Clients who dare not speak their name.

At a public sexual health clinic in Sydney that gives clients the option not to provide a surname, 5% of first-time clients in 1998-2004 took advantage of that offer. (1) These clients were less likely than others to have had contact with an infected partner, to have STD symptoms or to receive a diagnosis of an STD other than HIV (unadjusted odds ratios, 0.6-0.8); they were more likely to be seeking HIV testing or STD screening (1.4-1.6). Multivariate analysis showed that heterosexual men were more likely than women not to give a surname (1.3); currently and formerly married clients and, especially, those who did not report their marital status were more likely than never-married clients to opt for anonymity (1.6-5.5). Other characteristics associated with not giving a surname were having had a same-sex partner in the past 12 months, having had no partner in the past three months and receiving an HIV test at the initial clinic visit (1.2-1.5); sex workers were particularly likely to choose this option (5.7). The researchers observe that clients who chose anonymity "were not conspicuously at higher or lower risk" than others. They add, however, that "in settings where sex workers have higher [STD] rates, offering an anonymous option could have a marked public health benefit."

(1.) Spillane HC et al., Who declines to give a name at a sexual health service? Sexually Transmitted Infections, 2007, 83(2):160-162.