TITLE:
Rates of receiving the result of an HIV test: data from the US
National Health Interview Survey.
AUTHORS:
Tao G; Kassler WJ; Branson BM; Peterman TA; Cohen RA
AUTHOR AFFILIATION:
National Center for Health Statisics, CDC, Hyattsville, MD,
USA.
SOURCE:
Int Conf AIDS. 1998;12:1064 (abstract no. 60354).
SECONDARY SOURCE ID:
ICA12/98408603
ABSTRACT:
BACKGROUND: HIV testing has several important benefits,
including risk reduction through prevention counseling and
referral of infected persons for medical and psychological
services. These benefits occur only if persons tested receive
their test results. METHODS: To determine the frequency and
predictors of receiving HIV test results (excluding blood
donations), we analyzed 19,127 adults in the 1994 US
National Health Interview Survey, a population-based,
probability sample household survey. We used multinomial
logit model to determine factors independently associated with
the rates of receiving HIV test results. RESULTS: HIV testing
was reported by 24.3% (+/- SE = 0.8%) of persons in the
survey (46 million US adults). Of those tested, 43.0% (+/-
0.9%) had primarily compulsory tests (military, employment,
insurance, immigration, or hospitalization); 26.5% (+/- 0.8)
had primarily self-initiated tests ("just to find out/I am worried
that I am infected"); 9.1% (+/- 0.5%) acted on advice of a
doctor, health department, or sex partner; and 21.4% (+/-
0.8%) were tested for other reasons. Of those tested, 78.6%
(+/- 0.7%) reported receiving their results; 12.0% (+/- 0.6%)
reported not receiving their results; and 9.4% (+/- 0.6%)
reported being told that they would be notified if their test
results were positive. The logit model revealed that persons
were more likely (p < .05) to receive their test results if they
believed they had good knowledge about AIDS, they lived
alone or with non-relatives, their tests were self-initiated, or
their tests were performed at public clinics, community health
centers, or private physician offices rather than at hospitals or
emergency rooms. Compared with those who did not receive
their test results, persons were more likely (p < .05) to report
being told they would be notified only of a positive result if
they believed they had good knowledge about AIDS, or if their
tests were performed at military, immigration, or private
physician settings. The rates of receiving the test results did
not differ by age, gender, race, education level, health status,
or the number of previous HIV tests. CONCLUSIONS: More
than one in ten persons tested for HIV did not receive their
test results. Measures to increase the number of tested persons
who receive their results, such as adding and enhancing
pre-test counseling, or using rapid HIV-screening tests that
provide results at the time of testing, are urgently needed.
MAIN MESH HEADINGS:
AIDS Serodiagnosis/*STANDARDS
HIV Infections/*DIAGNOSIS
Mandatory Testing/*STANDARDS
*Truth Disclosure
ADDITIONAL MESH
HEADINGS:
Adult
Health Care Surveys
Human
HIV Infections/PREVENTION & CONTROL
Knowledge, Attitudes, Practice
Logistic Models
Predictive Value of Tests
Questionnaires
United States
PUBLICATION TYPES:
ABSTRACT
LANGUAGES:
Eng
TITLE:
Rapid test strategies for HIV testing.
AUTHORS:
Branson BM
AUTHOR AFFILIATION:
Centers for Disease Control and Prevention, Atlanta, GA.
SOURCE:
5th Conf Retrovir Oppor Infect. 1998 Feb 1-5;:232 (abstract
no. S13).
SECONDARY SOURCE ID:
AIDS/98929724
ABSTRACT:
Background: Clinical trials demonstrate that rapid HIV tests
are acceptable, cost-effective, and practical for increasing the
number of clients who learn their infection status. However,
rapid tests are rarely used in the U.S. because the USPHS
recommends that a positive EIA be confirmed before results
are given. Objective: To quantify the impact for US
publicly-funded testing programs from using rapid HIV tests
and giving unconfirmed screening tests results. Methods: A
decision model was constructed to compare outcomes from
current HIV testing and rapid tests. We used data on rates of
return for results observed in clinical trials of rapid tests and
from the CDC client record database for 1995. We determined
the number of persons who would have received results under
each strategy and the number who would have received a
false-positive rapid test result. Outcomes were calculated for
testing sites with different HIV prevalences and aggregated to
project the impact of using the rapid test algorithm for all
publicly-funded HIV testing in the U.S. Results: From the
2,112,270 publicly funded HIV tests performed in 1995.
7,874 (28%) more HIV positive persons and 581,308 (42%)
more HIV negative persons would have learned their results
using the rapid test algorithm. False-positive rapid tests
results would have been given to 10,376 (0.4% of those
tested). Of these, most (93%) would have returned to learn
they were truly HIV negative after confirmatory testing.
Conclusions: Evidence suggests that changing the USPHS
recommendation against giving results from HIV screening
tests before confirmation and wider use of rapid HIV tests will
substantially increase the number of persons receiving both
positive and negative HIV tests results. Such a step warrants a
comprehensive reconsideration of the current algorithm for
HIV testing.
MAIN MESH HEADINGS:
AIDS Serodiagnosis/*METHODS
ADDITIONAL MESH
HEADINGS:
AIDS Serodiagnosis/STANDARDS
Human
Outcome Assessment (Health Care)
Predictive Value of Tests
PUBLICATION TYPES:
ABSTRACT
LANGUAGES:
Eng
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