, Volume 20, Issue 7, pp 618-622

A population-based study of HIV testing practices and perceptions in 4 U.S. states

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OBJECTIVE: To evaluate testing practices and perceptions of HIV risk among a geographically diverse, population-based sample of sexually active adults who reported behaviors that could transmit HIV.

DESIGN: Secondary analysis of the Centers for Disease Control and Preventions Behavioral Risk Factor Surveillance System (BRFSS) 2000 survey.

PATIENTS/PARTICIPANTS: Sexually active adults less than 50 years old, who completed the Sexual Behavior Module of the BRFSS 2000 survey administered in 4 U.S. states.

MEASUREMENTS AND MAIN RESULTS: Nineteen percent of the study population reported one or more behaviors in the past year that increased their risk of HIV infection (men 23%; women 15%). In this subgroup at any increased risk of HIV infection, 49% reported having had an HIV test in the past year. For 71% of those tested, the HIV test was self-initiated. Younger age was the only factor independently associated with whether or not individuals with behaviors that increased their risk of HIV infection had had a recent HIV test. Among the 51% of individuals at risk who reported no recent HIV test, 84% perceived their risk as low or none.

CONCLUSIONS: In this study, about half of the individuals who reported behaviors that could transmit HIV had not been recently tested for HIV. Of those not tested, most considered their risk of HIV to be low or none. Interventions to expand HIV testing and increase awareness of HIV risk appear to be needed to increase early detection of HIV infection and to reduce its spread.

The authors have no conflicts of interest to report.
This study was supported by the Northwest VA Seattle Epidemiologic Research and Information Center (ERIC) and the Northwest Center of Excellence of Health Services Research and Development. Dr. Takahashi and Dr. Johnson are staff physicians at the VA Puget Sound Health Care System, and Dr. Takahashi is currently supported by the National Institute on Drug Abuse (NIDA #RO3DA14518). Dr. Bradley is an investigator at the VA Puget Sound Health Care System and is currently supported by the National Institute of Alcohol Abuse and Alcoholism (NIAAA #K23AA00313) and was a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar at the time this study was conducted. This study was presented as a poster at the Society of General Internal Medicine Annual Meeting, Vancouver, British Columbia, April 30–May 3, 2003. We thank Freya Spielberg, MD, MPH for her critical review of the manuscript.