In a confidential test, the tester knows who is being tested and reports the results to the person and the government, and then adds the information to the person’s medical records. The test result is supposed to be treated as confidential by everyone who has access to it, as is all information in a person’s medical records.

In an anonymous test, the person is tested without disclosing their identity to anyone, and the testing facility gives the person a unique identifier — a number, instead of using the person’s name — to deliver results. After the testing is complete, the result is not connected to the person tested. Most, but not all, states allow anonymous testing.

Reporting requirements and practices vary by state and by testing facility. Confidential results are added to the person’s medical records, and some facilities also report the results to health care providers and health insurance companies. Testing that is paid for entirely or in part by federal funds requires the legal name of the person being tested, and results must be reported to the state government.

How that information may be used varies by state. In every state, the names and certain demographic information of people testing HIV positive are reported to the federal government for purposes of better understanding the epidemic across the United States. In many states, the information may also be used to identify and contact people living with HIV who are not receiving HIV-related medical care, in efforts to re-engage them in such care. If you don’t want your name connected to your test result, choose an anonymous test or an at-home test.

Founded in 1973, Lambda Legal is the oldest and largest national legal organization whose mission is to achieve full recognition of the civil rights of LGBT people and all people living with HIV through impact litigation, education and public policy work. 

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