HIV testing behaviors and attitudes after adoption of name-to-code HIV case surveillance in Washington State

Controversy over HIV reporting in Washington State raised concerns that name-to-code reporting might reduce HIV testing. We assessed HIV testing and the influence of reporting among people at risk for HIV. An anonymous survey was conducted 9 months after HIV reporting began. Recruitment for men who have sex with men was at bars; high-risk heterosexuals at a sexually transmitted disease clinic; and injection drug users at needle exchange sites. Eighty-nine percent of 267 participants had been tested for HIV at least once but only half reported testing regularly. Injection drug users and men who have sex with men were more likely than HRH to report regular testing. Main reasons for delaying testing were thinking that HIV exposure was unlikely or not wanting to think about being HIV positive; concern about government reporting was cited by only 2%. Over half the respondents hadn't heard about the new name-to-code HIV reporting mechanism, although 69% thought there was some type of HIV reporting. Only 18% correctly identified the mechanism of HIV reporting. HIV prevention programs should focus on the most common reasons for delaying or avoiding HIV testing: believing that one has not been exposed to HIV, and the fear of learning that one is HIV positive.