Real-name HIV testing may scare off infected: experts

(Ecns.cn) – Officials from China's Ministry of Health and Centers for Disease Control (CDC) have expressed support for real-name HIV testing regulations, asserting that the policy would allow healthcare personnel to maintain contact with HIV carriers and help prevent the transmission of the virus to their sexual partners, according to the Beijing News.

Official advocacy of the policy has fueled outrage among opponents who believe the move is a violation of patient privacy as well as discrimination against those with AIDS in society.

South China's Guangxi Zhuang Autonomous Region recently drafted legislation demanding personal information for HIV testing, requiring those with positive results to inform their spouses and sexual partners. Central China's Hunan Province followed soon after, announcing its own plan to adopt the real-name system for AIDS prevention and treatment by the end of this year.

Though aimed at lowering infection rates, the rule has been attacked by many Web users and AIDS prevention activist groups, mostly out of fear that a real-name registry might create privacy issues and discourage people from being tested in the first place.

Calls for suspension

Tianxiagong (Justice for All), a Nanjing-based non-profit organization, wrote to the Ministry of Health to demand a nationwide suspension of the implementation of the real-name HIV testing policy last week.

Meanwhile, the International HIV/AIDS Alliance China Office has also drafted a letter calling for suspension of the policy and plans to mail it to the CDC.

Their reasons mainly concentrate on a possible decrease in the number of people who allow themselves to be tested, a lack of confidentiality protection and a contradiction with the AIDS Prevention and Control Regulation enacted in 2006.

Yu Fangqiang, a lawyer and managing director of Tianxiagong, said that measures such as allowing anonymity and paying cash awards have all failed to encourage at-risk groups to take HIV tests, let alone the real-name registration, according to the Beijing Times.

By being mandated by real-name registration, more high-risk people will likely go underground and be driven away from government testing and treatment programs, added Yu.

Meng Lin, a supporter of the real-name system, also showed concern about the push. Meng noted that he had seen many people who had tested positive for HIV suffer great discrimination from society. Though he admits the move will, in theory, help protect sex partners and avert secondary transmission, discrimination by employers, schools, landlords and even hospitals is still quite commonly seen in China, which creates severe inconvenience and even psychological scars.

Will goodwill scare away infected?

Last week, Zhang Ping (pseudonym) went to the AIDS outpatient department of the Nanning No. 4 People's Hospital in Guangxi for an HIV test. After closing the door of the consulting room, Zhang began to tell the doctor what he had been through over the past few days.

Zhang said he had engaged in behavior that put him at risk for HIV transmission, and later felt physically ill. To set his mind at rest, he decided to take an HIV test. Zhang was then led by a nurse to the testing area, but only after he was asked to show his identity card and write down his contact information.

The scene was described by Liang Hailing, a nurse practitioner on duty that day. According to Liang, all HIV test-takers are now required to file copies of their identity cards and contact information with the hospital, and that personal data is kept secret with concrete measures to prevent information leakage.

Liang said different HIV test-takers have different states of mind, so the hospital has tailored services for all individuals as a way to relieve tension and assuage concerns. Till now, very few have refused to show their identity cards and failed to take HIV tests, she added.

According to a survey of 1,025 people conducted by the Beijing News on real-name HIV testing, 42.9% of the respondents agree that the legislation is good for AIDS prevention and treatment; 22.8% are against it as they think it will scare away potential test-takers and may disclose patient information unintentionally; and 34.3% suggest that test-takers should have the right to decide without being mandated.

Information protection

Though the idea of real-name registration will bring benefits to HIV carriers directly, it could also collapse if there are cases of information leaks, which would cause many HIV-positive people to go into hiding, warned Lv Fan, director of the Policy Studies Department at the CDC.

Lv said there is still a lot of work to do before real-name testing can be implemented, including confidentiality training for healthcare personnel, strengthened legal supervision and public anti-discrimination campaigns.

Among them, confidentiality protection is the most important. Even if people who commit information leakage face criminal penalties and victims can ask for compensation, this is not a guarantee of the smooth implementation of the policy, because all efforts come to nothing once trust is gone. In order to ensure the success of the move, the government must enhance stronger confidentiality protections and stronger laws on discrimination.

Statistics from an evaluation report on the AIDS epidemic show that an estimated 780,000 people in China were living with HIV/AIDS by the end of 2011. However, only around 300,000 people were aware that they were infected and had reported to relevant authorities.