Associated Press - Wednesday, October 28, 1998
Brenda C. Coleman, AP Medical Writer

The first study found that where publicly funding anonymous testing is available -- as it is in 39 states -- people eventually diagnosed with AIDS sought HIV tests and HIV-related treatment more than a year earlier than other patients.

"That is one of the biggest (positive) effects of any public health program anywhere," said the lead author, Dr. Andrew Bindman of San Francisco General Hospital Medical Center.

Researchers said early testing and treatment not only prolongs lives but allows precautions to prevent the spread of the disease.

The study involved 835 patients in Arizona, Colorado, Missouri, New Mexico, North Carolina, Oregon and Texas. North Carolina has since mandated name reporting of HIV tests.

Name reporting has been required since 1981 in all states for full-blown AIDS cases and has been routine even longer in all states for other diseases ranging from tuberculosis to gonorrhea and salmonella poisoning.

But only 11 states require name reporting of HIV-positive tests; all others offer the option of anonymous testing.

The second JAMA study found that public clinics saw no significant decline in the number of people tested in states were names are required.

In confidential testing, the person's name is linked to test results in a medical chart and kept on file at health departments to prevent cases from being tracked more than once. The names are stripped before results are sent to the Centers for Disease Control and Prevention. In anonymous testing, only a number is recorded with the test result, never a name.

The CDC studied about 459,000 tests at health departments in six states before and after public clinics began reporting names of people who tested positive for HIV.

Name reporting did not appear to diminish the use of testing in the states studied -- Louisiana, Michigan, Nebraska, Nevada, New Jersey and Tennessee -- the CDC said.

Federal authorities favor the availability of both. They say name reporting is the only way to track the epidemic, but anonymous testing may help curb it by getting people into treatment earlier.

"The history of this disease has been a little different than ... other diseases, because we haven't had a therapy until recently that was highly effective," said Dr. Allyn Nakashima, lead author of one study and a CDC medical epidemiologist.

Public reluctance to give names to public health officials for testing has eased, since a person's anonymity disappears when he or she becomes a patient, she said.
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