Study examines how age and ethnicity impact HIV testing
RIVERSIDE, Calif. — Many barriers prevent people from getting tested for HIV, including lack of knowledge, competing priorities during medical visits, and stigma associated with the test on the part of both the patient and provider.
Not much is known, however, about what impact age and ethnicity have on HIV testing.
Brandon Brown, an HIV researcher at the University of California, Riverside's School of Medicine, is the lead author on a study published today in the journal Medicine, in which he and his co-authors argue that interventions are urgently needed to reach older adults and Hispanics to address HIV testing and beliefs.
"These interventions must debunk beliefs among physicians that older adults are not sexually active, and beliefs among older adults that only others are at risk of HIV," said Brown, an associate professor of social medicine, population, and public health.
The study also found that Hispanic participants were less likely to receive HIV testing than non-Hispanic participants.
"Timely interventions, including HIV testing, are especially important for the Hispanic community in the United States because Hispanics are disproportionately affected by HIV," Brown said. "They account for 20 percent of HIV infections, with a rate of three-to-four times that of whites."
Brown and colleagues explored data on self-reported HIV risk and willingness to be tested. They focused on age and ethnicity in the Coachella Valley using the 2014 Get Tested Coachella Valley Community Survey. The team collected data from nearly 1,000 participants related to demographics, sexual history, HIV testing history, thoughts on who should get tested, and future preferences for HIV testing.
"We found stigma, education, provider recommendations, risk perceptions, and cost are among major factors contributing to accepting HIV testing and intention to receive HIV testing," Brown said.
More than 1 million people live with HIV in the United States, with as many as 25 percent likely unaware of their HIV status. The Coachella Valley holds more than half the people living with HIV and AIDS in Riverside County, California's fourth-largest county by population. Approximately 24 percent of people living with HIV in the Coachella Valley are aged 60 or older. Caucasians make up about 74 percent of the population; nearly 20 percent are Hispanic.
The study also found:
- Most untested participants did not believe they are at risk.
- Men were more likely than women to have been tested.
- Significantly fewer participants aged 50 or older said they are at risk of HIV compared to participants younger than 50.
- Participants aged 50 or older were less likely to be tested for HIV compared to participants between the ages of 25 to 49.
- Compared to younger participants, significantly fewer participants aged 50 years or older accepted HIV testing when it was offered by a health care provider.
- Older adults tend to underestimate their HIV risk and severely delay HIV testing or forgo testing altogether.
- Older adults are more likely than younger adults to be diagnosed with HIV later in the disease course.
- Many participants claimed they would get tested if their health care provider offered testing.
"Our recommendations to health care providers are that they talk directly with their patients during clinical visits about HIV prevention and HIV risk, and that they routinely offer HIV screening as part of primary care," Brown said.
Brown, a member of the Center for Healthy Communities, was joined in the study by Logan Marg and Zhiwei Zhang of UCR; Jenna LeComte-Hinely of Health Assessment and Research for Communities Inc., Palm Desert; David Brinkman of Desert AIDS Project, Palm Springs; and Greer Sullivan of Borrego Community Health Foundation.
The study was supported in part by the UCLA/Charles R. Drew University – Resource Centers for Minority Aging Research "Center for Health Improvement of Minority Elderly"; and the UCLA Clinical and Translational Science Institute.
The University of California, Riverside is a doctoral research university, a living laboratory for groundbreaking exploration of issues critical to Inland Southern California, the state and communities around the world. Reflecting California's diverse culture, UCR's enrollment is now nearly 23,000 students. The campus opened a medical school in 2013 and has reached the heart of the Coachella Valley by way of the UCR Palm Desert Center. The campus has an annual statewide economic impact of more than $1 billion.