Anonymous HIV Testing and Medical Care—Reply

In Reply: We agree that the interval between individuals learning that they are HIV-positive and an AIDS diagnosis is too short. More effective strategies are needed to help individuals at risk for HIV infection learn about their health condition at an earlier stage in the disease process and to encourage them to use this information to quickly access medical care. Anonymous testing is the most proven effective strategy that has been developed to date.

The short interval between HIV infection and AIDS diagnosis does limit the potential for using name-based surveillance data on HIV to contact and help individuals sooner than could occur through named AIDS surveillance that already exists in all 50 states. We believe the Centers for Disease Control and Prevention's (CDC) draft guidelines in favor of HIV reporting¹ are not based on an argument that they will enable public health officials to reach HIV-infected individuals who could benefit from but are not already receiving medical care. Rather, it is hoped that HIV named reporting can provide data that are representative of more recent trends in the AIDS epidemic and thereby provide opportunities for planning services.¹ It remains to be seen whether the potential planning benefits of named surveillance data outweigh the costs of delayed testing among individuals who fear having their name reported to the health department in the event that they are found to be HIV-positive.