Factors associated with HIV testing among undergraduate university students

Background: In the context of persistent increases in HIV incidence among young adults (18–29 years) in the United States in recent years, research indicates that HIV testing rates remain lower in this population compared to all other age groups. Contrary to widely held assumptions that more education necessarily predicts healthier behavior, undergraduate university students test at even lower rates than their nonstudent peers. Methods: We conducted a cross-sectional survey of undergraduates at a large, ethnically diverse public university in Orange County, California (n=1,210) to assess history of having ever tested for HIV and to identify factors associated with testing. We used multiple logistic regression to control for demographic, psychosocial, and health status covariates that were significantly associated with HIV testing in our bivariate analyses. Results: Students were 62.3% female, 63.2% non-white, and 57.8% from households with annual incomes less than $50,000. The mean age was 20.9 years (SD=3.4), and 96.2% of students identified as heterosexual. Whereas 73.4% of students had at least one sex partner in the past year, only 26.3% had ever tested for HIV. Testing was associated with older age [AOR=1.19 (95% CI=1.12, 1.27)]; being female [AOR=2.86 (1.94, 4.23)]; African-American [AOR=2.47 (1.09, 5.61)]; having a higher number of sexual partners [AOR=1.40 (1.25, 1.58)]; a history of sexually transmitted infection other than HIV [AOR=3.35 (1.96, 5.71)]; and verbal abuse victimization (AOR=1.69 (1.06, 2.69)]. Conclusions: Programs to scale up HIV testing for undergraduates are needed and should particularly engage younger, male students and victims of abuse from diverse racial/ethnic groups.