An evaluation of disparities in HIV testing among Nevadans

Background: In 2006, the CDC revised recommendations for HIV testing among adults, to include the incorporation of HIV testing into routine medical care. The purpose of this study was to determine: which factors are most strongly associated with reporting never being tested for HIV among adult Nevadans and if disparities exist by race and gender.

Methods: A cross-sectional analysis was performed using aggregated weighted data from 2003-2005 Nevada Behavioral Risk Factor Surveillance System. Using SAS v9.1, multivariate logistic regression was used to evaluate which variables were potential risk factors for never being tested for HIV. Weighted odds ratios and 95% confidence intervals were obtained for all participating respondents 18 years or over (N=9,029) in Nevada.

Results: For all three years combined, a total of 3,627 [53.2% (95% CI 51.4 - 54.9)] respondents reported never being tested for HIV. Significant predictors associated with HIV testing included high risk sexual behavior, age, healthcare coverage, and education. Males were significantly more likely to not get tested compared with female respondents [OR=1.2 (95% CI 1.1 – 1.4)]. Respondents classifying themselves as a race other than white [64.8% (95% CI 61.4-68.1)] were twice as likely to not have any health care coverage compared with the white subgroup [35.2% (95% CI 31.9-38.6)], a significant predictor for not getting tested.

Conclusions: Our findings suggest that simply incorporating HIV testing into routine medical care may not address lack of testing among minority populations. Larger epidemiological studies are necessary to investigate whether true disparities exist for not getting HIV tested.