SEPTEMBER 1998

NUMBER ONE

Orwell's Nightmare
Pinch yourself--HIV names reporting is on the rise.partner-notification laws are on the books.

New Yorkers were shocked in early June to wake up and find Big Brother knocking at the door. Practically without warning, New York state officials voted for one of the most far-reaching names-reporting bills in the nation. Signed by Governor Pataki in July, the law made New York the 30th state to require names reporting of people who test positive for HIV-and notification of their sexual and needle-sharing partners.

Under the law, doctors must disclose the names of people testing positive for HIV or diagnosed with AIDS to the Health Department, which, in turn, notifies their current and former sex and needle-sharing partners. Physicians and health-care professionals who don't comply will be breaking the law.

The movement away from anonymous testing has shaken AIDS activists, who say the trend deals a blow to national prevention efforts and is another step toward criminalization of HIV. Critics of names reporting have long argued that fewer people will seek HIV testing if they know the authorities will be told their names. This is particularly true of injection drug users, who tend to think names reporting will lead to a witch-hunt of other intravenous users. Prevention advocates across the country have expressed fear that the success of the New York bill could inspire other states to follow suit.

Those who have come out publicly in support of a national system for names reporting include such health groups as the American Medical Association and the Centers for Disease Control. They feel that HIV reporting is needed to fight AIDS and that antidiscrimination laws sufficiently protect those living with HIV. Meanwhile, Gay Men's Health Crisis drew widespread criticism from other AIDS community groups earlier this year by publicly stating the group "did not oppose" names reporting-a sign the tide on names reporting was changing.

So far, two alternatives exist to names reporting: voluntary anonymous reporting and "unique identifiers," a system that uses coded information (social security numbers, race, gender, birth dates) to record cases but not identify individuals. Massachusetts and Hawaii are planning revised "non-name" "de-linked" unique-identifier systems that make it virtually impossible to trace coded information back to a person's identity. Moving in another direction, Texas is now considering a switch from unique identifiers to names reporting.

Partner Notification: All states are required to have a system of partner notification as a condition of receiving federal Ryan White CARE Act funds, which states rely on to supplement the health-care funding gaps created by apathetic legislatures. Methods of notification vary from state to state. In at least 32 of them, mandatory partner-notification laws are on the books.partner-notification laws are on the books.

Anonymous testing: Ten states do not offer anonymous testing. But use of HIV home-test kits allow people in these states to get confidential testing.

What would George Orwell say about all this? Here's what you can do: If you're opposed to names reporting, get organized and fight back. National HIV groups are working overtime on this issue. A great website run by the National Conference of State Legislatures can keep you up-to-date on state HIV laws and policies regarding names reporting, testing, partner notification, and more. Check it out at http://stateserv.hpts.org.