HIV antibody testing among those at risk for infection. The National AIDS Behavioral Surveys. JAMA 270: 1576-1580

Center for AIDS Prevention Studies, Department of Medicine, San Francisco, CA 94105.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 11/1993; 270(13):1576-80.
Source: PubMed


To determine the prevalence of testing for human immunodeficiency virus (HIV) antibody among adults with various risk factors for infection, particularly those residing in large metropolitan areas where the bulk of cases of acquired immunodeficiency syndrome (AIDS) have occurred.
A nationwide, population-based telephone survey eliciting testing, sexual, and injection drug use histories.
A total of 2673 randomly chosen US residents and 8263 randomly chosen residents of 23 metropolitan areas containing 64% of reported cases of AIDS.
Testing for HIV antibody.
Overall, rates of individuals ever tested were only slightly higher in the urban areas (23%) than in the nation as a whole (21%). Testing frequencies were low among all risk groups (less than 40%), except men engaging in same-sex sexual activity (60%) and male and female injection drug users (46% and 73%, respectively). The low rate of testing (35%) among the largest risk group, heterosexual men and women engaging in unprotected sexual intercourse with multiple partners, was particularly worrisome.
To encourage antibody testing among the many at risk for infection who have not yet been tested, promotional campaigns should explain the universal susceptibility to infection among those at risk, and the availability of prophylactic medical therapies and social support services to persons who are HIV-seropositive. As there were comparable levels of risk-taking behavior among subjects in both samples, these campaigns must be designed to reach all segments of the population.

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    • "Men and women who reported that they personally knew someone who had HIV/AIDS were more likely to have ever taken an HIV test, and women who believed that HIV was worse in their community than in other communities in Philadelphia were more likely to have tested. These findings are supported by other research that has shown that personally knowing someone who has HIV or AIDS is associated with a higher perceived risk for HIV (Henson et al., 1998) and an increased likelihood of HIV testing (Berrios et al., 1993), and that a perception of community risk may motivate some high-risk individuals to test (Downing et al., 2001). "
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    ABSTRACT: This study determined the overall prevalence of HIV testing within a community sample of heterosexual men and women at high risk for HIV infection, and analysed the gender-specific individual- and structural-level barriers and facilitators to testing. Data were collected through 1,643 personal interviews conducted in Philadelphia between 1999 and 2000. Overall, 79.4% of participants had ever taken an HIV test; women were significantly more likely to have tested than were men. Among the individual-level factors we examined, very few, including sexual and drug-using risk behaviours, were significantly associated with an increased likelihood of ever being tested for HIV. Structural-level factors were important correlates of HIV testing for both women and men. Results of this study indicate that there are gender-based similarities and differences in the correlates of testing, and that efforts to increase HIV testing must consider how structural factors, including access to health care, may deter or facilitate opportunities for HIV testing. In particular, efforts to improve the uptake of HIV testing by heterosexual men at high risk should focus on improving men's access to, and utilization of, routine health care.
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    ABSTRACT: This paper assesses consistency in self-reports of human immunodeficiency virus testing using two waves of longitudinal data from a large, national probability survey, the National AIDS Behavioral Survey. Of those reporting at Wave I that they had been tested for reasons other than blood donation, 18 percent reported at Wave 2 that they had never been tested. Of those reporting at Wave I that they had been tested when they donated blood, 29 percent reported at Wave 2 that they had never been tested. Inconsistent responses may be due to poor recall and to high self-presentation bias, that is, a desire to provide socially acceptable answers. Poor recall may be exacerbated by passive conditions such as blood donation. The authors conclude with recommendations for reducing measurement error in surveys of testing behavior.
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    ABSTRACT: The National AIDS Behavioral Survey (1990-1992) of heterosexual adults (18-49 years) measured human immunodeficiency virus (HIV) risk factors, condom use, and HIV antibody testing, with a focus on major "high-risk" cities. A longitudinal survey was conducted. There was little reduction in the overall prevalence of HIV risk factors in the national or high-risk cities cohorts over time. Despite this picture of stability, approximately 39% of the population at risk for HIV because of multiple sexual partners turns over annually. There was little change in HIV test-seeking or in consistent condom use with primary sexual partners. Although the majority of at-risk respondents used condoms sporadically or not at all (65%), a significant increase in condom use was found among those reporting multiple sexual partners in both waves, particularly among Black heterosexuals. Data from other surveys and condom sales nationally support the findings. There is a need for a series of surveys in this area to assess the reliability of the present findings and to monitor the general US population's response to prevention programs.
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