Evaluating the utilization of HIV testing by populations disproportionately affected by HIV/AIDS in high risk San Francisco neighborhoods

A large proportion of people who inject drugs (PWID) and transfemales (male-to-female transgender) in San Francisco live in the Tenderloin and South of Market neighborhoods, where many HIV prevention services are located. Despite living within close proximity to testing sites, these two populations remain disproportionately affected by HIV/AIDS, suggesting underutilization of these services. Identifying determinants of utilization of regular HIV testing (defined as testing every 6 months) may inform community based organizations how to target HIV testing efforts.

We conducted a secondary data analysis of data collected by the National HIV Behavioral Surveillance System in 2012 (PWID) and the TEACH2 Study in 2013 (transfemales). We fitted multivariable logistic regression models to identify correlates of testing regularly among HIV-negative participants from Tenderloin and South of Market.

43.6% of PWID and 76.5% of transfemales had been tested for HIV in the past 6 months. A larger proportion of PWID who had utilize HIV had also participated in individual counseling sessions about HIV prevention (38.4% vs. 19.1%, χ²=15.42, p-value=<0.01), and group counseling sessions about HIV prevention (15.8% vs. 4.8%, χ²=11.52, p-value=<0.01). No significant differences were found between transfemales who had and had not been tested.

Although community based organizations have addressed traditional barriers to accessing preventive care services, such as language, financial, and geographical barriers, the rate of HIV testing remain low among these key populations. Targeted efforts are needed to increase regular HIV testing rates among men, and those who do not access individual and group HIV risk reduction counseling programs.