Uptake of HIV testing during post-reproductive years among midlife women (50-64 years old): An analysis of 2008 Behavioral Risk Factor Surveillance System survey data from six Deep South states (Alabama, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina)

Objective: To examine HIV testing uptake among post-reproductive age women. Background: Many women are routinely tested for HIV during pregnancy. Disproportionate numbers of women beyond reproductive age are diagnosed HIV-positive late in the disease course. Some older women and healthcare providers have dismissed early AIDS symptoms as signs of aging. This has resulted in missed opportunities for early initiation of effective antiretroviral therapy. Methods: Behavioral Risk Factor Surveillance System 2008 data were analyzed for non-Hispanic white and non-Hispanic black women (50-64 years) from six Deep South states. Logistic regression models examined associations between uptake of HIV testing and population/behavioral characteristics. Results: More than half (n=1,091) of our sample (n=2,027) had an HIV test during their post-reproductive years (>45 years old). Women 50-54 years old (AOR=0.64, 95% CI 0.46-0.88) were less likely to have been tested for HIV during their post-reproductive years than those 60-64 years old. Urban (AOR=1.53, 95% CI 1.15-2.03) and suburban (AOR=1.66, 95% CI 1.09-2.52) women were more likely to have been tested for HIV beyond reproductive age than rural women. Compared to non-Hispanic black women, non-Hispanic white women were less likely to have been tested for HIV in more recent years (AOR=0.48, 95% CI 0.36-0.64). Vulnerable domain population characteristics were not potential confounders in the final population/behavioral characteristics model. Discussion: Routine HIV testing is underutilized among women during their post-reproductive years. HIV prevention messages that target midlife women are needed to reduce the prevalence of HIV/AIDS and disproportionate burden of late diagnosed HIV infection in this population.