In British Columbia, all HIV testing is confidential. People can test for HIV using their full name or they may choose to go to a site that offers testing using a pseudonym or their initials. For most people, these HIV testing options work well.
However, research and feedback from health care providers and AIDS Service Organizations has identified that a small but significant number of individuals at risk of HIV in BC are delaying or not getting tested due to concerns about confidentiality. In order to address these concerns, an anonymous HIV testing pilot project has recently been launched in BC by Regional Health Authorities and coordinated through the BC Centre for Disease Control.
Anonymous HIV testing is a low-threshold HIV testing model where results can be linked to the client using a code known only to them, without collection of identifiable or contact information. All testing, recording and reporting of results are made under the code and the client is responsible for getting their result and must provide their code to do so.
The objectives of the anonymous HIV testing pilot project are:
- To increase the uptake of HIV testing in people who may not test or delay testing due to confidentiality concerns (i.e. MSM, youth, and healthcare workers), and
- To optimize connection to follow-up, care and support for those who test HIV positive.
Research suggests that clients who test anonymously for HIV tend to do so earlier in their infection, and it is known that delays in HIV diagnosis can result in ongoing risk of transmission to others. This pilot project builds on the idea that testing for HIV is a key step that needs to occur before engagement in care, HIV treatment, and the individual clinical and public health benefits of an HIV diagnosis can happen. Making an anonymous HIV testing option available to clients opens a door that may encourage more people to test.
Given that there is no contact information collected from clients who test anonymously, if they test positive, there is no way to contact them. The inability to contact clients may be concerning for some testers and health care providers; therefore, a plan for returning for results should be discussed during the pre-test discussion. It is encouraging to note that the inability to contact a client should rarely occur. The Hassle Free Clinic in Toronto has been offering anonymous HIV testing for over 25 years with the vast majority of clients returning for their results.
The pilot project started in March 2013 and is available at various clinics in Vancouver. Anonymous HIV testing is also available in the Fraser Health Authority at select sites in New Westminster (call 604-777-6709), North Surrey (call 604-587-7902) and Abbotsford (call 604-864-3437). BCCDC is continuing to work with regional health authorities to expand to a small number of testing sites around the province. Where appropriate, participating sites will be listed in the SmartSexResource Clinic Finder.
A thorough evaluation of the anonymous HIV testing pilot project is planned once all sites have been operational for a year, with the results of the evaluation determining whether to offer anonymous HIV testing on an ongoing basis.