Changes Sought In UHS' AIDS Testing

Backed by a poll showing strong student support, Aids Education and Outreach is calling for University Health Services (UHS) to change its HIV testing policy to one which will completely protect the identity of the patient.

While UHS is not officially reconsidering its testing policy at the moment, the organization is open to dialogue on the question, said Linda J. Frazier, a UHS health educator who supervises the students of Aids Education and Outreach (AEO).

UHS now offers confidential testing, the results of which go on the patient's permanent medical record.

The alternative endorsed by Aids Education and Outreach is anonymous testing, which identifies a patient only by bar code and keeps the results completely secret.

In a December phone poll of 244 randomly-selected students, AEO found that of those who understood the difference between the two types of test 75 percent wanted UHS to switch to the anonymous tests.

Those who have been tested can face discrimination if that information becomes public, said AEO Co-Director Suzanne M. Gutter '95.

"With this current policy [confidential testing], we recommend that people go to alternative testing sites," Gutter said. "There are ways that insurance companies and employers can acquire and use those results to suit their purposes."

Frazier acknowledged that confidential testingcannot completely protect patients' test resultsfrom outside scrutiny.

Health records can be subpoenaed in courtcases, she said.

If anonymity is important, Frazier said sheherself recommends the patient seek an alternativesite, such as Cambridge City Hospital, whichoffers completely anonymous tests.

UHS has a number of reasons for dealining tooffer the anonymous tests, Frazier said.

"AEO"s goal is a good one," she said. "Butthere are a number of crucial implications thatneed to be addressed."

Instituting an anonymous testing program wouldrequire substantial time and effort to support thestandardization of protocols and counseling,Frazier said.

To make the switch to anonymous testing,physicians and nurse practitioners would have tobe trained to offer precisely the same advice andinformation to patients, she said.

Paying for such training could involve seekingsupport from the state, Frazier said, which wouldbe a concern for UHS officials.

"If we get outside funding, we need to askwhether UHS would still remain a health servicewith access limited to the Harvard staff andstudents," she said.

However, Frazier said she wants to insure thatstudents feel comfortable coming to UHS fortesting, rather than seeking another facilitywhich may not be so supportive.

"We don't want to be pushing students into asystem that we don't know much about," saidFrazier. "Our worst fear is that people will goand get tested anonymously else where, but notreceive accurate results or proper pre-test andposttest counseling."

AEO students are concerned that patients who donot know the difference between the two types oftest will not understand the consequences of theconfidential-rather than fully anonymous-testingprocedure.

The poll found that before explanations by AEOmembers, 40 percent of students did not know thedifference between the two types of test, saidJeanne L. Kwong '96, who is an AEO peer educator.

"Many of them were upperclassmen," said Gutter."This is trouble some because the first placeupperclassmen go when they want to get tested isUHS."

But the biggest concern for both Frazier andthe student members of AEO is that most Harvardstudents are not getting tested at all, whether atUHS' confidential site or an anonymous siteelsewhere.

AEO members say they have found that while asignificant number of Harvard students are awareof HIV-related issues, they do not translate thisknowledge into taking preventive measures.

"We assume that here at Harvard because wedon't have extensive drug use, we're not at risk,"said Frazier.

"That is simply not true, said Jafi A. Lipson'95, an AEO peer educator.

"There are definitely numbers [of HIV positivecases] here at Harvard," said Lipson, who is aCrimson comper. "Since a Winthrop house tutor diedof AIDS in 1986, many more grad students,teachers, lecturers, former students, and currentstudents have contracted the deadly disease."

Many students think that donating bloodprovides an adequate HIV test, Frazier said.

"Among those students who want to get testedmany think that if they donate blood, this is away to find out if they are HIV positive," shesaid. "However, this form of testing provides nosupport and no education or counseling."

AEO's attempts to educate students can "be veryfrustrating," Lipson said.

"I think until people know other people whoare HIV positive or who have relatives dying ofAIDS, people don't consider it a pressing issue intheir lives," she said. "It's a sad fact."

Anonymous testing is currently offered free ofcost at Cambridge City Hospital, MassachusettsGeneral Hospital and Fenway Hospital

Frazier acknowledged that confidential testingcannot completely protect patients' test resultsfrom outside scrutiny.

Health records can be subpoenaed in courtcases, she said.

If anonymity is important, Frazier said sheherself recommends the patient seek an alternativesite, such as Cambridge City Hospital, whichoffers completely anonymous tests.

UHS has a number of reasons for dealining tooffer the anonymous tests, Frazier said.

"AEO"s goal is a good one," she said. "Butthere are a number of crucial implications thatneed to be addressed."

Instituting an anonymous testing program wouldrequire substantial time and effort to support thestandardization of protocols and counseling,Frazier said.

To make the switch to anonymous testing,physicians and nurse practitioners would have tobe trained to offer precisely the same advice andinformation to patients, she said.

Paying for such training could involve seekingsupport from the state, Frazier said, which wouldbe a concern for UHS officials.

"If we get outside funding, we need to askwhether UHS would still remain a health servicewith access limited to the Harvard staff andstudents," she said.

However, Frazier said she wants to insure thatstudents feel comfortable coming to UHS fortesting, rather than seeking another facilitywhich may not be so supportive.

"We don't want to be pushing students into asystem that we don't know much about," saidFrazier. "Our worst fear is that people will goand get tested anonymously else where, but notreceive accurate results or proper pre-test andposttest counseling."

AEO students are concerned that patients who donot know the difference between the two types oftest will not understand the consequences of theconfidential-rather than fully anonymous-testingprocedure.

The poll found that before explanations by AEOmembers, 40 percent of students did not know thedifference between the two types of test, saidJeanne L. Kwong '96, who is an AEO peer educator.

"Many of them were upperclassmen," said Gutter."This is trouble some because the first placeupperclassmen go when they want to get tested isUHS."

But the biggest concern for both Frazier andthe student members of AEO is that most Harvardstudents are not getting tested at all, whether atUHS' confidential site or an anonymous siteelsewhere.

AEO members say they have found that while asignificant number of Harvard students are awareof HIV-related issues, they do not translate thisknowledge into taking preventive measures.

"We assume that here at Harvard because wedon't have extensive drug use, we're not at risk,"said Frazier.

"That is simply not true, said Jafi A. Lipson'95, an AEO peer educator.

"There are definitely numbers [of HIV positivecases] here at Harvard," said Lipson, who is aCrimson comper. "Since a Winthrop house tutor diedof AIDS in 1986, many more grad students,teachers, lecturers, former students, and currentstudents have contracted the deadly disease."

Many students think that donating bloodprovides an adequate HIV test, Frazier said.

"Among those students who want to get testedmany think that if they donate blood, this is away to find out if they are HIV positive," shesaid. "However, this form of testing provides nosupport and no education or counseling."

AEO's attempts to educate students can "be veryfrustrating," Lipson said.

"I think until people know other people whoare HIV positive or who have relatives dying ofAIDS, people don't consider it a pressing issue intheir lives," she said. "It's a sad fact."

Anonymous testing is currently offered free ofcost at Cambridge City Hospital, MassachusettsGeneral Hospital and Fenway Hospital