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HIV testing and reporting to Public Health in Ontario

HIV testing and reporting to Public Health in Ontario

HIV is the Human Immunodeficiency Virus.

If left untreated, HIV can lead to AIDS. AIDS is the Acquired Immunodeficiency Syndrome.

Being infected with HIV is often called “living with HIV” or being “HIV positive”. With treatment, HIV can be a chronic, manageable medical condition that is unlikely to lead to AIDS.

HIV testing

In Ontario, there are two main ways you can get tested for HIV: nominal testing and anonymous testing.

Nominal testing means you are tested using your name. You might need an Ontario Health Insurance Plan (OHIP) card or number to get a nominal test. See Nominal HIV testing.

Anonymous testing means you are tested without using your name. You do not need an OHIP card or number to get an anonymous test. See Anonymous HIV testing.

Recently, some people have been able to get HIV self-testing kits that allow them to test themselves on their own or with the help of others such as community organizations. If you test positive for HIV using a self-testing kit, you will usually have to get a nominal or anonymous test before you can get medical care for HIV.

If you are using HIV self-testing kits with the help of others such as community organizations, ask the following questions before the test and before you share any health information:

  • How will my health information be stored?
  • Will my health information be shared with others, including Public Health authorities in Ontario?

Informed consent for HIV testing

It is your choice to be tested for HIV or not. You must give your informed consent. This means before the test, a healthcare provider must tell you:

  • about the different testing options and what can happen after you get tested
  • whether your name or other personal information will be shared with Public Health authorities in Ontario

You should also be offered pre- and post-test counselling. If you are tested for HIV without your informed consent, you may want to get legal advice. See Getting legal help.

Nominal HIV testing

Nominal HIV testing is done through a healthcare provider. The test order form asks for the reason that you want the test. The form also asks for personal information, including your:

  • name, date of birth, and country of birth
  • gender
  • race, ethnicity, and Indigeneity
  • HIV-related risk factors
  • contact information

If your nominal test is positive, the testing laboratory will report your HIV infection and other personal information, including your name and contact information, to Public Health authorities in Ontario. If you test positive for some other medical conditions, including some sexually transmitted infections (STIs), they are also reported.

Your local Public Health Unit will then contact you to offer counselling and support, and to make sure that you have been referred to HIV-related services, including medical care.

Your local Public Health Unit will also require that your sexual and needle-sharing partners be notified that they may have been exposed to HIV. This is known as contact tracing, partner counselling, or partner notification. Depending on the circumstances, your local Public Health unit might:

  • let you, your doctor, or your nurse practitioner notify your partners and may require proof that your partners were notified
  • contact your partners directly

Even though Public Health will not give your name to your partners, your partners might figure out that it is about you.

Anonymous HIV testing

Anonymous HIV testing is only done through anonymous testing clinics. See Find an anonymous testing clinic. Doctors’ offices do not do this.

Anonymous testing clinics test for HIV using a test code instead of your name. But other personal information will be included on the test order form, such as the reason for the test and your:

  • year of birth and country of birth
  • gender
  • race, ethnicity, and Indigeneity
  • HIV-related risk factors

You might be asked for your year of birth and the name of the town or city where you live. If you do not want to give this information, you can just give the year you were born.

Testing and results

Anonymous testing clinics use the “rapid HIV test”, also known as the “point of care” test. The test requires a drop of blood from a finger prick. The test result is available in a few minutes.

If your rapid test is “negative”, it means HIV is not showing in your blood at the time of the test. It can take up to 3 months for HIV to show in your blood, so a counsellor will talk to you about if you should have another test at a later date. The counsellor will also talk to you about protecting yourself from future risks.

If your rapid test is “reactive”, it means you most likely have HIV. A second laboratory test is needed to confirm this. The counsellor will talk to you about having this second test. The second test is still anonymous and will not include your name or contact information, but you will be asked for the other information noted above. A sample of your blood is taken and sent to the testing laboratory. It takes about one week to get your test result.

A counsellor will meet with you again to talk about the result. If your second test confirms that you are HIV positive, then the counsellor will talk to you about:

  • managing your health and HIV, and accessing medical care
  • preventing the transmission of HIV
  • getting support and more information

Reporting to Public Health authorities

If your second test is positive for HIV, the testing laboratory will also tell Public Health authorities in Ontario the test result but will not include your name or contact information.

In the past, doctors and nurse practitioners who provided HIV medical care were required to report your name to Public Health authorities, even if you tested HIV positive anonymously. This is no longer required, as long as the doctor or nurse practitioner orders an anonymous viral load test. It is important that they do not also order a nominal HIV test, as your name will be reported if they do.

Not all doctors and nurse practitioners are aware of this change. This means your name may be reported to Public Health authorities when you seek medical care, even if you had an anonymous HIV test.

Anonymous viral load test

A viral load test measures the amount of HIV in your blood and is used to make decisions about your treatment. It can also be used to confirm that you are living with HIV.

An anonymous viral load test is a viral load test ordered without your name. To get one, you need a test code from the anonymous testing site. The test code can be used to order viral load tests on an ongoing basis.

Keeping results private from Public Health authorities

To reduce the possibility that Public Health authorities in Ontario will learn that you are living with HIV:

  • keep your anonymous test code, and
  • contact the HIV & AIDS Legal Clinic Ontario (HALCO) for free legal advice as soon as possible after you receive the positive test result and before you seek medical treatment. See Getting legal help.

HALCO will follow-up with the doctor or nurse practitioner about your care, treatment, and the option of anonymous viral load testing.

It is important to remember that even if you have an anonymous viral load test, Public Health authorities might still find out that you are living with HIV. For example, a member of the public who knows you are living with HIV may report you to Public Health authorities, or a hospital administrator may be required to report your name and contact information if they know you are living with HIV.

Find an anonymous testing clinic

Anonymous HIV testing is free in Ontario. To find a clinic, contact the free, anonymous, and confidential Sexual Health Infoline Ontario:

Getting legal help

The HIV & AIDS Legal Clinic Ontario (HALCO) provides free information and legal services for people living with HIV in Ontario, even if not related to HIV. For more information visit halco.org or call toll-free 1-888-705-8889 or 416-340-7790.