Barriers to HIV testing and confidentiality: the concerns of HIV-positive and high-risk individuals.

The authors report that individuals who are at highest risk of contracting HIV indicated the greatest concern about confidentiality and the greatest knowledge of local reporting laws. Although concern about confidentiality may not be cited as the most common reason to delay or defer testing, it is an important consideration for a minority of individuals--the very segment who are at highest risk of contracting HIV and are the most important targets of campaigns to encourage HIV testing. The particular concerns of this critical segment of the population at risk must be directly and carefully addressed and not lost in a general assessment of population-wide attitudes/concerns about HIV testing. Studies that examine individuals' concerns about HIV testing and privacy and do not stratify by level of HIV risk may obscure the important and heightened concerns of this most important subpopulation.