Before December, 1986, all public human immunodeficiency virus (HIV) testing in Oregon was done confidentially (using names). In December, clients were offered the option of either anonymous or confidential services. As judged by questionnaire responses, the availability of anonymity increased overall demand for testing by 50%: 125% for homosexual/bisexual (gay) men, 56% for female prostitutes, 17% for intravenous drug users, and 32% for other clients. The number of gay clients who had tests increased from a mean of 42 per month during the 4 months before anonymity was available to 108 per month during the 4 months after, whereas, at public sites in Colorado or California and private sites in Oregon, the number of gay clients tested did not increase. Twice as many seropositive persons were identified during the 3 1/2 months after anonymity became available (n = 85) as in the 3 1/2 months before (n = 36). Thus, availability of anonymous HIV testing and counselling drew gay men who had not sought services under a confidential testing system.
PIP: Before December, 1986, all public human immunodeficiency virus (HIV) testing in Oregon was done using names confidentially. Since December, clients have been offered the option of either anonymous or confidential testing. Clients choosing anonymous testing still received pre-test counseling, but were identified only by number. Demographic and risk factor data were collected, and a self administered questionnaire investigated opinions regarding anonymous testing. There was a sharp increase in the number of individuals seeking testing, from 363 first-time clients in the 3 1/2 months preceding anonymous testing to 1250 in the 3 1/2 months after the change (50% increase). 29% of clients indicated that they would not have come without anonymity, although 11% of these chose confidential testing. Of those who would have come without anonymity, 46% chose anonymity. This was most marked among homosexual men, 49% of whom would not have been tested without anonymity. Anonymous testing is strongly implicated as causing these changes, as there was no sharp increase in the number of people coming for testing in Colorado or California. Neither actual nor perceived antibody status was associated with the choice of anonymous or confidential testing. In the 3 1/2 months after anonymous testing was available 85 seropositive individuals were identified, versus 36 in the 3 1/2 months before. 95% of the client who tested positive after the change (81/85) were gay, and 48% (39/81) would not have come without anonymous testing. Thus, anonymous testing attracted homosexual men who would not have been tested confidentially and resulted in the identification of twice as many seropositive individuals as before.