HIV testing rates, testing locations, and healthcare utilization among urban African-American men. J Urban Health 2009 Jan;86(1):119-31
Date
12/11/2008Pubmed ID
19067176Pubmed Central ID
PMC2629519DOI
10.1007/s11524-008-9339-yScopus ID
2-s2.0-58649121048 (requires institutional sign-in at Scopus site) 51 CitationsAbstract
African-American men bear a disproportionate burden of HIV infection in the United States. HIV testing is essential to ensure that HIV-infected persons are aware of their HIV-positive serostatus, can benefit from early initiation of antiretroviral therapy, and can reduce their risk of transmitting the virus to sex partners. This cross-sectional study assessed HIV testing history and healthcare utilization among 352 young African-American men recruited in urban neighborhoods in a Midwestern city. The self-administered survey measured sexual risk behaviors, factors associated with HIV testing, and barriers to testing. The acceptability of community venues for HIV testing was also assessed. Of the respondents, 76% had been tested for HIV at some time in their lives, 52% during the prior 12 months. Of the participants, 70% had unprotected intercourse during the prior 12 months, 26% with two or more partners. Nearly three-quarters (72%) of participants had seen a healthcare provider during the prior year. In univariate analyses, those who had at least one healthcare provider visit during the prior 12 months and those who had a primary doctor were more likely to have been tested in the prior 12 months. In multivariate analyses, having a regular doctor who recommended HIV testing was the strongest predictor of having been tested [OR=7.38 (3.55, 15.34)]. Having been diagnosed or treated for a sexually transmitted disease also was associated with HIV testing [OR=1.83 (1.04, 3.21)]. The most commonly preferred testing locations were medical settings. However, community venues were acceptable alternatives. Having a primary doctor recommend testing was strongly associated with HIV testing and most HIV testing occurred at doctors' offices. But, a substantial proportion of persons were not tested for HIV, even if seen by a doctor. These results suggest that HIV testing could be increased within the healthcare system by increasing the number of recommendations made by physicians to patients. The use of community venues for HIV testing sites could further increase the number of persons tested for HIV.
Author List
Petroll AE, DiFranceisco W, McAuliffe TL, Seal DW, Kelly JA, Pinkerton SDAuthors
Wayne J. DiFranceisco Research Scientist II in the Psychiatry and Behavioral Medicine department at Medical College of WisconsinJeffrey A. Kelly PhD Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Timothy L. McAuliffe PhD Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
Andrew Petroll MD Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Educational Status
Employment
HIV Infections
Health Services
Health Services Accessibility
Health Services Research
Humans
Male
Middle Aged
Physicians, Family
Risk-Taking
Sexual Behavior
United States
Urban Population
Young Adult
