San Francisco Chronicle - The Voice of the West, 901 Mission Street, San Francisco, CA 94119 - Thursday, September 11, 1997 - Page A1
Charles Petit, Chronicle Science Writer

Such a move -- which some members of Congress already support -- would reopen a battle fought bitterly in the early years of the AIDS epidemic. That conflict pitted worries about privacy against arguments that public health measures used effectively against other communicable diseases should also work against AIDS.

Many people with AIDS and their allies maintained that gathering names, in the absence of effective treatment, was pointless and that if the names became public, those infected would be vulnerable to discrimination by employers, insurers and even from friends, neighbors and family.

AIDS interest groups in San Francisco, as well as U.S. Representative Nancy Pelosi, D-San Francisco, attacked the newly recommended policy as dangerous yesterday. While treatments have improved enormously in recent years, the groups still fear that mandatory reporting would discourage many people from being tested for the virus in the first place.

Federal regulations already require that people with a diagnosis of AIDS be reported to health officials. However, it is up to individual states whether to keep individual records on the many more people infected by the virus but not yet gravely ill.

About 30 states require confidential reporting of people who are HIV-positive.

The states with the highest incidence of HIV and AIDS, California and New York, are among those that gather general statistics on HIV infections but don't list names.

The editorial, written by the journal's deputy editor, Dr. Robert Steinbrook, says that improved treatments for HIV, the fading social stigma of the disease and other factors make traditional arguments against mandatory reporting "less persuasive."

Steinbrook writes that HIV should be reportable in the same category as tuberculosis and some sexually transmitted diseases such as syphilis.

Lists of names, intended to be kept confidential, would help public health authorities contact people who might have been exposed to HIV and advise them to get tested.

Steinbrook said federal regulations could be written to assure people with HIV that their "privacy will be maintained and they will not face discrimination in employment, insurance or elsewhere."

The California Medical Association has endorsed mandatory reporting of HIV, but many other California health agencies and private advocacy groups are adamantly opposed.

"When people believe their names will be reported, they do not seek testing at all," said Pat Christen, executive director of the San Francisco AIDS Foundation. "We have seen in San Francisco that when you make sure that treatments are available, people with HIV benefit. They do not benefit if we take names."

Steve Morin, an assistant to Pelosi, said, "No one has provided us with a clear rationale why knowing who is infected will discourage further infections. The real need is to get those who are at risk to get tested and to get treatment."

On the fence is the state Department of Health Services.

"There is an effort to examine the potential benefits as well as detriments of such a system (of name gathering)," said Wayne Sauseda, chief of the California Office of AIDS. "What might work in Mississippi or North Carolina might not work in California. In the past, we have opposed HIV names reporting . . . but we do re-examine it periodically to see if that policy still makes sense."
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