The HIV code

Confidentiality is an essential part of testing for HIV. The usual practice is of using a code to represent the patient's name. Commonly, this has included the date of birth. However, no definite guidelines are available to standardise the coding methods used in various situations. This has often led to confusion with results, a situation that is to be avoided at all costs, especially in an illness such as HIV.

With the increasing longevity of persons with HIV, it is essential to have a coding system that will stand the test of time. Difficulties have arisen with the manner in which the name is represented in the code and in the format in which the date is expressed. Some centres have further complicated the issue by asking patients to choose their own code. As the patient is advised not to choose his birthday or any easily identifiable number (ridiculous as birth dates are the usual identifier used by doctors), codes are chosen at random, and hence often forgotten. Those of us who have forgotten our automated teller machine card personal identification numbers will testify that this is a common occurrence.

The problem is compounded if the doctor forgets to enter the randomly chosen code in the patient's notes, something that happens more often in a busy clinic than most of us like to admit.

Using fictional situations, we illustrate the practically innumerable variations that are possible.

To list all the variations would take an entire journal. A few examples are listed.

Mary Smith, born on 2 June 2004

Possible codes are as follows:

1. Name before the date, first name first, surname second, date as day/month/year

   • -MS 2604
   • -MS 262004
   • -MS 02062004
   • -MS 020604
   • -MS 6204
   • -MS 622004
   • -MS 060204
   • -MS 060204
   • -MS 0462
   • -MS 040602

2. Name before the date, surname first, first name second, date as day/month/year and various other formats

   • -SM 2604
   • -SM 262004
   • -SM 02062004
   • -SM 020604
   • -SM 6204
   • -SM 622004
   • -SM 060204
   • -SM 060204
   • -SM 0462
   • -SM 040602

3. Name after the date of birth, first name first, surname second, date as day/month/year and various other formats

   • -2604 MS
   • -262004 MS
   • -02062004 MS
   • -020604 MS
   • -6204 MS
   • -622004 MS
   • -060204 MS
   • -060204 MS
   • -0462 MS

4. Name after the date of birth, surname first, first name second, date as day/month/year and various other formats

   • -6204 SM
   • -Etc…

5. Mary Smith has a twin sister. Her name is Michelle Smith. Her code will be the same as above as they were both born on the same day.

6. Checking the registration records in the city, there were 102 girls born on 2 June 2006. Follow‐up showed that 13 of these girls had the following names:

   • -Samantha Masters
   • -Margret Simmons
   • -Mallika Sundar
   • -Miranda Silas
   • -Sandra Mathew
   • -Melinda Sedak
   • -Etc…
   • -Their codes will be identical to Mary Smith's code.

7. Mary Smith gets married to Thomas Jones and changes her name to Mary Smith‐Jones. What will be the appropriate code for Mary Smith‐Jones?

   • -MS‐J 040602
   • -MJ 040602
   • -Etc…

8. Mary Smith has a baby on 25 July 2030. It is a girl, and the parents cannot agree on a name. Until they do agree, it is decided the baby should remain as Baby of Mary Smith‐Jones or Mary Smith‐Jones's baby. What will be the appropriate code for the baby?

   • -B/O MSJ 240730
   • -MS BABY 240730

9. Several months later, the baby is named Ava Delia Smith‐Jones. What will be the appropriate code for the baby now?

   • -AS‐J 240703
   • -ASJ 240703
   • -ADSJ 240703
   • -Of course, the laboratory has no way of knowing that B/O MSJ is the same as AS‐J.

10. Mary Smith's best friend is Charlene de Mille who was born on 8 May 2003. What will be the appropriate code for Charlene?

    • -CM 8503
    • -CD 8503
    • -CdM 8503

11. Mary Smith joins the police force as a young woman and becomes an outspoken advocate of children's rights. After a police raid of a human trafficking operation, three unidentified boys aged around 5, 7 and 8 years are brought into the accident and emergency department. Their names and dates of birth are unknown. For identification purposes, they are given the names: John Doe 1, John Doe 2 and John Doe 3. What will be the appropriate codes for these John Does?

    • -JD‐1 Unknown
    • -JD‐1 date of arrival at A&E
    • -JD‐ approximate year of birth
    • -Months later, checking for the results, one finds many John Does all over the city. How does one know which one is which?

12. Mary Smith is taking karate classes. Her tutor is Lee Wan Chuc. He was born on 1 January 1980. He insists that he does not have a surname. What will be the appropriate code for Mary Smith's tutor?

    • -LWC 1180
    • -CWL 1180
    • -LC 1180

13. Mary Smith is interested in Indian dance and she has finally found an authentic Indian dance teacher. His name is CK Mitra. He was born on 10 February 1974. He explains his name as follows: C is for Candoth, which is the name of his ancestral home; K is Kurla, which is the hometown of his mother; his father's name (which is his surname) is Sripal, but Sripal does not figure in Mitra's name. What will be the appropriate code for her dance teacher?

    • -CM 10274
    • -CKM 10274

14. Well into middle age, Mary Smith divorces Mr Jones. She converts to Buddhism and changes her name to Shanthi. What will be the appropriate code for Shanthi?

    • -S 2604
    • -No one will ever know that she is Mary Smith, who tested positive for AIDS 6 years ago.

Another example

And last, but not least, the artiste, formerly known as Prince, was born on 7 June 1958. What will be the appropriate code for him?

AFKAP 7568

7658

070658

07061958

and so on.

Surely, Da Vinci never had it so bad?