HIV testing rates and testing locations by race/ethnicity: Data from the Behavioral Risk Factor Surveillance System, 2005

The purpose of this study is to report the HIV testing rates and HIV testing locations among Whites, African Americans, and Hispanics according to a variety of socio-demographic variables. The three research questions: What proportion of individuals has been tested for HIV within each racial/ethnic category?; What are the rates of HIV testing rates based on racial/ethnic background and other socio-demographic characteristics?; and What HIV testing locations are most frequently used, and are there differences among racial/ethnic groups?

The data used for this study comes from the 2005 Behavioral Risk Factor Surveillance System (BRFSS). Participants were recruited from residential households in the United States using an on-going, random-digit-dial telephone survey. The HIV testing rates and testing location was computed using SUDAAN by the weighted percentage of participants in each racial/ethnic group. Cross-tabs and Pearson Chi-squares were used to determine bivariate relationships. The results were based on 252,117 U.S. resident men and women.

Among White participants, individuals having tested for HIV are more likely to be female (OR =1.17; CI =1.12-1.21); to be between the ages of 25 and 34 (OR =2.65; CI =2.43-2.89); and to be individuals whose annual household income less than $25,000.

For African Americans, gender is not a significant factor in HIV testing rates: females have about the same testing rates as males (X 2 = .06, df =1, p= .800). In general, among African American participants, individuals who have tested for HIV are more likely to be between the ages of 25 and 34 (OR =1.54; CI =1.23-1.93); and income level is not a significant factor in HIV testing rates among African Americans (X 2 =3.67, df =3, p= .299).

Among Hispanics, individuals who have tested for HIV are more likely to be female (OR =1.39; CI =1.13-1.72); to be individuals between the ages of 25 and 34 (OR =1.87; CI =1.51-2.32); and individuals with lower incomes (annual household income less than $25,000) may be less likely to have tested for HIV.

In general 41% of the sample report having their last HIV test at a private doctor's office or HMO; about one quarter (24%) of respondents sought testing at a clinic; and one fifth (19%) received testing at a hospital. The location of HIV testing differs among racial/ethnic groups (X 2 =475.9, df =28, p< .001). Whites (44%) and African Americans (41%) were most likely to be tested at a private doctor's office or HMO, while Hispanics (36%) were most likely to be tested at a clinic.

While the paradox remains from the analysis that populations with higher testing rates also have higher infection rates, this inconsistency should not be interpreted to undermine the value of HIV testing as an important prevention method, it may warrant the closer inspection of multiple methods of prevention. Social workers could play an integral role in promoting preventative approaches that do not solely rely on HIV testing, but also promote contextually, culturally, and evidence-based HIV prevention strategies.