Georgia plans to implement a system of HIV case reporting by the end of the year, without holding public meetings like those across the state when officials first weighed the issue in 1998, according to Dr. Luke Shouse, acting section chief of HIV/AIDS surveillance for the state Department of Human Resources. "I'm not sure we are really going to have time to go back around and do community meetings for this," said Shouse. "That is costly and very time consuming."

When DHR hosted community forums in all the state's 19 public health districts in 1998, activists spoke out almost unanimously against reporting HIV cases using patient's names, advocating instead for codes known as unique identifiers. "If people know that if they test positive they are going to have their name reported, it may delay the time until they get tested, and if they know they will have their name reported when they seek services, they may delay seeking those services," said Jeff Graham, executive director of AIDS Survival Project, one of at least nine community organizations that opposed name-based reporting at the earlier meetings.

Despite the short timeline, Shouse said there is still "lots of debate" among state officials over whether to use name- or unique identifier-based case reporting. "It's still undecided for Georgia," he said. Before making a recommendation to DHR's Board of Health, which makes the final decision, Shouse said his office would re-examine all the information from the earlier hearings as well as talk with states that had implemented each system and review scientific literature on the issue. There is opportunity for community feedback when DHR completes a draft proposal for public comment, likely by late summer, Shouse said.

"In two years, Ryan White starts being based on HIV numbers, not just AIDS numbers, and some people are very anxious about it," Shouse said.

CDC supports confidential name-based reporting, to reduce duplicate reports or incomplete information, and as the easiest method to use for public and private health care providers. CDC recommends states continue to offer anonymous testing sites so those afraid of names-reporting could still access testing. "Any system that I am a part of will offer anonymous testing," Shouse said.

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