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Missed Opportunities for HIV Testing Among High-Risk Heterosexuals

Jenness, Samuel M. MPH*; Murrill, Christopher S. PHD*; Liu, Kai-Lih PHD*; Wendel, Travis JD; Begier, Elizabeth MD*; Hagan, Holly PHD

doi: 10.1097/OLQ.0b013e3181ab375d

Background: HIV testing is an important HIV prevention strategy, yet heterosexuals at high risk do not test as frequently as other groups. We examined the association of past year HIV testing and encounters with institutional settings where the Centers for Disease Control and Prevention recommends annual testing for high-risk heterosexuals.

Methods: We recruited high-risk heterosexuals in New York City in 2006 to 2007 through respondent-driven sampling. Respondents were asked the date of their most recent HIV test and any potential encounters with 4 testing settings (homeless shelters, jails/prisons, drug treatment programs, and health care providers). Analyses were stratified by gender.

Results: Of the 846 respondents, only 31% of men and 35% of women had a past year HIV test, but over 90% encountered at least one testing setting. HIV seroprevalence was 8%. In multiple logistic regression, recent HIV testing was significantly associated with recent encounters with homeless shelters and jails/prisons for men, and encounters with health care providers for both men and women.

Conclusions: HIV testing was low overall but higher for those with exposures to potential routine testing settings. Further expansion of testing in these settings would likely increase testing rates and may decrease new HIV infections among high-risk heterosexuals.

A study of heterosexuals in New York City found low testing rates despite high-risk. However, those who visited at least one setting where routine human immunodeficiency virus testing was potentially offered were more likely to be tested.

From the *HIV Epidemiology Program, New York City Department of Health and Mental Hygiene, New York, New York; and †New York University of Nursing, New York, New York

The authors thank Alan Neaigus, Thomas Farley, and James Hadley for reviewing earlier drafts of this article and also acknowledge the valuable contributions of the NHBS field and data management staff (Olufunmilola Adedokun, Alix Conde, Libertad Guerra, Shavvy Raj-Singh, Dipal Shah, Noel Trejo, and Aundrea Woodall).

Supported by a cooperative agreement between the New York City Department of Health and Mental Hygiene and the Centers for Disease Control and Prevention (grant U62/CCU223595-03-1).

Correspondence: Samuel M. Jenness, MPH, HIV Epidemiology Program, New York City Department of Health and Mental Hygiene, 346 Broadway, Suite 707D, New York, NY 10003. E-mail:

Received for publication January 22, 2009, and accepted April 21, 2009.

© Copyright 2009 American Sexually Transmitted Diseases Association