Testing for Antibody to HIV: Confidentiality vs Anonymity-Reply

Abstract

In Reply.— We appreciate the interest of Selvey et al, but we believe they misunderstood the purpose of our letter. The intent was to point out that alternate-site testing for antibody to HIV cannot be effective unless anonymity is ensured. The reason is obvious: since confidentiality is also ensured by all blood banks, some high-risk persons might prefer to donate blood to get tested to avoid going to a health department—operated sexually transmitted disease clinic for that purpose. We did not say nor intend to imply that alternate-site testing is the primary means of safeguarding the blood supply. The primary means of safeguarding the blood supply is to use only volunteer donors without any penalty fee. We have not done a controlled study comparing anonymity and confidentiality. Such a study would be difficult to design. We do know that alternate testing sites in communities not ensuring anonymity have had very