Important note: Information in this article was accurate in January 1999. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, January 18, 1999
Daniel J. DeNoon, Senior Editor
A U.S. Centers for Disease Control and Prevention (CDC) study shows that name-based reporting of people who test positive for HIV may deter some high-risk individuals from being tested.
"The findings suggest that state HIV reporting policies may deter or delay some persons, particularly MSM [men who have sex with men], from being tested," the CDC noted in an editorial accompanying a report on the study.
The study, conducted from November 1995 to December 1996, was reported in the December 25, 1998 issue of the CDC's Morbidity and Mortality Weekly Report ("HIV Testing among Populations at Risk for HIV Infection - Nine States, November 1995-December 1996," MMWR, 1998;47(50):1086-91.
Despite the study findings, the CDC recently recommended (but did not require) that all states adopt name-based HIV reporting while continuing to fund anonymous test sites (see Health Letter on the CDC, December 28, 1998).
The HIV Testing Survey (HITS) was conducted in nine states with different HIV reporting requirements (the name-based-reporting states were Arizona, Colorado, Mississippi, Missouri, and North Carolina; the unique-identifier (UI)-reporting states were Maryland and Texas; and the states with neither type of reporting were New Mexico and Oregon).
HITS workers interviewed 2570 eligible participants at gay bars (MSM), through street outreach (intravenous drug users; IDUs), or in sexually transmitted disease clinics (sexually active heterosexuals). Among the 2370 HIV negative or untested participants, at least one HIV test was reported by 68 percent of the 851 heterosexuals, 79 percent of the MSM, and 82 percent of the IDUs.
Name-based reporting clearly was not the main concern of these respondents: at least 60 percent did not know whether the names of people who tested HIV positive were reported to their health departments. And relatively few knew their states' reporting policies: 19 percent in states with name-based reporting, 12 percent in states with UI reporting, and 11 percent in the other states.
"The main factors for not being tested or delaying testing were fear of learning they were HIV positive (25 percent and 23 percent, respectively); thinking they were unlikely to have been exposed to HIV (18 percent and 10 percent); thinking that they were HIV negative (13 percent and 11 percent); not wanting to think about the possibility of being HIV positive (8 percent and 9 percent); and thinking there was little they could do about being HIV positive (6 percent and 4 percent)," the report noted.
But while name-based reporting was a major factor for not being tested for only 2 percent of subjects, 19 percent cited it as a factor.
When put another way, name-based reporting appeared more significant. While 84 percent of respondents said they were likely to get tested during the next year if they could be tested anonymously, only 61 percent said they would seek testing if there was name-based reporting.
A significantly higher proportion of MSM in states with name-based reporting cited concern about having their names reported than did MSM in states without name-based reporting (35 percent vs. 11 percent).
"The findings in this report support the importance of addressing privacy concerns both in states that are considering implementing name-based HIV reporting and in states that already have adopted such policies," the CDC editorial stated. "Maintaining access to anonymous HIV testing is an important option for some persons at high risk for HIV infection, and CDC strongly recommends that all states provide publicly funded anonymous HIV testing and counseling."
The CDC will conduct studies similar to HITS in other states.
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