HIV Testing Rates and Testing Locations, by Race and Ethnicity
Rountree, Michele A., Chen, Lynn, Brown, Adama, Pomeroy, Elizabeth C., Health and Social Work
In 2001, the Centers for Disease Control and Prevention (CDC), proposed, a new HIV-prevention strategy, titled HIV Prevention Strategic Plan through 2005," with the aim of increasing the U.S. population's knowledge of their HIV status by 25 percent. HIV testing was promoted as a core strategy in this initiative on the basis that knowledge of HIV status reduces the likelihood that a person will transmit the virus to others. Of course, early detection of the virus is also critical for initiating life-saving treatment. The CDC (2005b) reported that approximately 25 percent to 30 percent of individuals in the United States infected with HIV are unaware of their positive status and that less than half (48 percent) of the population (18 years and older) has been tested for HIV.
Given the importance of HIV testing, it is important to quantify rates of testing and determine whether and how testing rates vary by sociodemographic factors. Scholarship in this area has shown that HIV testing rates vary according to race (Fernandez, Perrino, Bowen, Royal, & Varga, 2003; Fernandez, Perrino, Royal, Ghany, & Bowen, 2002; Zaidi et al., 2005), age (Lekas, Schrimshaw, & Siegel, 2005; Nguyen et al., 2006; Opt & Loffredo, 2004), gender, educational level, and marital status (Ebrahim, Anderson, Weidle, & Purcell, 2004; Inungu, 2002). However, few studies have compared different racial--ethnic groups' HIV testing rates relative to multiple sociodemographic characteristics (Ebrahim et al., 2004; Inungu, 2002). This study examined the Behavioral Risk Factor Surveillance System (BRFSS) 2005 data to determine HIV testing rates and the frequency of use of various testing locations among white, African, and Hispanic Americans.
Race-Ethnicity and HIV Testing
There are clear differences in HIV testing rates among race and ethnicity (Ebrahim et al., 2004; Inungu, 2002; Liddicoat, Losina, Kang, Freedberg, & Ealensky, 2006). Ebrahim et al. examined the 2001 BRFSS data and found that HIV testing rates were significantly higher for African Americans and Hispanics compared with white Americans. Similarly, Liddicoat et al. found that African Americans, when compared with white Americans, are more likely to report previous HIV tests. The CDC (2006c) corroborated these findings in a study in which HIV testing rates were higher among Hispanics than among other races except for African Americans.
Gender and HIV Testing
Gender is an important sociodemographic variable in the consideration of HIV testing (Inungu, 2002; Kalichman & Coley, 1995; Kline & Strickler, 1993). Researchers from different time periods showed different results regarding HIV testing rates for men and women. In the early 1990s, few women sought HIV testing (Kalichman & Coley, 1995; Kline & Strickler, 1993). However, as HIV prevention efforts increased, women reported higher testing rates than men (Inungu, 2002).The 2001 BRFSS (CDC, 2003) shows that, overall, men and women were tested at comparable rates.
Age and HIV Testing
A number of studies (Grinstead, Peterson, Faigeles, & Catania, 1997; Inungu, 2002; Liddicoat et al., 2006; Nguyen et al., 2006) have examined HIV testing rates in relation to age. Nguyen et al. indicated that 50 percent of all new HIV infections in the United States were among adolescents (ages 10 to 19 years) and young adults (ages 20 to 24 years). In addition, among those infected, half had not been tested. Liddicoat et al. found that older patients generally refused testing because of a perceived lack of risk for infection. These findings are in fine with the results of Inungu that individuals 18 to 24 years of age and those 50 years and older were less likely to have been tested for HIV compared with those ranging in age from 25 to 49.
Education and HIV Testing
Educational level has been studied extensively in relation to HIV testing. …