What Is The Difference Between Anonymous and Confidential HIV Testing?

HIV Testing Form
A form for ordering HIV testing and related bloodwork. Don Bayley / E+ / Getty Images

Question: What is the difference between anonymous HIV testing and confidential HIV testing?

Does it matter where you choose to get tested for HIV? It shouldn't, but it can. Sometimes just having been tested for HIV, regardless of the results, can cause problems in other areas of your life. The stigma associated with HIV infection is high. However, there's also stigma associated with believing you might be at risk.

Concerns about confidential testing have been declining over time, since universal HIV testing became recommended. Still, some people may prefer the anonymous route.

Answer: The difference is whether the clinic officially knows who you are.

With anonymous testing, the clinic has no way to identify you as an individual. When you come in for testing you are assigned a number, and you use that same number to receive your results. Your name is never associated with your test results, and you are the only person who knows what they are.

In contrast, with confidential testing, although your results are kept private, your name is associated with them, and they may be released to your insurance company, health care provider, or even the state or local government. HIV is, after all, a nationally notifiable disease.

Making HIV Testing Universal

With changes in the American healthcare system, more and more people are receiving HIV tests as part of their regular care.

That's a very good thing. The CDC has worked to improve HIV test coverage, because people who are undiagnosed are at greatest risk of passing on the virus. They're also unable to benefit from treatment advances that can help them live long healthy lives.

These changes have also reduced concerns about anonymous versus confidential testing.

In particular, as insurance companies can no longer deny coverage for pre-existing conditions, it's much less of an issue if they find out that their clients have HIV.

Although anonymous HIV testing is still available, sometimes it's easiest to just get tested by your doctor. That way it may be easier to access early treatment options that can greatly improve your life. On the other hand, if you're concerned about your doctor being able to care for you without stigma, it's perfectly reasonable to go to someone else. Some doctors are bad at dealing with STDs, and quality HIV care requires knowledge of current options.

Sources:

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Kendall CE, Manuel DG, Younger J, Hogg W, Glazier RH, Taljaard M. A population-based study evaluating family physicians' HIV experience and care of people living with HIV in Ontario. Ann Fam Med. 2015 Sep;13(5):436-45. doi: 10.1370/afm.1822.

Wilson IB, Landon BE, Hirschhorn LR, McInnes K, Ding L, Marsden PV, Cleary PD. Quality of HIV care provided by nurse practitioners, physician assistants, and physicians. Ann Intern Med. 2005 Nov 15;143(10):729-36.

Yehia BR, Stewart L, Momplaisir F, Mody A, Holtzman CW, Jacobs LM, Hines J, Mounzer K, Glanz K, Metlay JP, Shea JA. Barriers and facilitators to patient retention in HIV care. BMC Infect Dis. 2015 Jun 28;15:246. doi: 10.1186/s12879-015-0990-0.

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