Potent drug treatments have so improved the...

Potent drug treatments have so improved the prognoses of HIV patients that today, deaths from AIDS have plummeted since their mid-1990s peak, and the progression of HIV to AIDS has slowed dramatically. Still, as many as 950,000 Americans are infected with HIV, with an estimated 40,000 new infections each year. And because early treatment can at least delay the onset of AIDS, tracking HIV has become key to containing the epidemic. Starting in 2006, the federal government will allocate HIV/AIDS funds to states based on the number of HIV cases.

For all of these reasons, the state Senate Judiciary Committee is scheduled to take up a bill today that would require doctors and medical laboratories to report cases of HIV infection to county health officials by patient name, as they already do with AIDS. (HIV cases now are identified using a code number.) Some legislators are balking, citing concerns about patient privacy. Yes, naming names carries risks. Fear of being blacklisted by insurance companies or stigmatized by employers could deter some people from getting tested. But such fears can be addressed, and the bill, sponsored by Sen. Nell Soto (D-Pomona), builds in safeguards.

The higher risk lies in not accurately tracking this disease. And here lies the problem with California’s code-based reporting method. Public health officials say it is inaccurate, inefficient and expensive. It is so cumbersome that some healthcare providers are months behind in reporting. Hard-pressed county health departments don’t have the money to do the labor-intensive follow-ups needed to ensure that all cases are being reported or that the same person is not being counted two or three times. And without this verification, they stand to lose needed federal dollars.

The federal Centers for Disease Control and Prevention recommends name-based reporting, the method used by New York, Texas and 36 other states, as more accurate and cost-effective. In a flurry of phone calls and e-mails intended to sway legislators, the handful of HIV/AIDS advocacy groups opposing Soto’s bill cite a Palm Beach County, Fla., statistician who in February inadvertently attached a list of names of people with HIV/AIDS to an e-mail to 800 health department employees. But equally stunning was that department’s quick response. Within an hour, it had purged all the e-mails. Only 10 had been opened, and none had been saved, re-sent or printed. Yes, it was a terrible mistake. But not when compared with the risks of not keeping a handle on the spread of HIV.