Racial/Ethnic Attitudes towards HIV Testing in the Primary Care Setting: RESULTS

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One-hundred-one patients participated in the study (Table 1). The mean age of the participants was 33 years. Eighty percent of the sample was female, of which nearly 40% were married. Most respondents self-identified their race/ethnicity as black, Hispanic or white. Sixteen percent self-identified as American Indian/Alaskan Native, Asian and Pacific Islander, Cape Verdian, or mixed race/ethnicity. Due to sample size restrictions, we combined all of the latter groups into one category: “other” (Table 1).

Table 1. Distribution (%) of Demographic Characteristics for Survey Respondents, by Self-Reported Race/Ethnicity

	Total (N=101)	Black (N=21)	White (N=14)	Latino (N=4?)	Other0 (N=16)
Female	79	76	100	82	62
Married	42	29	29	47	53
Stable housing	92	81	93	96	94
Employed	76	76	57	79	80
Insurance coverage
Private	19	20	27	16	20
Public	53	50	27	59	53
Uninsured	28	30	46	25	27
Education
Less than high school	25	10	43	29	19
High school graduate or equivalent	34	38	36	27	50
Attended or completed college/graduate school	42	52	21	45	31
a “Other” refers to individuals who self-identified as American Indian/Alaskan Native, Asian and Pacific Islander, Cape Verdian or mixed race/ethnicity.

Seventy-six respondents admitted to being tested for HIV at least once during their lifetime. Seventy-one percent of black respondents, 86% of white respondents and 83% of Latino respondents had been HIV tested previously. Once the prenatal category was excluded from analysis, “I wanted to know” was the most common reason for testing in both males and females in the sample; however, males were more likely to be tested for this specific reason than were females (p=0.039). Seventeen percent of the respondents provided written responses, stating the following as reasons for previous testing: “I wanted to know,” “prevention” or “physical examination” (Table 2). Only 9.2% of the respondents stated that they obtained an HIV test specifically on the advice of their physician/healthcare provider, and all of these respondents were either Latina or white females. No males were tested as a result of health provider recommendation. There was no difference in the mean number of times tested among the four racial categories (Table 3). Examining the reasons for previous HIV testing based on racial/ethnic identification, we found that 27% of blacks were tested because of personal curiosity, whereas 23% of whites and Hispanics were tested because their provider suggested it. Females in the study consented to HIV testing more frequently than the male respondents and were tested primarily as a result of prenatal testing. The women respondents were also more likely to be insured (p<0.05). Males in the sample were tested primarily as a result of their curiosity. The number of times pre­viously tested for all respondents ranged from zero to 15. The serostatus of the participants was not assessed in this survey. Your life is worth living. buy revatio online

Table 2. Distribution (frequency) of Reasons Identified for Obtaining the Most Recent HIV Test

Reason	Total (N=101)		Males (N=21)		Females (N=80)
			В	W  L О	В W L О
Prenatal testing		26	0	0   0 0	6  1 16 3
1 was not at high risk, but 1 wanted to know		15	0	0   5  1	4 2   3 0
Other*		13	0	0   1   1	12   7  1
My healthcare provider suggested it **		7	0	0   0 0	0 3   3 1
1 knew 1 was at risk		7	1	0   0 0	13   2 0
Job requirement		4	2	0   0 0	0 2   0 0
Premarital blood work		2	0	0   0  1	0 0   10
Military		1	0	0   0  1	0 0   0 0
1 knew a sexual or needle sharing partner was at risk		1	0	0   0  1	0 0   0 0
1 was in prison		0	0	0   0 0	0 0   0 0
Insurance requirement		0	0	0  0 0	0 0   0 0
W: white, B: black, L: Latino, O: other; * “Other”	includes a large proportion (46%) of respondents
answering that they wanted to know in addition to other explanations tor HIV testing;					** Testing was only
offered to the white and Latino females in the sample.

The majority of the respondents reported previously being tested for HIV at a doctor’s office or clinic (63.9%). However, almost 28% were tested at a hospital, and less than 5% identified a community agency as their prior location of testing. Almost 90% of the respondents returned for their test results. Lower educational level was not significantly associated with failure to return for the test results. The major reason cited for not returning for test results was the false assumption that they would be contacted with the results.
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Table 3. Perceived and Actual HIV Risk Reported by Gender and Ethnicity

	N	Perceived	Actual	Mean#	Mean#	Mean #      Mean #
		Risk: Anya	Riskb	Male Partners0	Female Partners0	Partners   Times Tested
Gender
Male	21	0.48	0.62	1.57	7.92	9.07	1.57
Female	80	0.42	0.54*	4.20	0.00	4.20	2.89 **
Ethnicity
Black	21	0.15	0.62	5.14	7.50	6.00	3.30
White	14	0.50	0.64	4.46	0.00	4.46	2.21
Latino	49	0.53	0.53	4.00	4.91	4.97	2.63
Other	16	0.44	0.50	4.82	2.67	4.93	2.33
Gender/Ethnicity
Male
Black	5	0.60	0.80	missing	10.00	10.00	2.50
White	0	—	—	—	—	—	—
Latino	9	0.56	0.78	0.00	10.80	10.80	1.17
Other	6	0.33	0.33	11.00	4.00	8.17	1.50
Female
Black	16	0.00	0.56*	5.14	0.00	5.14	3.50
White	14	0.50	0.64	4.46	0.00	4.46	2.21
Latina	40	0.53	0.48	4.12	0.00	4.12	2.91
Other	10	0.00	0.60	2.50	0.00	2.50	3.17
* Significant difference between perceived and actual risk (p<0.05); ** Significant difference in the
number of times tested between males and females (p<0.05);					a Perceived risk based on question: What
do you think your risk level is for contracting HIV? The responses were 0 (no risk), 1 (low risk), and 2 (high
risk). The responses were dichotomized into any risk (categories 1 and 2) or no risk (0); b Actual risk was
coded as 1	1 if participants responded positively to one or more of the responses to the following
question: Have you ever had any of the following risk factors for HIV/AIDS? Unprotected sex, multiple
sexual partners, intravenous drug use, illicit drug use (crack, cocaine, marijuana, heroin, speed, etc.).
sexual partner of the same sex, sexually transmitted disease, or blood transfusions prior to 1984; c							This is
based on two reports of eight and 25 male partners, the only nonzero values in the male to male
partnering response. No female-to-female partnering was reported.

When queried about lifetime risk factors for HIV infection, the most common risk response was “unprotected sex.” Similarly, among those respondents who had risk factors within the previous six months, 90% stated that they engaged in unprotected sex. The mean number of sexual partners for the males in the survey was double that of females (Table 3). There was no statistically significant difference in the mean number of sexual partners (male or female) for any of the racial/ethnic groups. Only 4% of the respondents in the sample admitted to engaging in same-sex or bisexual relationships. These individuals reported a higher-than-average number of sexual partners. Half of the respondents underestimated their risk of HIV acquisition compared to their reported risk factors. Almost all of the respondents (90%) considered themselves either at low or no risk for contracting HIV infection. Seventy-one percent thought that it was not at all likely that they would have ever been exposed to HIV. In particular, black females significantly underestimated their risk for HIV (Table 3). There was no association between the number of sexual partners and the respondent’s self-perceived level of risk for contracting HIV. Specifically, one female respondent with 56 sexual partners considered herself to be at no risk for transmission of the virus that causes AIDS. Among the female respondents, only 5% reported high-risk behavior; however, 53% reported multiple sexual partners.
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In spite of their low risk perception, 86% of the respondents answered that they would be willing to be tested for HIV on a regular basis. Almost three-quarters of the participants wanted to be tested for HIV on the day of the survey, although this was not offered as part of the study. In addition to patients wanting to be tested regularly for Hiy they also preferred that their primary care providers perform these tests; nearly 80% wanted their doctor instead of an HIV counselor to perform their counseling and testing. The majority (77%) wanted to be tested either annually or semiannually. Seventy-three percent of the respondents also felt that if HIV testing could be obtained during their regularly scheduled clinic visits and the results were available in 30 minutes, they would be more inclined to be tested on a regular basis for HIV Responses to two open-ended questions soliciting patients’ advice on ways to increase acceptance of routine testing among outpatient minorities overwhelmingly suggested increased HIV education, increased availability of testing centers in primary care offices and destigmatization of the testing process through routine offering of the tests.