Frequently asked questions.
In a confidential test, the tester knows who is being tested and reports the results to the person and the government, and then adds the information to the person’s medical records. The test result is supposed to be treated as confidential by everyone who has access to it, as is all information in a person’s medical records.
In an anonymous test, the person is tested without disclosing their identity to anyone, and the testing facility gives the person a unique identifier—a number, instead of using the person’s name—to deliver results. After the testing is complete, the result is not connected to the person tested. Most, but not all, states allow anonymous testing.
Reporting requirements and practices vary by state and by testing facility. Confidential results are added to the person’s medical records, and some facilities also report the results to health care providers and health insurance companies. Testing that is paid for entirely or in part by federal funds requires the legal name of the person being tested, and results must be reported to the state government.
How that information may be used varies by state. In every state, the names and certain demographic information of people testing HIV positive are reported to the federal government for purposes of better understanding the epidemic across the United States. In many states, the information may also be used to identify and contact people living with HIV who are not receiving HIV-related medical care, in efforts to re-engage them in such care. If you don’t want your name connected to your test result, choose an anonymous test or an at-home test.
Except in two states (Indiana and North Carolina), people testing positive for HIV are not required to inform previous sexual partners of a positive result. However, once you become aware of your HIV-positive status and then have sexual relations, state laws often require that you disclose your positive status to those sexual partners.
State health officials often encourage people to notify previous sexual partners and, if requested, will contact partners themselves without disclosing the newly diagnosed person’s name. But such “partner notification” programs are voluntary for the newly diagnosed person, and with the exception of Indiana and North Carolina (which require that you inform previous partners, though not necessarily through the partner notification program), there are no criminal penalties for not participating.
If the idea of telling your positive result to a previous (or current) sexual partner is very stressful to you, these partner notification programs can be very valuable. The person notified can then be tested and find any needed health care, and you don’t need to do the disclosing yourself.
If, on the other hand, it is important for your own safety that a previous sexual partner not know that you recently learned you are HIV positive, think carefully about whether “partner notification” services are right for you. If you have concerns about your safety, consider the repercussions if the person is able to guess your identity despite not being told your name.
Home HIV tests vary in their reliability. The most accurate of the two FDA-approved tests involves pricking your finger and collecting a small amount of blood to send to a laboratory that you later call to collect your results. The other FDA-approved test uses a mouth swab and provides results in approximately 20 minutes. About 1 in 12 people who take this test receive a “false-positive” result after a swab test.
The main advantages of home tests are the anonymity and relative accuracy. They generally cost about $40 each.
Downsides include that results are not provided by a counselor (though both manufacturers provide a phone number to call for confidential counseling) and that it is harder to make sure that people testing positive find the health care services that they then will need.