Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.
The Associated Press - Wednesday, October 23, 1996.
Lauran Neergaard, Associated Press Writer
In anonymous testing, patients are identified only by a number. In confidential testing, the state records names on a list that, by law, is kept private. State workers use the names to track down people the patient may have infected and to contact patients themselves to offer health services.
North Carolina now offers both types of tests statewide, but the state Health Department wants to end all anonymous testing. A lawsuit seeking to block that move is pending in state Supreme Court.
North Carolina tried out such a move between September 1991 and January 1993, when it ended anonymous testing in all but 18 counties. Those 18 counties offered a choice of both tests.
Testing increased statewide as AIDS awareness grew during that period, Irva Hertz-Picciotto of the University of North Carolina, Chapel Hill, reported in today's American Journal of Public Health.
But counties that retained anonymous testing saw a 64 percent jump, while those that banned anonymous tests saw just a 44 percent increase, her study found.
Also, counties that ended anonymous tests saw a 12.4 percent drop in testing of homosexual men and a 3.1 percent drop in testing of intravenous drug users, two high-risk groups, she reported.
Of the 71,434 people who visited an HIV testing center during that period, 238 changed their minds about getting the test after the process was explained. Three times as many declined the test in counties that barred anonymous testing, Hertz-Picciotto reported.
"The data suggest there's a detrimental effect" to banning anonymous HIV tests, Hertz-Picciotto said. But she cautioned that she could not say whether the AIDS epidemic was worse in the 18 anonymous-test counties, which could have skewed her findings.
But North Carolina epidemiology chief Michael Moser said the state's own figures showed that 87 percent of the increase in the anonymous-test counties came from people who agreed to have their names recorded.
"These data do not prove that under the circumstances of having no anonymous testing, you would necessarily have reduced testing," he said.
He added that without knowing patients' names, states cannot even ensure patients know how to seek life-prolonging treatment. "Denial can be the difference between life and death," he said.
But AIDS activists insist some anonymous testing must be offered for people who fear being identified. They cite a Florida health worker who was fired this month for allegedly using that state's HIV list to screen potential dates.
"It really is in their best interest to make sure anonymous test sites are available" for those people, said Jay Coburn of AIDS Action Council in Washington.
Twenty-six states require reporting of names of HIV-infected people, although some of those states also allow some anonymous testing. The states are: Alabama, Arizona, Arkansas, Colorado, Idaho, Indiana, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Utah, Virginia, West Virginia, Wisconsin and Wyoming.
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