Information

 

Definition of HIV Testing

According to World Health Organization, HIV testing determines whether or not the person is infected with HIV virus. It is recommended by CDC that every one at age 13-64 get to tested at least once, and high risk groups get it more often. Testing can be performed in both health care or non-health care settings. There are different technologies for HIV testing, those of which include: antibody screening test, which is the most common, antigen detection tests, and follow-up diagnostic tests upon positive detection during the initial test. 

 

Definition of HIV

Human Immunodeficiency Virus, or HIV, is a life-long virus that remains untreatable. HIV breaks down the immune system and is most commonly contracted through unprotected sexual relations.

According to the Center for Disease Control and Prevention, “the most common ways HIV is transmitted is through anal or vaginal sex or sharing drug injection equipment with a person infected with HIV” (2014). The CDC states that the diagnosis of HIV refers to “persons diagnosed with HIV infection, regardless of the stage of disease at diagnosis (i.e., HIV infection Stage 1, 2, 3 [AIDS], or unknown), from 50 states, the District of Columbia, and 6 U.S. dependent area” (2013). HIV can advance to AIDS, or Acquired Immune Deficiency Syndrome, by destroying CD4 positive T cells (AIDS.com).

 

Testing Helps Prevent Disease Transmission

According to the data in 2009, about 18.1% of HIV positive individuals didn’t know about their HIV status and more than 1.1 million people in the United States are living with HIV infection, and almost 1 in 6 (15.8%) are unaware of their infection (CDC). Early knowledge of HIV positive status provides opportunities for individuals to seek treatment, reduce risk of transmission to partners or children, and reduce HIV related morbidity and mortality rates. Early detection of positive status also allows an individual to seek education to make informed decisions about sexual behaviors. Effective HIV treatment reduces, by up to 96%, the chance that the patient will transmit the virus to his/her sexual partner (WHO).

 

HIV Testing Statistics

“More than half (54%) of U.S. adults, aged 18-64, report ever having been tested for HIV, including 22% who report being tested in the last year.  The share of the public saying they have been tested for HIV at some point increased between 1997 and 2004, but has remained fairly steady since then. Of those U.S. adults, aged 18-64, who say they have never been tested for HIV, nearly 6 in 10 (57%) say it is because they do not see themselves as at risk” (KFF, 2012).

For more information, please visit here.

 

Groups at Risk

Racial Disparities

  • 47% of new infections were among the African American population
  • In 2011, more HIV infections were diagnosed in African Americans (60.4 per 100,000) and Hispanic (19.5 per 100,000) compared to Whites (7.0 per 100,000)
Self-Reported HIV Testing by Race/Ethnicity: Adults 18 and Older that have ever been tested. January-June 2013

picture 1

Retrieved from CDC

Age Disparities & Gender Disparities

  • Youth (ages 13-24) counted for 21% of HIV diagnoses
  • Older individuals (50 and older) made up 17% of the overall HIV diagnoses,
  • Ages 50-54 making up 39.6% of those diagnoses
  • Adult Males counted for 78.7% of the new HIV cases
Self-Reported HIV Testing by Age and Gender

testing

Retrieved from CDC

 

Estimated New Incidence of HIV (2010)

picture3

Retrieved from CDC

Other High Risks Groups

Males who have Sex with Males (MSM)

    • 49.8% who were diagnosed with HIV were MSM

Injection Drug Use (IDU)

    • 3.2% of males contracted HIV through IDU
    • 6.7% of female contracted HIV through IDU
    • 3.9% of all cases were contracted through IDU

It is also high among people who trade sexual favors for other items such as income, drugs, or shelter.

Socioeconomic Determinants

HIV Prevalence by Income (2006-2007)

Picture2

Retrieved from CDC

It appears that there is a disparity related to income for HIV incidence. Those with low income may also be at risk for engaging in questionable behaviors.  Low socioeconomic status is believed to be associated with riskier health behaviors, more specifically not using condoms and substance abuse (CDC, 2013). One study found that that those with unstable housing were more likely to engage in exchanging sex for drugs, money, or housing (Aidala, Cross, Stall, Harre, & Sumartojo, 2005). For individuals with low socioeconomic status, there is may be a lack of healthcare services and HIV testing facilities (American Psychological Association, n.d.).

 

Risk Factors for HIV Testing

 

Biological Risk Factors

Some people are more inclined to avoid HIV testing depending on which method is available. One of the more common methods, Rapid HIV testing requires a needle prick to obtain a blood sample. For those that have a fear of needles, this may be a deterrent.

  • Psychological Fear Factors
    • There are varying psychological fear factors that come with getting an HIV test. Some may experience stress or anxiety due to fear of results. In addition, people may not be psychologically ready to receive the news of results, whether it be good or bad. For those that test HIV positive, suicide, anxiety and depression may become prevalent problems after becoming aware of a positive serostatus.

Social Risk Factors

  • Social Norms
  • Stigma Associated with Disease and Outcome
    • There is a negative stigma associated with MSM and it may prevent individuals from getting tested for the infection (CDC, 2013).
  • Cultural Differences in Acceptance
    • For example, in the Hispanic population, there is a fear about being deported so they are less likely to seek HIV services, and in American Indians and Alaskan natives, there is a distrust of the government and medical facilities (CDC, 2013).
  • Variation in Testing Attitudes
  • Peer Influence Factors

Behavioral Risk Factors

  • Personal Characteristics
    • Some people may have personal reasons as to why they may not want to get tested. Aside from psychological risk factors, some may be afraid to do it alone, or may have  a family member who was recently diagnosed so there could be an increased reluctance to know one’s status.
  • High Risk Sex Behaviors
    • Studies show that those that engage in high risk sex behaviors are more likely to get tested, however there may be population that avoids getting HIV testing due to socioecologic factors or the lack of support.
  • Fear of Outcome
    • As discussed earlier, HIV testing results can bring about anxiety and depression, therefore those who are worried about the possible outcomes may avoid getting tested altogether in an attempt to avoid additional stress and anguish.
  • Requirements for Prevention Counseling
  • Informed Consent
    • Some testing sites require prevention counseling in order to obtain an HIV Test. For those that may be too busy to do the additional counseling or do not feel as though they need it, this serves as an inconvenience and becomes an actual barrier to test testing. Additionally, HIV testing also requires informed consent, therefore the patient will need to understand and sign a document that shows that they understand the procedure that will be performed and give consent. For those that do not understand this process, it may become a deterrant as well.

Environmental Risk Factors

  • Federal Funding
    • Ryan White HIV/AIDS Program
      • The Ryan White HIV/AIDS Program is focused exclusively on HIV/AIDS care for individuals who have health insurance,  insufficient health care coverage, or lack financial resources to care for their HIV disease.
  • Federal Guidelines
    • Fortunately, The U.S. Department of Health and Human Services has established guidelines for providers of care across the country. These guidelines are tailored to specific populations, which include the use of antiretroviral agents in pediatric HIV infection and the use of antiretroviral drugs in pregnant HIV-  infected women to reduce perinatal HIV transmission.
  • Research
    • There are also many federal agencies that actively conduct and publish research. The National   Institutes of Health is the “single largest funder of HIV/AIDS research in the world” (AIDS.gov).  The   NIH holds the primary responsibility within the government to produce research and is followed up   by the Centers of Disease Control, Department of Defense, and Department of Veterans Affairs, just   to name a few.
  • Geographical and/or remote locations that hinder healthcare availability
  • A possible lack of incentive for HIV testing
  • Advertisement/media that endorses risky behavior