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.
HIV HIV risk perception HIV risk behaviors sexual behavior testing practices
Holtgrave DR. Estimation of annual HIV transmission rates in the United States, 1978–2000. J Acquir Immune Defic Syndr. 2004;35:89–92.PubMedCrossRefGoogle Scholar
Karon JM, Fleming PL, Steketee RW, De Cock KM. HIV in the United States at the turn of the century: an epidemic in transition. Am J Public Health. 2001;91:1060–8.PubMedGoogle Scholar
Centers for Disease C, Author: Prevention. Increases in HIV diagnoses—29 States, 1999–2002. MMWR. 2003;52:1145–8.Google Scholar
Wolitski RJ, MacGowan RJ, Higgins DL, Jorgensen CM. The effects of HIV counseling and testing on risk-related practices and help-seeking behavior. AIDS Educ Prevent. 1997;9(3 S):52–67.Google Scholar
Weinhardt LS, Carey MP, Johnson BT, Bickham NL. Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985–1997 [see comment]. Am J Public Health. 1999;89:1397–405.PubMedGoogle Scholar
Anonymous. Adoption of protective behaviors among persons with recent HIV infection and diagnosis—Alabama, New Jersey, and Tennessee, 1997–1998. MMWR. 2000;49:512–5.Google Scholar
Carpenter CC, Cooper DA, Fischl MA, et al. Antiretroviral therapy in adults: updated recommendations of the International AIDS Society-USA Panel. JAMA. 2000;283:381–90.PubMedCrossRefGoogle Scholar
Holtzman D, Bland SD, Lansky A, Mack KA. HIV-related behaviors and perceptions among adults in 25 states: 1997 Behavioral Risk Factor Surveillance System. Am J Public Health. 2001;91:1882–8.PubMedGoogle Scholar
Catania JA, Gibson DR, Chitwood DD, Coates TJ. Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990;108:339–62.PubMedCrossRefGoogle Scholar
Berrios DC, Hearst N, Coates TJ, et al. HIV antibody testing among those at risk for infection. The National AIDS Behavioral Surveys. JAMA. 1993;270:1576–80.PubMedCrossRefGoogle Scholar
Anderson JE, Carey JW, Taveras S. HIV testing among the general US population and persons at increased risk: information from national surveys, 1987–1996. Am J Public Health. 2000;90:1089–95.PubMedCrossRefGoogle Scholar
Valdiserri RO, Weber JT, Frey R. Trends in HIV seropositivity in publicly funded HIV counseling and testing programs: implications for prevention policy. Am J Prev Med. 1998;14:31–42.PubMedCrossRefGoogle Scholar
Prevention CfDCa. (Centers for Disease Control and Prevention). HIV Counseling and Testing in Publicly Funded Sites Annual Report 1997 and 1998. 2001.Google Scholar
Epstein RM, Morse DS, Frankel RM, Frarey L, Anderson K, Beckman HB. Awkward moments in patient-physician communication about HIV risk. Ann Intern Med. 1998;128:435–42.PubMedGoogle Scholar
Wenrich MD, Curtis JR, Carline JD, Paauw DS, Ramsey PG. HIV risk screening in the primary care setting. Assessment of physicians skills [see comment]. J Gen Intern Med. 1997;12:107–13.PubMedGoogle Scholar