This information cannot be released without the student's written consent, Kasper says. However, if the student does not consent to the release of his confidential file, the medical record may be noted as "incomplete."

Most students will have their medical records transferred as they leave their family insurance policy or move on to graduate school. Insurance companies could question an incomplete record.

"There is no particular reason to get a confidential test at our age," says Kasper. "Anonymous is much preferable. It's better not to have on your medical record. There are cases when people have been discriminated against, even if the results were negative."

Additionally, Harvard students have faced limited access to anonymous tests at sites funded by the Massachusetts Department of Public Health (MDPH) over the last two years.

In 1994, one-third of those receiving tests at MDPH-supported sites like Cambridge City Hospital were college-age students according to Linda J. Frazier, UHS health educator.

"[It's] very clear that for the college-age population testing is important," Frazier says.

Because funding to MDPH has suffered cuts, anonymous testing sites, including one at Cambridge City Hospital, now conduct phone screening to ensure that those who seek testing are in high risk groups, Frazier says. Phone screening actually works to encourage those at low risk not to test.

Although the Harvard student body includes such "high risk" populations as blacks, women, homosexuals and people under age 22, university students as a group are considered low risk, according to Kasper.

Whereas one in four new HIV infections occurs in people under age 22, only one in 500 university students is HIV infected, Frazier says.

Implementation

In response to these observations, the Undergraduate Council a year ago passed a resolution, written by Kasper, calling for the implementation of anonymous HIV testing at UHS.

The resolution sparked a meeting last February between UHS personnel and representatives from AEO and PCC. The task force created during that meeting issued a report on May 21 recommending that "...UHS establish and provide anonymous HIV testing and counseling services. ..."

After deciding to implement that recommendation, UHS administrators turned the report over to an implementation team. In order to ensure students' anonymity, the team "really had to bypass most of our systems," says Michael, a member of the task force.

Everything about the anonymous testing procedure must be standardized. "The only difference between anonymous and confidential testing is on the medical record, not in the quality of care or information available," Frazier says.

Students must call for an anonymous testing appointment during regular business hours, like any other appointment scheduled at UHS. But no identifying information is asked.

The student schedules two appointments, one 45-minute session for pre-counseling and to take the blood sample, and one 15-minute post-test counseling session scheduled for two weeks later.