HIV testing among adults with a disability, 2005 and 2008 NHIS

Background: People with a disability (PWD) have been found to be at higher risk for HIV due to increased risk of sexual assault, higher rates of substance abuse and limited knowledge about HIV prevention. In 2006, CDC introduced revised recommendations, advising routine HIV screening for all persons aged 13-64. It is important to establish that public health efforts to increase HIV screening result in similar increases among all sub-populations. This work assesses how this policy change affected HIV screening among PWD.

Methods: Data from the 2005 and 2008 National Health Interview Survey (NHIS) were used to determine the prevalence of HIV testing among adults aged 18-64 years with and without a disability. The data were stratified by several socio-economic and health measures and multivariate analyses were used to control for these in assessing HIV screening by disability.

Results: PWD report a higher prevalence of ever having an HIV test than do those without a disability (2005: 47.7% vs. 38.6%; 2008: 49.9% vs. 44.1%). Following the recommendation change, there was a larger increase among people without a disability (PWOD) (5.5% points) than PWD (2.2% points). In addition, testing among PWD in select socio-demographic groups decreased (specifically respondents aged 18-34, Hispanics and the unemployed), while it increased for PWOD.

Conclusion: The narrowing of the gap in prevalence of HIV testing between PWD and PWOD suggests that the implementation of the new recommendations may have had less of an impact on PWD, especially given that PWD seek medical care more often than PWOD.