SF Chronicle: Thousands of HIV Cases Not Counted in California

CALIFORNIA:   "HIV Count in State Misses Thousands"
San Francisco Chronicle     (02.23.10):: Erin Allday

A Legislative Analyst's Office report released Monday finds an outdated public health surveillance tracking system has missed tens of thousands of HIV cases - costing California possibly tens of millions of dollars in federal funding.

States receive federal money for HIV/AIDS-related prevention, medical, and social services based on the number of reported cases. Epidemiologists estimate California has between 68,000 and 106,000 residents living with HIV who have not progressed to AIDS. But as of April, just 36,000 of those people had been counted by the state's surveillance system.

Lisa Murawski, author of the report, blames a surveillance system that is not properly tracking patients. Another part of the problem is the number of HIV-positive people who do not know their status.

The state continues to work to reconfirm all HIV cases diagnosed before 2005, when California switched, at the federal government's insistence, from code-based to name-based HIV reporting.

Electronic reporting would help reduce errors that result from the current method of manually adding data, and many missing cases could be accounted for by cross-referencing people who are receiving state or federal HIV/AIDS support to ensure they are included in surveillance reports.

In addition, the state could improve diagnosis rates by making it easier for health care workers to administer HIV tests. California continues to require a patient's written consent for HIV testing.

"Historically, HIV has been treated differently from other conditions, but the trend now is to treat it like another chronic condition and not have all of these strings attached," said Murawski. "We have really strong privacy protections for all health data. Treating HIV in a special category was really damaging our ability to manage it."