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Irie WC, Mahone A, Nakka R, Ghebremichael M. Factors Associated with Comfort Discussing PrEP with Healthcare Providers among Black Cisgender Women. Trop Med Infect Dis 2023; 8:436. [PMID: 37755897 PMCID: PMC10534734 DOI: 10.3390/tropicalmed8090436] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/17/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023] Open
Abstract
Preexposure prophylaxis (PrEP) for HIV prevention uptake remains low among Black cisgender women in the United States, despite their disproportionate HIV burden. This study aimed to examine factors associated with Black women's comfort discussing PrEP with healthcare providers and its link to their interest in PrEP use. A cross-sectional survey was conducted with a national sample of 315 Black cisgender women. Descriptive statistics and logistic regression models were utilized for data analysis. The results showed that 79% of Black women felt comfortable discussing PrEP with their healthcare provider. Age, recent healthcare provider visit, interest in PrEP, and positive social norms were associated with increased odds of comfort in discussing PrEP, while anticipated PrEP disapproval and stigma were associated with decreased odds. Older age was related to greater comfort, potentially due to increased familiarity and self-efficacy in discussing sexual health. Recent healthcare utilization indicated positive provider relationships, facilitating discussions about sexual health. Anticipating support from social networks positively influenced comfort levels. Conversely, PrEP-related stigma and anticipated disapproval were barriers to comfort. These findings highlight the importance of provider-patient communication and social support in facilitating PrEP engagement among Black cisgender women. Interventions should consider age-appropriate strategies and address structural and provider biases to improve PrEP discussions and promote HIV prevention.
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Affiliation(s)
- Whitney C. Irie
- Boston College School of Social Work, Chestnut Hill, MA 02467, USA
- The Fenway Institute, Fenway Health, Boston, MA 02215, USA
| | - Anais Mahone
- School of Social Work, Rutgers University, New Brunswick, NJ 08901, USA
| | - Raja Nakka
- The Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA (M.G.)
| | - Musie Ghebremichael
- The Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA (M.G.)
- Department of Medicine, Harvard Medical School, Cambridge, MA 02215, USA
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Zolopa C, Høj SB, Minoyan N, Bruneau J, Makarenko I, Larney S. Ageing and older people who use illicit opioids, cocaine or methamphetamine: a scoping review and literature map. Addiction 2022; 117:2168-2188. [PMID: 35072313 PMCID: PMC9544522 DOI: 10.1111/add.15813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 01/06/2022] [Indexed: 11/26/2022]
Abstract
AIMS To provide an overview of research literature on ageing and older people who use illicit opioids and stimulants by documenting the conceptual frameworks used and content areas that have been investigated. METHODS We conducted a scoping review of literature relating to ageing and older people who use illicit stimulants and opioids, defining 'older' as 40 years and above. Primary studies, secondary studies and editorials were included. Searches were conducted in PubMed and Embase in July 2020 and March 2021; the Cochrane library was searched in November 2021. Charted data included methodological details, any conceptual frameworks explicitly applied by authors and the content areas that were the focus of the publication. We developed a hierarchy of content areas and mapped this to provide a visual guide to the research area. RESULTS Of the 164 publications included in this review, only 16 explicitly applied a conceptual framework. Seven core content areas were identified, with most publications contributing to multiple content areas: acknowledgement of drug use among older people (n = 64), health status (n = 129), health services (n = 109), drug use practices and patterns (n = 84), social environments (n = 74), the criminal legal system (n = 28) and quality of life (n = 15). CONCLUSIONS The literature regarding older people who use illicit drugs remains under-theorized. Conceptual frameworks are rarely applied and few have been purposely adapted to this population. Health status and health services access and use are among the most frequently researched topics in this area.
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Affiliation(s)
- Camille Zolopa
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada
| | - Stine B Høj
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada
| | - Nanor Minoyan
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.,Department of Social and Preventative Medicine, School of Public Health, Université de Montréal, Montreal, Québec, Canada
| | - Julie Bruneau
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.,Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Iuliia Makarenko
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.,Department of Family Medicine, McGill University, Montreal, Québec, Canada
| | - Sarah Larney
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), Montréal, Québec, Canada.,Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Québec, Canada
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Parish CL, Pereyra MR, Yanez IG, Vidot DC, Metsch LR. Patient acceptance of HIV rapid testing in the dental care setting. AIDS Care 2022; 35:745-752. [PMID: 35603879 DOI: 10.1080/09540121.2022.2073326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Dental settings are untapped venues to identify patients with undiagnosed HIV who may otherwise lack testing opportunities. Perceived lack of patient acceptance has been a significant barrier limiting dentists' willingness to offer HIV testing. This study implemented rapid HIV testing in dental settings located in an HIV prevalent region to evaluate patient acceptance. Two South Florida community health centers implemented routine oral rapid HIV testing as part of clinical practice, followed by exit interviews with patients immediately after to determine patient acceptance. The binary primary outcome was patient's acceptance of the rapid HIV test. Multivariable logistic regression assessed associations between patient characteristics and acceptance. Overall acceptance by dental patients (N = 600) was 84.5%. Patients who were more likely to participate in other medical screenings in dental settings were more than twice as likely to accept the test compared to those who were neutral/less likely (OR: 2.373; 95% CI: 1.406-4.004). Study findings highlight the high patient acceptance of HIV testing in dental settings. Widespread implementation of such testing will require an expanded societal view of the traditional role of the dentist that will embrace the potentially valuable role of dentistry in preventive health screenings and population health.
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Affiliation(s)
- Carrigan L. Parish
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
| | | | - Iveth G. Yanez
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
| | - Denise C. Vidot
- School of Nursing and Health Sciences, University of Miami, Miami, FL, USA
| | - Lisa R. Metsch
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
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Nduaguba SO, Ford KH, Wilson JP, Lawson KA, Cook RL. Identifying subgroups within at-risk populations that drive late HIV diagnosis in a Southern U.S. state. Int J STD AIDS 2020; 32:162-169. [PMID: 33327899 PMCID: PMC7879228 DOI: 10.1177/0956462420947567] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We aimed to identify subgroups within age, racial/ethnic, and transmission categories that drive increased risk for late HIV diagnosis (LHD). A 1996–2013 retrospective study of HIV-diagnosed individuals (N = 77,844) was conducted. The proportion of individuals with LHD (AIDS diagnosis within 365 days of HIV diagnosis) was determined, stratified by age, race/ethnicity, and transmission category. Logistic regression with interaction terms was used to identify groups/subgroups at risk for LHD during 1996–2001, 2002–2007, and 2008–2013. Respectively, 78%, 27%, 38%, and 31% were male, White, Black, and Hispanic. Overall, 39% had LHD with a 6.7% reduction for each year increase (OR = 0.93, 95% CI = 0.93–0.94, p < 0.01). Older age was significantly associated with increased odds of LHD (OR range = 1.90–4.55). Compared to their White counterparts, all Hispanic transmission categories (OR range = 1.31–2.58) and only Black female heterosexuals and men who have sex with men (MSM) (OR range = 1.14–1.33) had significantly higher odds of LHD during 1996–2001 and/or 2002–2007. Significance was limited to Hispanic MSM (all age categories), MSM/IDUs (30–59 years), and heterosexuals (18–29 years) and Black MSM (30–39 years) during 2008–2013. Older individuals and Hispanics (driven by MSM) are at increased risk for LHD. HIV testing interventions directed at seniors and Hispanic MSM can further reduce rates of LHD.
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Affiliation(s)
- Sabina O Nduaguba
- Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA
| | - Kentya H Ford
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
| | - James P Wilson
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
| | - Kenneth A Lawson
- Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA
| | - Robert L Cook
- Department of Epidemiology, University of Florida College of Medicine, Gainesville, FL, USA
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Screening for Military Sexual Trauma Is Associated With Improved HIV Screening in Women Veterans. Med Care 2019; 57:536-543. [PMID: 31194701 DOI: 10.1097/mlr.0000000000001130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine factors associated with HIV screening among women veterans receiving health care in the Department of Veterans Affairs. MATERIALS AND METHODS Cross-sectional study of women veterans receiving Veterans Affairs care between 2001 and 2014 derived from the Women Veteran's Cohort Study. Descriptive and bivariate statistics were calculated comparing patients with and without an HIV screen. Generalized estimating equations were conducted to estimate the odds of HIV screening among women screened for military sexual trauma (MST) and the subset with a positive MST screen. Multivariable analyses were adjusted for demographic characteristics, mental health diagnoses, pregnancy, HIV risk factors, and facility level clustering. RESULTS Among the 113,796 women veterans in the sample, 84.3% were screened for MST and 13.2% were screened for HIV. Women screened for MST were over twice as likely to be tested for HIV (odds ratio, 2.8; 95% confidence interval, 2.2-3.5). A history of MST was inversely associated with HIV screening (odds ratio, 0.9; 95% confidence interval, 0.8-0.9). CONCLUSIONS Women veterans screened for sexual trauma received more comprehensive preventive health care in the form of increased HIV screening.
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Kuofie AA, Bauer A, Berkley-Patton J, Bowe-Thompson C. HIV Knowledge and Risk Behaviors Among Older Church-Affiliated Blacks. Gerontol Geriatr Med 2019; 5:2333721419855668. [PMID: 31276020 PMCID: PMC6598319 DOI: 10.1177/2333721419855668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 05/01/2019] [Accepted: 05/10/2019] [Indexed: 11/15/2022] Open
Abstract
There is an emerging population of older adults living with HIV, and among them, Black older adults experience the greatest burden of the disease. This is a growing public health concern, as older adults are disproportionately diagnosed at a later stage of the disease, while reporting similar risk factors as younger adults. It has also been shown that the Black Church is well positioned to offer health screenings. Thus, this study aimed to assess HIV knowledge, beliefs, and risk behaviors of older church-affiliated Black adults. Data were collected from a sample of Black adults (N = 543) from four predominately Black churches in Kansas City, MO. Participants were surveyed on measures assessing demographic characteristics, HIV knowledge and attitudes, and HIV testing and risk behaviors. Results indicated that compared to younger Black adults, Black older adults were less knowledgeable about the transmission of HIV and were less willing to be tested for HIV in church settings. However, there was no significant difference on the perceived seriousness of HIV in the community. Results further showed that Black older adults were less likely to use condoms/barriers during the past 6 months and over their lifetime. We discuss the implications of results for HIV intervention programs.
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Affiliation(s)
- Araba A. Kuofie
- University of Kansas, Lawrence, USA
- Araba A. Kuofie, Department of Psychology, University of Kansas, 1415 Jayhawk Blvd., 327 Fraser Hall, Lawrence, KS 66045, USA.
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Sangaramoorthy T, Jamison A, Dyer T. Older African Americans and the HIV Care Continuum: A Systematic Review of the Literature, 2003-2018. AIDS Behav 2019; 23:973-983. [PMID: 30519903 PMCID: PMC6459701 DOI: 10.1007/s10461-018-2354-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Evidence suggests that racial disparities in the HIV care continuum persist in older age groups, particularly among African Americans. The objective of this systematic review was to identify factors that facilitate or hinder older African Americans' engagement in the HIV care continuum. For studies published between 2003 and 2018, we: (1) searched databases using keywords, (2) excluded non-peer-reviewed studies, (3) limited findings to older African Americans and the HIV care continuum, and (4) retrieved and summarized data focused on barriers and facilitators of the HIV care continuum. Among the 1023 studies extracted, 13 were included: diagnosis/testing (n = 1), engagement in care (n = 7), and antiretroviral adherence (n = 5). Barriers included lack of HIV risk awareness, routine testing, and healthcare access, stigma, and multimorbidities. Social support, health/medication literacy, and increased self-efficacy facilitated engagement. A targeted focus on older African Americans is needed to achieve national goals of improving HIV care and treatment outcomes.
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Affiliation(s)
- Thurka Sangaramoorthy
- Department of Anthropology, University of Maryland, 1111 Woods Hall, 4302 Chapel Lane, College Park, MD, 20742, USA.
| | - Amelia Jamison
- Center for Health Equity, University of Maryland, College Park, MD, USA
| | - Typhanye Dyer
- Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD, USA
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Lo CC, Runnels RC, Cheng TC. Racial/ethnic differences in HIV testing: An application of the health services utilization model. SAGE Open Med 2018; 6:2050312118783414. [PMID: 29977553 PMCID: PMC6024279 DOI: 10.1177/2050312118783414] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 05/21/2018] [Indexed: 11/25/2022] Open
Abstract
This study applying the health services utilization model examined the importance of predisposing, enabling, and need variables to the social mechanisms explaining lifetime HIV testing across racial/ethnic groups. Data for the study were derived from the National Health Interview Survey (collected 2013–2014), our final sample numbering 18,574 adults. Four subsamples reflected race/ethnicity: 13,347 Whites, 2267 Blacks, 2074 Hispanics, and 886 Asians. Logistic regression established respondent odds of ever having received HIV testing. Further statistical testing evaluated race/ethnicity’s potential moderating role in HIV testing. The findings generally support a role for Aday’s predisposing, enabling, and need factors in explaining HIV testing. Across the four subsamples, female gender, older age, and sexual minority status consistently increased lifetime HIV testing. However, we found racial/ethnic differences in HIV testing’s associations with these factors and others. Our study made a beginning in the effort to specify mechanisms leading to HIV testing—and reliable diagnosis—among four racial/ethnic groups. Understanding these mechanisms might multiply opportunities to raise testing rates for all, in turn reducing racial/ethnic disparities in HIV treatment.
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Affiliation(s)
- Celia C Lo
- Department of Sociology and Social Work, Texas Woman's University, Denton, TX, USA
| | - Ratonia C Runnels
- Department of Sociology and Social Work, Texas Woman's University, Denton, TX, USA
| | - Tyrone C Cheng
- Department of Social Work and Child Advocacy, Montclair State University, NJ, USA
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Youssef E, Cooper V, Delpech V, Davies K, Wright J. Barriers and facilitators to HIV testing in people age 50 and above: a systematic review. Clin Med (Lond) 2017; 17:508-520. [PMID: 29196351 PMCID: PMC6297712 DOI: 10.7861/clinmedicine.17-6-508] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Approximately 13% of people living with HIV in the UK are unaware of their infection. New diagnoses among people ≥50 years is increasing. Unique factors may be associated with testing in this group. This systematic review aims to identify patient and clinician-related barriers/facilitators to HIV testing in people aged ≥50 years. A systematic electronic search was conducted. Papers were assessed for eligibility and data from eligible studies were extracted. Barriers/facilitators were grouped, and the number of times they were reported was noted. Because of considerable heterogeneity, a narrative approach has been undertaken to synthesise data. In total, 17 studies were included. Main barriers to testing were low perceived risk and clinicians' preconceptions about older people. Main facilitators were regular use of healthcare services or being offered/encouraged to test by a healthcare provider. Although being encouraged to test was a common facilitator, clinicians' preconceptions about older people was the biggest barrier. This shows a divide between clinicians' preconceptions and patients' expectations, which may impact on testing rates. This review is an important first step in identifying potential barriers/facilitators for further study or to be addressed in the design of future interventions.
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Affiliation(s)
| | | | | | - Kevin Davies
- Brighton and Sussex Medical School, Brighton, UK
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Guo Y, Sims OT. Assessment of recent HIV testing among older adults in the United States. SOCIAL WORK IN HEALTH CARE 2017; 56:855-864. [PMID: 28696906 DOI: 10.1080/00981389.2017.1339762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Older adults are the fastest growing segment of people living with HIV, and unfortunately many are unaware of their HIV status. Many providers are reluctant to ask older adults about their sexual histories, evaluate their risk factors, and test for HIV, and older adults have low perception of HIV risk. Using data from the 2013 to 2014 National Health and Nutrition Examination Survey, this study assessed the prevalence of recent HIV testing among older adults in the United States (n = 1,056) and identified predictors and barriers to recent HIV testing. The prevalence of recent HIV testing was 28%. Recent HIV testing was associated positively with male gender, education level, having public insurance, having same sex sexual behavior, African, and Hispanic ethnicity, whereas age, income-to-poverty ratio, and Asian ethnicity were associated negatively with recent HIV testing. Public health social workers are advised that targeted HIV testing for Asian, economically disadvantaged, female older adults is needed to increase HIV awareness and detection and to decrease late diagnosis of HIV. Provided public insurance was identified as a predictor of recent HIV testing, facilitating economically disadvantaged older adults' eligibility for public insurance that will likely improve access to HIV testing services and increase HIV testing rates.
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Affiliation(s)
- Yuqi Guo
- a School of Social Work , University of Alabama , Tuscaloosa , Alabama , USA
| | - Omar T Sims
- b Department of Social Work, College of Arts and Sciences , University of Alabama at Birmingham , Birmingham , Alabama , USA
- c Department of Health Behavior, School of Public Health , University of Alabama at Birmingham , Birmingham , Alabama , USA
- d Center for AIDS Research , University of Alabama at Birmingham , Birmingham , Alabama , USA
- e Comprehensvie Center for Healthy Aging , University of Alabama at Birmingham , Birmingham , Alabama , USA
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Syme ML, Cohn TJ, Barnack-Tavlaris J. A Comparison of Actual and Perceived Sexual Risk Among Older Adults. JOURNAL OF SEX RESEARCH 2017; 54:149-160. [PMID: 26813853 PMCID: PMC5573595 DOI: 10.1080/00224499.2015.1124379] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Sexual risk among older adults (OAs) is prevalent, though little is known about the accuracy of sexual risk perceptions. Thus, the aim was to determine the accuracy of sexual risk perceptions among OAs by examining concordance between self-reported sexual risk behaviors and perceived risk. Data on OAs aged 50 to 92 were collected via Amazon.com's Mechanical Turk. Frequency of sexual risk behaviors (past six months) were reported along with perceived risk, namely, sexually transmitted infection (STI) susceptibility. Accuracy categories (accurate, underestimated, overestimated) were established based on dis/concordance between risk levels (low, moderate, high) and perceived risk (not susceptible, somewhat susceptible, very susceptible). Approximately half of the sample reported engaging in vaginal (49%) and/or oral sex (43%) without a condom in the past six months. However, approximately two-thirds of the sample indicated they were "not susceptible" to STIs. No relationship was found between risk behaviors and risk perceptions, and approximately half (48.1%) of OAs in the sample underestimated their risk. Accuracy was found to decrease as sexual risk level increased, with 93.1% of high-risk OAs underestimating their risk. Several sexual risk behaviors are prevalent among OAs, particularly men. However, perception of risk is often inaccurate and warrants attention.
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Recent HIV Testing Prevalence, Determinants, and Disparities Among U.S. Older Adult Respondents to the Behavioral Risk Factor Surveillance System. Sex Transm Dis 2016; 42:405-10. [PMID: 26165428 DOI: 10.1097/olq.0000000000000305] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although routine human immune deficiency virus (HIV) testing during health care visits is recommended for most adults, many older adults (i.e., ages 50-64 years) do not receive it. This study identified factors associated with HIV testing in the past 12 months (i.e., recent HIV testing) among US adults in the 3 categories of older adulthood (50-54, 55-59, and 60-64 years) for which routine HIV testing is recommended. METHOD This was a cross-sectional analysis of data from US older adult respondents to the 2010 Behavioral Risk Factor Surveillance System. We calculated prevalence (proportions) of HIV testing by age category and race/ethnicity. Using multiple logistic regression, we identified predisposing, enabling, and need factors associated with recent HIV testing within and across age categories, by race/ethnicity and controlling for covariates. RESULTS HIV testing prevalence was low (<5%), varied by race/ethnicity, and decreased with age. Within and across age categories, the odds of testing were highest among blacks (odds ratio [OR], 3.47; 95% confidence interval [CI], 2.82-4.25) and higher among Latinos (OR, 2.06; 95% CI, 1.50-2.84) and the oldest and youngest categories of American Indians/Alaska Natives (OR, 2.48; 95% CI, 1.11-5.55; OR, 2.98; 95% CI, 1.49-5.95) than among whites. Those reporting a recent doctor visit (OR, 2.32; 95% CI, 1.92-2.74) or HIV risk behaviors (OR, 3.50; 95% CI, 2.67-4.59) had higher odds of HIV testing. CONCLUSION Regardless of risk, the oldest older adults, whites, and older women may forego HIV testing. Doctor visits may facilitate HIV testing. Additional research is needed to understand why eligible older adults seen by providers may not be screened for HIV infection.
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