Support Gains For Proposal To Identify All Hiv Carriers May Be Time To End ‘Aids Exceptionalism’ For The Good Of Those Who Risk Infection

The first U.S. decline in new AIDS cases is boosting support for a proposal once considered too controversial: identifying and monitoring everyone who tests positive for the virus that causes the disease.

Such a shift - gaining momentum at the state and federal level - would change years of public health policy and mark the end of “AIDS exceptionalism.”

In Washington state, public health officials now track only full-blown AIDS cases. Under the new proposal, they would monitor - by name - everyone who tests positive for HIV, the virus that causes AIDS and try to notify their sexual or needle-sharing partners that they have been exposed and may be infected.

The federal Centers for Disease Control and Prevention is asking all states to consider the policy change. Now that new AIDS drugs are keeping people with HIV healthier longer - leading to a drop in full-blown AIDS cases - such a change would enable authorities to get more HIV-positive people on the drugs sooner.

“We need to keep our policies in line with the new scientific evidence that early notification saves lives,” said Dr. Alonzo Plough, director of the Seattle-King County Department of Public Health.

“Names reporting is the best way for us to keep track of the epidemic and to make sure individuals and infected partners have this information.”

The change also would mean that epidemiologists could - for the first time - enlist traditional public-health strategies in the battle against AIDS.

Thirty states already record the names of people who have tested positive for HIV.

In Washington state, names reporting begins when the patient has clinically defined AIDS.

Names reporting has long been used to help contain and combat other dangerous infectious diseases. The state monitors 54 such ailments including measles, tuberculosis, whooping cough, certain types of hepatitis and several sexually transmitted diseases.

Now some health authorities say it’s time to add HIV to the list.

The CDC considers names reporting of HIV the only accurate way to “track the front end of the epidemic,” said Judith Billings, the state’s former top school official and a member of the President’s Advisory Council on HIV-AIDS.

But as a person with AIDS, she said she understands concerns that it could lead to discrimination in housing, employment and medical care.

Citing such concerns, the Seattle-based Northwest AIDS Foundation is opposing the proposed change in policy.

“We think HIV surveillance is important, but we think there needs to be an alternative to a name-based system,” said Steven Johnson, the foundation’s public policy director and a member of the governor’s advisory council.