Private screening a safety net for students

by Katie Hunhoff

HIV testing for college students is often a scary, emotional and even embarrassing experience.
Beginning in 1990, Boynton Health Service began offering confidential testing to make the experience easier on students.
Students make between 30 to 40 appointments at Boynton Health Service weekly to receive either HIV testing or results; many of them wouldn’t get tested without the confidential option.
The testing is called confidential because after the results are in, there is no evidence on the patient’s record that the test took place. The test is so confidential that only number labels are used on blood samples and appointments are written in as a simple “nurse visit.”
Dave Golden, director of public health, marketing and program development at Boynton, said 356 people came to Boynton for confidential testing in 1998. Only one of these tested positive.
Golden added that from a spring 1998 survey, 24.1 percent of the campus reported that they had been tested for HIV. The number of people on campus who reported a positive HIV test is .2 percent.
Pam Smith, community program associate at Boynton, said one reason people like the confidential test is that it won’t be shown to prospective insurers or employers who may be biased against someone with a past HIV test.
“We’re not as liberated as we’d like to believe,” she said. “People still look at you strange if you’ve had testing. That’s just the way it is.”
Some students say they would not get tested if there wasn’t confidentiality.
“The fact that it didn’t go on my record was a big relief to me. I’m sure a lot of students here feel the same way. My insurance is covered by my parents’ policy, and if something like an HIV test was billed to them, I would die,” said one recently-tested student, who wished to remain anonymous.
The bill for the testing is split by the Minnesota Department of Health and University student services fees.
Insurance companies will never be billed because there is no record that the test ever took place, said Maree Hampton, director of health promotions at Boynton.
“It is important that students know they can come to Boynton to get confidential care, if it’s about HIV or other services,” Hampton said. “It may reduce barriers for the students.”
After the patient is tested, a future appointment is made to get the results. Smith said this meeting is not only to return the results, but also to review and reinforce where the risk may be and to answer questions.
“As far as the number of positives, it has been really, really low. That’s good, but it doesn’t mean that they are at a low risk,” Smith said. “Most of the time people test because they suspect they’ve been exposed or have high-risk behavior.”
If a patient’s test is positive, it will remain off Boynton’s records, but according to Minnesota law, it must be reported to the state health department.
HIV testing is done through appointment and is sometimes suggested to those who seem to be at a higher risk, but is not offered as a regular check-up procedure.
Many people feel they are being paranoid by getting an HIV test, Smith said.
“I tell them that no one should be paranoid. We should all have this awareness. Anyone can be exposed.”
Richard Danila, supervisor of HIV and emerging infections at the Minnesota Department of Health, said Minneapolis is in the top 50 high-risk cities in the United States for HIV cases. In Minnesota, between 52 percent and 53 percent of the total HIV and AIDS cases are in the Minneapolis area.
Danila said the number of AIDS cases peaked in 1992 and has declined since then. This is in part because new treatments allow HIV-infected patients to live longer without acquiring AIDS, he said.
Although the number of cases is declining, Danila said there is still a steady flow of between 200 and 300 newly diagnosed cases reported to the state health department annually.