Sitting in a clinic or a doctor’s office on the eve of discovering the results of an HIV test can be unbearable. Left to contemplate the prospects of testing positive, you wait… recounting those moments you may not have been exactly 100-percent safe.

Becoming almost ritual for sexually–active gay and bisexual men, the entire process from beginning to end is uncomfortable, to say the least, but has been instrumental in curbing the spread of HIV. Having knowledge of infection prevents the possibility of unknowingly infecting others, and for those that do test positive, they are immediately given access to resources and provided with support. Regular testing also helps catch HIV early on, giving people greater chances for effective treatment.

In recent years testing has become less painful, with rapid testing delivering results in 10 to 20 minutes in comparison to those one-to-two week long waiting periods of just a few years ago. Regardless, it takes a lot of courage to get tested.

Maintaining the anonymity of the person being tested has proven to be effective in breaking down some of the barriers connected with HIV testing. The negative stigma associated with HIV and homosexuality, as well as the well-founded fears of HIV-related discrimination, has made anonymous testing essential in reaching out to areas of the community that do not feel comfortable providing personal information when getting tested.

Rousing much debate is the Centers for Disease Control and Prevention’s (CDC) recommendation that California (and other states that haven’t yet) adopt a names-based reporting system.

In a code-based system, when a person tests positive for HIV, that information is reported to the CDC as a unique identifier code based on certain pieces of information such as the month and year of birth, the individual’s social security number or other personal information. According the CDC and authors of California Senate Bill 945 (SB 945) – a bill seeking to replace the current code-based reporting system with a names-based system – code-based reporting is riddled with inefficiencies that lead to inaccurate data reporting. The current system has also been criticized for failing to provide doctors and laboratories with an incentive to construct and complete the code-reporting process.

The CDC, however, has underestimated the potential negative impact a names-based system can have on HIV testing. For example, one study, cited by the ACLU, found that over 60 percent of people that tested anonymously would not have tested if their names were reported to public health officials. This deterrent effect is especially pronounced among those populations with the greatest need for preventive intervention: men who have sex with men, people of color, intravenous drug users and sex workers.

If that statistic doesn’t resonate, try a study in South Carolina where, following the elimination of code-based testing, the number of men who have sex with men who got tested dropped by 51 percent.

While different studies show a multitude of varying statistics, it doesn’t take a rocket scientist to figure out that anonymous testing helps break down psychological barriers to testing, which are due in part to the shame and negative reproach associated with contracting HIV.

Speculation concerning the actual confidentiality of a names-based registry is not unfounded. Just recently, in Palm Beach County, Fla., a confidential list of about 4,000 AIDS patients and 2,500 people with HIV was mistakenly emailed to county health workers. Following the breach, people on the county health department list received letters regarding their HIV status, signaling that the information was out and had been used illegally.

The CDC, however, allocates funds from the Ryan White CARE Act based on the data it receives from states. Because the code system here in California is unable to accurately represent the number of people infected and in need of services (the number for HIV infection is much higher in reality than what has been reported), the state receives less funding with San Diego County victim to $1 million in cuts in the past two years.

The CDC announced that in 2007 they will only accept names-based reporting, which means that unless California follows suit, our budget could be sliced by 40-60 percent.

It may be inevitable. Access to resources will no doubt take precedent over people’s right to privacy. The CDC should not hold funding hostage if states like California do not comply. Instead, it should focus on increasing the accuracy of code-based reporting and evaluate costs associated with creating a system that would respect the anonymity of those tested, while providing the CDC accurate information needed to fight the epidemic. In a country that harbors so much disdain for the GLBT community and those living with HIV/AIDS, safe and anonymous testing must be available so people will continue to get tested.