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Racial Variance in Rationale for HIV Testing in Community-Based Setting in the United States: Evidence from the National Health Interview Survey

Institute of Community Health, University of Houston, Texas Medical Center, Houston, TX, drlholmesjr{at}gmail.com

Emmanuel Monjok, MD, MPH

Institute of Community Health, University of Houston, Texas Medical Center, Houston, TX

Doriel Ward, PhD, MPH

Anderson Cancer Center, University of Texas, Houston

Orsolya M. Garrison, MPH

Anderson Cancer Center, University of Texas, Houston, University of Texas at Houston, School of Public Health, Houston, TX

Evette D. Toney, PhD

Anderson Cancer Center, University of Texas, Houston

Gbadebo Ogungbade, DVM, MPH

Institute of Community Health, University of Houston, Texas Medical Center, Houston, TX

E. James Essien, MD, DrPH

Institute of Community Health, University of Houston, Texas Medical Center, Houston, TX, University of Texas at Houston, School of Public Health, Houston, TX

Background: HIV testing varies across racial/ethnic groups in the United States, but it is unclear whether the rationale for testing differs as well racially. The authors aimed to assess the rationale for HIV testing and the racial/ethnic variation therein. Methods: Using the National Health Interview Survey 2003 (n = 29 753), the authors examined the association between rationale for HIV testing and race. Chi-square statistic and multinomial logistic regression analyses were used to test for racial differences and the effect of race/ethnicity on the rationale for HIV testing. Results: There was a statistically significant racial difference with respect to HIV testing rationale, ² = (24, N = 10481) = 808.9, P < .001. After adjustment for relevant covariates, compared with Caucasians, African Americans were 37% less likely to be tested due to exposure to sex/drugs, whereas Hispanics were not (prevalence risk ratio [PRR], 0.63, 95% confidence interval [CI] = 0.47-0.84, respectively). Likewise African Americans and Hispanics were less likely to be tested if they were sick or had a medical problem (PRR = 0.66, 95% CI = 0.44-0.99 and PRR = 0.65, 95% CI = 0.43-0.98). Conclusions: Substantial racial variation occurred in the reasons for being tested for HIV in the United States, indicative of the need to understand such rationale for effective HIV screening and testing.

Key Words: HIV testing rationale • racial variance • African American • Hispanic • Caucasian

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