Summary of Washington state HIV/AIDS reporting requirements and regulations

Reporting requirements

Complete and timely reporting of HIV and AIDS benefits King County and people living with HIV or AIDS (PLWHA). Reported cases allow our HIV/AIDS Epidemiology group to provide comprehensive analysis of local needs to agencies, planning groups, and community members. These data are crucial for obtaining and distributing over $10 million yearly (2007) in HRSA Ryan White Care funds and CDC prevention money.

Each diagnosis of HIV and of AIDS is reportable within three working days. Health care providers, health care facilities, and laboratories each have specific legal reporting obligations. More information is available at online and WAC 246-101.

Laboratories are required to report each test result including

• tests confirming HIV infection (positive Western Blot assays, p24 antigen tests, and viral culture tests)
• HIV viral load results, both detectable and undetectable
• CD4+ (T4) lymphocyte results of any value

For each result, the lab must provide the test result, date of collection, requesting health care provider, and patient information including name, sex, date of birth, address, and telephone number. Many HIV and AIDS case reports are initiated from a laboratory result, and completed when our surveillance staff contact health care providers.

Anonymous testing remains an important part of Washington and King County policy. Local health officers must ensure anonymous testing is reasonably available (WAC 246-100-036), and anyone ordering an HIV test must discuss "as appropriate, the availability of anonymous HIV testing" (WAC 246-100-207). Laboratories and providers are not required to report anonymous tests.

Providers conducting clinical HIV research are exempt from reporting the identity of HIV+ individuals participating in the research if the project has institutional (human subjects) review board approval and if the project has a system in place to remind referring or primary health care providers of their HIV/AIDS reporting obligations (WAC 246-101-320).

For questions about reporting regulations or uses of HIV data, you may email susan.buskin@kingcounty.gov or call 206-263-2020.

• Download HIV/AIDS Case Reporting Form (112 KB)
  Health care providers diagnosing or treating a patient with HIV or AIDS must complete a case report form as mandated by law. The form is submitted to Public Health at the address printed on the form. Please contact our staff at 206-263-2000 with any questions on completing this form.

Confidentiality restrictions

Local health departments that maintain names of persons reported with HIV infection must adhere to the 2006 Security and Confidentiality Guidelines developed by the Centers for Disease Control and Prevention. Linkage of registry data to other public health data bases may be performed if the identity of the HIV+ person is not disclosed outside of the health department. HIV registry data may not be linked with databases such as health professions licensing records, certifications or registries, teacher certification lists, other employment rolls, or data bases maintained by law enforcement (WAC 246-101-520).

The penalty for unauthorized disclosure of STD (including HIV/AIDS) report data is $5,000, or imprisonment of not more than one year, or both (RCW 70.24.080). The Department of Health must report annually to the Board of Health any incidents of unauthorized disclosure by the department, local health departments, or their employees and recommend methods of preventing future unauthorized disclosure and improving the system of confidentiality of reported information (RCW 70.24.450).

The identity of anyone tested for a sexually transmitted disease including HIV may not be disclosed except as authorized. The exchange of medical information among health care providers and within health care facilities in order to provide health care services to the patient is permitted. Additional parties listed below who may receive this information must be advised "this information has been disclosed to you from records whose confidentiality is protected by state law. State law prohibits you from making any further disclosure of it without the specific written consent of the person to whom it pertains, or as otherwise permitted by state law. A general authorization for the release of medical or other information is NOT sufficient for this purpose" (RCW.24.105). The permitted recipients are limited to:

• the subject of the test
• a person with a release of information from the tested person
• health officials in accordance with reporting requirements for diagnosed sexually transmitted diseases
• facilities that collect blood, tissue, or semen
• health officials, first responders, or victims of sexual assault who petition the court to order testing (see RCW 70.24.024, 70.24.340)
• a person allowed access to information by a court order
• local law enforcement if health officers have exhausted procedures to stop behaviors that present a danger to the health of the public
• exposed persons who are notified because releasing the identity of the infected person is necessary
• payers of health claims
• agencies or guardians responsible for children under age 14 with an STD

HIV case reporting and partner notification

Reporting of HIV infections strengthens our ability to describe and monitor the epidemic, but can also facilitate HIV-infected persons' awareness of their own infection and entry into medical care, and lead to earlier diagnosis of exposed partners. The intent of contacting persons reported with HIV infection is to assist infected persons in notifying spouses and sex and needle-sharing partners that they may be infected, and to provide referral for care and other services. Public health staff elicit partner information, then work with the infected person to determine which he/she will reach and which public health will contact (without disclosing the case's identity). Exposed persons are then offered counseling and testing to learn of their status, hasten their entry into care if positive, and prevent further transmission to others.

Public health officials will contact the principal health care provider to determine the best means of contacting the HIV-infected person to conduct partner notification. The health care provider who recommends the health officer not meet with the HIV-infected individual, must inform the HIV-infected individual of the necessity to notify partners, assist in notifying partners, and inform health officials of the identity of certain partners.

Health officers shall use identifying information only for contacting the HIV-infected individual to provide post-test counseling, to assure health services are being accessed, to contact partners, or to investigate behaviors that endanger the public health. The information linking HIV-infected persons and their partners generally must be destroyed within 3 months (WAC 246-100-072).