United Press International - Tuesday, October 27, 1998
Lidia Wasowicz, UPI Science Writer

They say the safety of secrecy encourages people to get tested earlier, thereby having the chance to start treatment earlier should the results come out positive.

The investigators had been curious about the effectiveness of the controversial practice. It appears its supporters have a solid point, they say in their report in The Journal of the American Medical Association.

"HIV is the only infectious disease with dedicated anonymous testing programs that are funded by public health departments, and this practice has been controversial," said Dr. Andrew Bindman, director of the UCSF Primary Care Research Center at San Francisco General Hospital Medical Center and principal investigator of the study.

"Our findings show anonymous testing is associated with earlier diagnosis of HIV infection, which means persons who know they are HIV positive can take steps to control the spread of the virus, and to earlier follow-up treatment, which can significantly impact quality and length of life."

The conclusions are based on a review of confidential versus anonymous testing in Arizona, Colorado, Missouri, New Mexico, North Carolina, Oregon and Texas. Anonymous testing, which uses a unique identifying label instead of a patient's name, is publicly funded in 40 states.

The results of previous studies on the effectiveness of anonymous testing -- most of them on small numbers of patients in only one state -- have varied.

The new study of 835 patients diagnosed with acquired immune deficiency syndrome, or AIDS, which is caused by the human immunodeficiency virus, HIV, shows a number of advantages associated with anonymous testing, said co-researcher Dr. Arthur Reingold of the University of California, Berkeley.

--Persons being tested anonymously tended to be in an earlier stage of HIV disease and to be diagnosed with AIDS about a year and a half later from the time of diagnosis than the confidental group.

--The anonymous group received 918 days of medical care between testing positive and being diagnosed with AIDS, compared to only 531 days for the confidential patients.

--The anonymous group had higher CD4 counts than those testing confidentially. CD4 cells in the immune system are HIV's primary target and serve as markers of disease progression.

The researchers also found those opting for anonymous testing were younger, white, better educated and more likely to be homosexual than those seeking confidential testing, said co-researcher J. Stan Lehman of the Centers for Disease Control and Prevention in Atlanta.

"As more states adopt HIV named reporting policies, the interest in the option of anonymous HIV testing may grow," Bindman said.

HIV named reporting is a public health program designed to keep better tabs on the epidemic. Individuals testing anonymously are temporarily exempt from the program and are not reported to the public health department until after they seek HIV-related medical care.

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