Regional and Gender Differences in HIV Testing when Risk Factors Are Present: Evidence from the 2012 BRFSS

Objective:  HIV/AIDS remains a significant public health problem affecting every demographic group in the U.S. The CDC estimates that 1.1 million Americans have HIV and nearly 200,000 are unaware of their infection. Testing for HIV, particularly among subgroups with known behavioral risk may facilitate targeted interventions. We analyzed the 2012 Behavioral Risk Factor Surveillance System (BRFSS) data to examine regional and gender differences in voluntary HIV testing among persons reporting known risk factors for HIV and other sexually transmitted diseases.

Methods:  We identified 10,309 (weighted estimate: 86,543) individuals,  >=18 years old who responded ‘yes’ to the BRFSS question (q18.3) on known HIV risk factors. We computed weighted estimates of  those who tested for HIV and measured their association with region, gender and potential confounders. Multiple logistic regression (MLR) generated odds ratios for HIV testing after controlling for confounders.  Results:  The  sample mean age was 64.2 (SD.14.9), 54% male; 51.5% White, 18.9% Black or African American. Approximately 62% had voluntarily tested for HIV. HIV testing was associated with region of residence and gender (p<0.001). MLR showed that compared to the Northeast, respondents from the Midwest (OR: 0.51: 95%CI: 0.40 - 0.65, p =0.001) and West (OR: 0.73: 95%CI: 0.57 – 0.93, p= 0.001) had significantly lower odds of getting tested for HIV. Women had 1.5 times greater odds of HIV testing than men (OR: 1.57; 95% CI: 1.33 -1.85, p=0.001). Conclusion: HIV/AIDS prevention outreach strategies stressing the benefits of early testing and treatment should focus on populations most at risk.