Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
San Francisco Chronicle - Wednesday, October 28, 1998
Carl T. Hall, Chronicle Science Writer
In the first major comparison of anonymous testing versus programs that take names along with blood samples, experts found strong evidence in favor of the no-names option.
"From the public-health standpoint, it's a slam-dunk," said Dr. Andrew Bindman of the University of California at San Francisco.
Bindman, who serves as director of a UCSF Primary Care Research Center at San Francisco General Hospital, was lead author of a report on the testing study that appears today in the Journal of the American Medical Association.
The study comes amid national controversy about whether publicly financed HIV-testing programs should record the names of those who get tested, typically with promises of confidentiality.
Advocates of so-called "confidential" testing claim that taking names allows for more effective follow-up in cases of positive results, prevents double-counting and helps in tracking down sexual partners and others who may have been infected.
All states now have confidential reporting, by name, in cases where AIDS is diagnosed. Recent advances in HIV treatment have extended the time of symptom- free carrier status, bringing new importance to the issue of whether names should also be reported for those found to be HIV-positive.
About 40 states, including California, have anonymous testing for HIV. The new study included data on a random sample of 835 people in whom AIDS was diagnosed between May 1995 and December 1996. Testing programs were examined in seven states -- Arizona, Colorado, Missouri, New Mexico, North Carolina, Oregon and Texas.
On average, the study found, those offering anonymous testing had nearly a year and a half more time between the initial finding that HIV was present in their blood before disease was diagnosed.
Anonymous testing "lowers the barriers" to getting tested, Bindman said, drawing substantially more people into the medical system long before symptoms of disease show up.
Eleven states do not have anonymous testing available, and one of the seven states in the study, North Carolina, repealed the program after the research was conducted. Bindman noted that debates are under way in several other states considering a move to the "confidential" testing approach.
A separate report in the same medical journal by researchers at the Centers for Disease Control and Prevention suggested that states choosing to report the names of HIV-infected individuals should still make the anonymous- testing option available.
However, the CDC found that states using some form of HIV-surveillance did not drive away large numbers of people from testing programs for the virus.
The study also noted that merely reporting the AIDS cases no longer serves as an effective way to keep track of the AIDS virus, because recent advances in anti-viral medications have fueled a big increase in the ranks of those living with HIV but without symptoms.
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