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PubMed1990

[364 anonymous screening tests for AIDS at the Vaudois University Hospital Center: who? why?].

From 1 July to 31 December 1988 risk factors for HIV infection were systematically recorded for all individuals tested anonymously at our institution and compared with similar data observed when anonymous testing was introduced (1985-1986). The absolute number of homosexuals and intravenous drug abusers remained stable but their ratio decreased because most tests are now performed in persons with multiple heterosexual partners. More than half of heterosexuals said they used condoms. Tests were positive only in homosexuals and intravenous drug abusers. These data suggest that the ongoing Swiss nationwide educational programmes have been successful in reaching people potentially exposed to HIV. Such campaigns may still prevent the dissemination of HIV infection to the heterosexual population.

AIDS Serodiagnosis↗
PubMed1988

Anti-HIV screening of pregnant women in south-eastern Norway.

Routine anti-HIV screening of 36,053 sera from pregnant women in South-Eastern Norway yielded four (0.011%) true positive individuals. Three of these were known to be HIV-infected before pregnancy. In addition 23 women (0.064%) gave false positive results. Fifty (0.14%) women actively refused anti-HIV test. Anonymous testing of the sera from these women probably yielded one single true anti-HIV positive (2%). The prevalence of HIV-infection among pregnant Norwegian women is very low. Nevertheless, this screening programme could be instrumental in the future for the indirect monitoring of the incidence and prevalence of HIV-infection among the sexually active section of the population. False positive results were rare and caused no real diagnostic problem.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Multistate evaluation of anonymous HIV testing and access to medical care. Multistate Evaluation of Surveillance of HIV (MESH) Study Group.

CONTEXT: Infection with the human immunodeficiency virus (HIV) is the only infectious disease for which anonymous testing is publicly funded, an exception that has been controversial. OBJECTIVE: To assess whether anonymous HIV testing was associated with earlier HIV testing and HIV-related medical care than confidential HIV testing. DESIGN: Retrospective cohort. SETTING: Arizona, Colorado, Missouri, New Mexico, North Carolina, Oregon, and Texas. PARTICIPANTS: Probability sample of 835 new acquired immunodeficiency syndrome (AIDS) cases reported to the state health department's HIV/AIDS Reporting System from May 1995 through December 1996. All had responded to the AIDS Patient Survey; 643 had been tested confidentially for HIV, and 192 had been tested anonymously. MAIN OUTCOME MEASURES: First CD4+ cell count; number of days from HIV-positive test result to first HIV-related medical care, from first HIV-related medical care to AIDS, and from first HIV-positive test result to AIDS. RESULTS: Persons tested anonymously sought testing and medical care earlier in the course of HIV disease than did persons tested confidentially. Mean first CD4+ cell count was 0.427x 10(9)/L in persons tested anonymously vs 0.267x 10(9)/L in persons tested confidentially. Persons tested anonymously experienced an average of 918 days in HIV-related medical care before an AIDS diagnosis vs 531 days for persons tested confidentially. The mean time from learning they were HIV positive to the diagnosis of AIDS was 1246 days for persons tested anonymously vs 718 days for persons tested confidentially. After adjustment for the subject's age, sex, race/ethnicity, education, income, insurance status, HIV exposure group, whether the respondent had a regular source of care or symptoms at the time of the HIV test, and state residence, anonymous testing remained significantly associated with earlier entry into medical care (P<.001). CONCLUSION: Anonymous testing contributes to early HIV testing and medical care.

AIDS Serodiagnosis↗
PubMed1997

Dilemmas of anonymous predictive testing for Huntington disease: privacy vs. optimal care.

Some persons at risk for Huntington disease (HD) seek predictive testing under the protection of anonymity to reduce the risk of insurance discrimination for themselves and their families. While Canadian and European health care systems seem to limit insurance discrimination to life and disability insurance, U.S. residents do not have national health insurance and are concerned about health insurance discrimination. Two persons residing outside Canada requested predictive testing anonymously. Their primary reason for doing so was to avoid the risks of medical insurance discrimination. After a detailed preparatory session and agreement to counselling and to receipt of results in person, we agreed to provide anonymous testing to these persons. One participant, whose psychological assessment was unremarkable, coped well with the predictive testing process and did not have the CAG expansion. The other participant had considerable emotional problems prior to testing, which necesitated postponement of discussion of results and referral for psychiatric assessment and support. Both participants had difficulty maintaining anonymity. The provision of anonymous predictive testing raises several problems. With anonymous testing, clinicians cooperate with participants to exclude insurance companies from information. This may invalidate the contract with insurance companies. A policy response by insurance companies or a universal health care system to protect individuals is preferable. Individuals who request anonymous testing may be precisely those most vulnerable and in need of additional support and counselling. However, the preservation of anonymity is a burden to participants and may frustrate the clinicians' ability to establish rapport in counselling and to provide appropriate follow-up typically available through genetic counselling in predictive testing programs.

Adult↗