Provider-Initiated HIV Test Offers: Important Strategy, Yet Underused 

Routine HIV screening tests are preventive measures recommended by the CDC for all patients aged 13 to 64 years. Provider-initiated HIV test offers are an important strategy for increasing HIV screening among heterosexual populations, but improvement is needed, according to a study published in the CDC’s Morbidity and Mortality Weekly Report.

By offering this service, health care providers remind patients of the importance of HIV testing, especially among heterosexual populations at an increased risk for acquiring the infection. To obtain more information about the prevalence and predictors of provider-initiated HIV test offers in this patient population, the National HIV Behavioral Surveillance (NHBS) used data from Virginia.

The NHBS recruited heterosexual, cis-gendered individuals aged 18 to 60 years, who have an increased risk for acquiring HIV attributed to heterosexual activity and are of low-income status. Patients must not have used injection drugs or had male-to-male sexual contact in the previous 12 months before interviews.

Patients who completed the face-to-face NHBS interviews, but did not meet all criteria were excluded from the study, leaving 333 respondents. To examine the association between HIV test offers and demographic and behavioral characteristics, researchers used univariable log-binomial regression models. All the analysis variables were self-reported by respondents.

According to the findings in this study, 58% of respondents reported not receiving an HIV test offer from their health care provider compared with 42% who did. Among the individuals who did report an HIV test offer, 71% of patients underwent HIV testing during the 12 months following the interview, while only 16% of patients not offered the HIV test went for screenings during that period.

HIV test offer prevalence was lower among patients uninsured than among those with health insurance (PR = 0.78; 95% Cl = 0.59-1.03). The prevalence of HIV test offers in patients aged 31 to 40 years (PR = 1.24; 95% Cl = 0.89-1.72) was higher compared with patients aged 51 to 60 years (PR = 0.71; 95% Cl = 0.49-1.01).

HIV test offer prevalence was lower among men than women (prevalence ratio [PR] = 0.67; 95% cl = 0.50-0.89). Researchers found the relationship between gender and HIV test offer significant (aPR = 0.72; 95% Cl = 0.53-0.97).

When potential confounders were adjusted for in this relationship, prevalence of HIV test offers remained significantly lower in men than in women (aPR = 0.69; 95% Cl = 0.51-0.93). The likelihood of females receiving more HIV test offers could be attributed to their participation in family planning services, fewer sex partners, and more frequent seeking of health care and routine health screens than male patients.

Health care providers who offer HIV tests will encourage patients to integrate preventive HIV screenings into their health care routines. If providers implement this strategy, heterosexual adults at increased risk for acquiring the infection, especially males, will be more inclined to undergo repeat HIV screening.

Reference

Karen D, Tina C, Anne R, et al. Prevalence and Predictors of Provider-Initiated HIV Test Offers Among Heterosexual Persons at Increased Risk for Acquiring HIV Infection-Virginia 2016. MMWR Morb Mortal Wkly Rep. 2018; 67(25);714-717.