Need to Improve Routine HIV Testing of U.S. Veterans: Results of an Internet Survey

Background: Late diagnosis of HIV infection contributes to poor medical outcomes and helps sustain continued transmission of virus. Published evidence suggests that despite current public health recommendations, patients receiving care in the Veterans Health Administration (VA) system are not being routinely tested for HIV infection. Using a sample of computer-literate veterans, we conducted a survey of recent testing experiences.

Methods: My HealtheVet (MHV) is a secure website allowing registered veterans to access limited personal VA health information. Using the American Customer Satisfaction Index (ACSI) Survey, an electronic questionnaire on “Health Screening” was conducted in late Fall 2008. A random sample (4%) of MHV users were surveyed; approximately 17% completed the survey (12,712).

Results: Only 9% of the respondents indicated that they have been offered a test for HIV in the last 12 months compared to 83% who had been offered cholesterol screening and 19% who had been offered testing for Hepatitis C virus (HCV). Of those who had been offered HIV testing, 91% indicated that they'd had the test performed. Of note, the percentage of respondents who indicated that they would “very likely” accept a test, if offered, was similar for HIV (73%), HCV (79%) and cholesterol (75%).

Conclusions: Although these results cannot be generalized to all veterans in care, they support growing evidence that routine testing for HIV is not taking place. Efforts targeted at both providers and patients must be undertaken in order to promote routine testing of HIV in support of the goal of early HIV diagnosis.