Ontario’s Anonymous HIV Testing Program AIDS Bureau Ministry of Health and Long-Term Care

1. Ontario’s Anonymous HIV Testing ProgramAIDS BureauMinistry of Health and Long-Term Care HIV Testing Conference 2013

2. Ontario’s HIV Testing Strategy - Principles • HIV testing is an integral part of Ontario’s HIV care and prevention programs. • HIV testing programs in Ontario provide choice: standard (nominal) and anonymous HIV testing, rapid/point of care and standard blood draw. • HIV testing is voluntary, promotes informed consent and decision-making, and accompanied by pre and post-test counseling, support, and referral. • HIV testing initiatives promote public health principles of testing, treating, and reducing the transmission of infectious diseases. • HIV testing initiatives are guided by evidence.

3. Anonymous HIV Testing Program • In practice there are three ways people can be tested for HIV in Ontario: • Nominal – person’s name appears on test requisition form; about 80% of tests done this way • Non-nominal – code is used instead of name; tester knows person’s identity, system does not; about 15% of tests are done this way • Anonymous – no personal identifying information is collected; tester may know person’s identity, system does not; individual identities are not linked to the test; about 5% of tests done this way

4. Anonymous HIV Testing Program • Anonymous testing gives clients time to weigh their options and next steps; once they choose to seek treatment, they are re-tested and are known to the system • Anonymous testing is permitted through an amendment to the Health Protection and Promotion Act (HPPA, Regulation 569); exempts AT sites from reporting people tested HIV positive to public health • Only sites legislated under the HPPA can perform AT and all sites are required to provide HIV pre and post-test counseling • Analysis of HIV positivity rates by testing method show that 1.1% of anonymous HIV tests are positive compared to .27% for nominal tests (2009)

5. Anonymous HIV Testing Program • AIDS Bureau undertook an expansion of the Anonymous HIV Testing program in 2006. • Call for applications, distributed to organizations that provide HIV testing; resulted in the expansion of program to 50 sites across Ontario. • Organizations that provide AT include: • 22 public health units’ sexually transmitted infections clinics • 16 community health centres • 4 midwifery practices • 3 sexual health centres • 5 other

6. Anonymous HIV Testing Program • Other jurisdictions in Canada which provide anonymous HIV testing include: • Saskatchewan • Manitoba • Quebec • New Brunswick • Nova Scotia

7. Anonymous HIV Testing Program • Anonymous HIV testing is an effective component of a multi-pronged approach to the promotion HIV testing to the approximate 25% of HIV positive people who do not know their status, during a time of continued anxiety, fear, and stigma associated with HIV/AIDS.

8. Thank you! For more information contact: Ken English AIDS Bureau 416 326-5275 ken.english@ontario.ca