HIV Antibody Testing Among Those at Risk for Infection

Abstract

Objective. —To determine the prevalence of testing for human immunodeficiency virus (HIV) antibody among adults with various risk factors for infection, particularly those residing in large metropolitan areas where the bulk of cases of acquired immunodeficiency syndrome (AIDS) have occurred. Design. —A nationwide, population-based telephone survey eliciting testing, sexual, and injection drug use histories. Participants. —A total of 2673 randomly chosen US residents and 8263 randomly chosen residents of 23 metropolitan areas containing 64% of reported cases of AIDS. Interventions. —None. Main Outcome Measure. —Testing for HIV antibody. Main Results. —Overall, rates of individuals ever tested were only slightly higher in the urban areas (23%) than in the nation as a whole (21%). Testing frequencies were low among all risk groups (less than 40%), except men engaging in same-sex sexual activity (60%) and male and female injection drug users (46% and 73%, respectively). The low rate of testing (35%) among the largest risk group, heterosexual men and women engaging in unprotected sexual intercourse with multiple partners, was particularly worrisome. Conclusions. —To encourage antibody testing among the many at risk for infection who have not yet been tested, promotional campaigns should explain the universal susceptibility to infection among those at risk, and the availability of prophylactic medical therapies and social support services to persons who are HIV-seropositive. As there were comparable levels of risk-taking behavior among subjects in both samples, these campaigns must be designed to reach all segments of the population. (JAMA. 1993;270:1576-1580)