Anonymous Hep A, B, and HIV testing.

December 15, 2007 1:03 AM

I am looking for places that do anonymous testing for Hep B, Hep A and HIV.

The county I live in tracks Hep B and HIV cases and I have no desire to enter into their records if I test positive.

I've found that my county health department does do anonymous HIV testing but their anonymous procedure leaves much to be desired and they don't offer an anonymous Hep B test. I've already tried Planned Parenthood and my GP, they both just directed me back to the county health department.

I'm running short on ideas.

I live in western Michigan and would be willing to drive a few hours to find this service.

posted by anonymous to health & fitness (14 comments total)

You might want to ask AIDS Partnership Michigan about the HIV testing. They can probably refer you to confidential Hep testing (and vaccinations) as well.
posted by mykescipark at 1:14 AM on December 15, 2007

Have you considered nearby counties? In most states, they each have their own rules and procedures. Also, I'm not sure what you don't like about your county's anonymity procedures, but would even the same procedures be ameliorated by going to a county where you do not reside and are not known?
posted by ubiquity at 2:46 AM on December 15, 2007

Check into local AIDS groups and needle exchanges. They often either offer that testing or know where you can get it.
posted by Stacey at 3:07 AM on December 15, 2007

I've seen this from an ad, and it looks helpful. Good luck to you.
posted by thetenthstory at 5:10 AM on December 15, 2007

Here in NC you can't get anonymous testing, per state law. Does anyone know if that's the case in MI?
posted by Stewriffic at 7:28 AM on December 15, 2007

This flyer makes it appear that anonymous Hepatitis testing might not be possible in Illinois. Date on form is 2002. Someone in Chicago might be able to comment as to what exactly they ask for in a lab.

Although anonymous testing might be possible in some areas, anonymous treatment is highly unlikely. Something to consider.

Me: not a/your doctor, etc etc.
posted by gimonca at 10:19 AM on December 15, 2007

I'm pretty sure all public health organizations in all states keep track of the prevalence and incidence of transmissible diseases. HIV, hepatitis, gonorrhea, chlamydia, syphilis, TB, confirmed influenza... Every place you can get tested for these things is mandated to report the number of positive results to state public health officials.

At the beginning of the HIV epidemic, a lot of work was done by advocacy organizations to make anonymous testing available, because there was a lot of bullshit going on about HIV status--people being denied jobs, health insurance, etc., on the basis of their positive status. I'm not aware of any similar stigma/problems regarding hepatitis status (especially hepatitis A, which isn't sexually transmitted); as such, far fewer anonymous testing programs are available.

You may not be able to find an anonymous hepatitis testing program anywhere near you. If you think you're at risk for having been infected, please don't let this deter you from being tested anyway. Your health information is strictly protected by HIPAA, and your name will not be released anywhere without your permission.

There are also very effective hepatitis A and B vaccines; if you get tested and are negative, please consider getting vaccinated.
posted by jesourie at 10:43 AM on December 15, 2007

jesourie: If anonymous is concerned about the hep being considered a pre existing condition for future health insurance reasons, I don't believe that HIPAA will do anonymous any good. I know that one of the big reasons people want anonymous HIV tests is so there is no proof of it being a pre existing condition. However, I really don't know enough about HIPAA to say this for sure, but I thought I should put out there that this could possibly be an issue.
posted by whoaali at 12:06 PM on December 15, 2007

I have a few thoughts on this, and will dig up some links, but am running out the door so will come back with more later.

One thing that many people have done is go through the confidential HIV testing system with a pseudonym. Few places will ask for id. You may be able to do the same thing for HBV and HAV. I'm not generally aware of any places that offer anonymous testing for hepatitis, as the stigma is so much lower and there has probably been less demand for anonymous testing. Not saying it's good or bad, just that there's been less need for it.

Also, if you have reason to want to be tested for hep B and for HIV, you may want to get tested for hepatitis C as well. Apologies if you already knew that and had other reasons for wanting hep A rather than hep C testing.
posted by gingerbeer at 1:07 PM on December 15, 2007

Just popping back in to note that one of the reasons I suggested a needle exchange is that I know at least the one I volunteer at, in Pennsylvania, does offer free and anonymous hepatitis testing. (Though at this point only hep C, I'm afraid.) So I know it can be done at least in some states, though I don't know what's available in Michigan specifically.

I'm guessing Pittsburgh's farther than you want to drive, anonymous, but feel free to MeFiMail me if I'm wrong and I'll let you know more details about our testing. I could ask around a little and see if anyone knows where to do hep A/B confidentially here, so perhaps you could get it all done in one trip.
posted by Stacey at 1:31 PM on December 15, 2007

Anon: All three conditions you mention have mandatory reporting requirements, and, depending on the state, may require ANY provider with a positive test result to report your name. I would just call your county health department (or a nearby county's) and ask what the procedure is for positive test results.

The reason these are reported (some just demographic information, some have to report your name, address, and contact info) is because they are communicable, and it's a public health interest to prevent further spread of these diseases. Similar example: if I have a patient who has new onset seizures, I am required by law to report them to the DMV, who will then decide if their license will be suspended. You wouldn't want a patient with untreated seizures driving, would you?

While I understand your concern for anonymity about these conditions and the stigma associated with them, you probably would want to know if you have them so that you can a) prevent others from getting them and b) get treatment for them yourself. Any treatment is going to require your doctor to disclose these conditions to your insurer--whoever that may be--unless you're paying in cash. (And still then, your doctor is going to have to put them in your medical record, which is private and confidential, but not anonymous.)

Also, for some states, the law is such that when you take an anonymous test, you also agree to take a confidential (non-anonymous) follow-up test to confirm the HIV/Hep diagnosis. This is how it works in California (or at least San Francisco).
posted by gramcracker at 2:20 PM on December 15, 2007

I think you may well have a hard time finding what you want for Hep B, because it isn't really considered a marker condition for anything and has a low stigma associated with it. The less stigma, the less chance folks have worked to offer anon testing to get people to come in. Hep C is more likely.

There is anon testing for HIV, but there is also confidential testing, which you should not get if you are concerned about your anonymity. Most states (all states, really, within the next little bit) are tracking HIV cases by name. The CDC has wanted better surveillance data for a long time, and has long required AIDS data be reported by name. The most recent version of the Ryan White Act, whic provides federal funding to states for HIV testing and care, mandates a change to names-only reporting in two years.

If I were you, and I work in an HIV testing and treatment clinic, I'd provide incorrect but easily remembered information so that I could retrieve the test but would be effectively anonymous.

It is worth giving some thought, if you think you're really at risk, what you plan to do if you get a positive test. HIV is treatable, but expensive, and, regardless, medical laboratories are (at least in my state) responsible for forwarding on the names of people who test positive to the health department. It's unlikely that you could get treated, in other words, without being reported to the CDC. At the same time, a positive test means very little without subsequent bloodwork to tell you what the stage of your disease is (it might be fine to forego treatment, it might be deadly), and you are unlikely to be able to maintain any fictions about your name and identity as treatment starts.

Best of luck. If you have questions about the process for HIV testing feel free to email me.
posted by OmieWise at 2:21 PM on December 15, 2007

I checked in with my exchange folks to see if they knew of anywhere closer to you. The consensus seems to be that you should give the Chicago Recovery Alliance a call. They definitely do free testing for HIV and all three types of hepatitis, but we're not sure if their testing is anonymous or not. this site seems to indicate they are. Worth a check. Looks like they do vaccinations as well, and some other STD tests, if either of those things interest you.
posted by Stacey at 5:11 PM on December 15, 2007

Back, with a few more thoughts. You've already got the link for hivtest.org, and it sounds like you already know what's available nearby. If you're able to drive into Chicago, I'll echo the recommendation for the Chicago Recovery Alliance. They're good folks, and should be able to take care of you. Otherwise, going to a nearby county would provide some insulation and the time-honored route is to use another name to get around the confidential testing. If at all possible, find a place that will do rapid testing for HIV - it takes about 20 minutes rather than 2 weeks. You'll still need to wait for the hepatitis results, and don't assume you're all clear if the HIV is negative, as hepatitis is more easily transmitted.

Second, a confidential report of any test results to your local health department is not something that an insurer can access. Health departments can't and don't ever release that kind of information, so as long as you are not using your insurance to pay for the test or doing it at your doctor's office, so that it ends up in your medical records, it will not be shared with any other kind of system. Counties send that information to only one place - the state health department, which encodes it and send it to one place - the CDC. Of course, all the legal confidentiality protections in the world are only as strong as the individuals following them, but that's the general rule for what happens to the information. I don't know if that's behind your concern, but wanted to add that in case it is.

As OmieWise says, if any of the tests are positive, please see a doctor and get treatment. Your doctor will want to run confirmatory tests and tests to find out where you are in terms of disease progression, and you'll be in the public health reporting system at that point. In my opinion, it's worth the trade-off to get treatment, but I know that every one has to make that decision for themselves.

Best of luck with it.
posted by gingerbeer at 6:43 PM on December 15, 2007