Dr. Lehman: Centers for Disease Control and Surveillance, HIV/AIDS Surveillance Branch, 1600 Clifton Road, Mail Stop E47, Atlanta, GA 30333.

Dr. Hecht: San Francisco General Hospital, Ward 84, 995 Potrero Avenue, San Francisco, CA 94110.

Dr. Reingold: University of California, Berkeley, School of Public Health, Division of Public Health Biology and Epidemiology, 140 Warren Hall, 7360, Berkeley, CA 94720.

Ann Intern Med. 1999;131(10):775-779. doi:10.7326/0003-4819-131-10-199911160-00010
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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.

*For members of the Multistate Evaluation of Surveillance for HIV Study Group, see Appendix.





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