Who Is Most Likely to Accept HIV Testing?

There have been many medical advancements in the fight to prevent and cure HIV/AIDS, but it still remains a serious social dilemma. Approximately 50,000 people are diagnosed with HIV/AIDS every year, and over 200,000 people are unaware they even have HIV/AIDS. This lack of awareness is a leading factor in the spread of HIV/AIDS every year. Despite the continued education about the illness, many people are fearful of the disease and avoid being tested because of the stigma that is still attached to HIV/AIDS. In recent years, the Centers for Disease Control and Prevention has spearheaded efforts to offer HIV testing to people in emergency rooms nationwide. This tactic has helped increase the number of identified cases, but many people who are offered such testing refuse or never complete it, hampering the overall goal of diagnosing those with HIV/AIDS in an attempt to reduce the spread of the illness.

Jeffrey Sankoff of the Department of Emergency Medicine at the Denver Health Medical Center in Colorado realized this and sought to determine which individuals were most likely to accept free rapid HIV testing and what factors prevented people from doing so. Sankoff analyzed data from 31,525 patients who were admitted to his emergency department (ED) over a 2-year period. He discovered that individuals with private insurance were least likely to accept the testing. Hispanic patients and Black patients, who made up 37% and 14% of the total patient pool, respectively, were the most likely to agree to the opt-out HIV test. Overall, only 23% of the individuals admitted to the ED during the 2-year period took the test.

Sankoff also discovered that the largest percentage of test-taking individuals came from the uninsured patient pool. Even though the number of uninsured Black patients was relatively equal to the number of uninsured White patients, more Black patients took the test than White patients. Another barrier to test taking was payment. The majority of individuals in the highest risk categories for HIV/AIDS had state or federally subsidized insurance or had no insurance at all. The high cost of HIV/AIDs testing could discourage these individuals from getting tested. Sankoff added, “Although efforts to improve payment for non-targeted HIV screening are ongoing, including improving commercial payment, additional efforts to fund HIV testing or focus scarce resources are required.”

Sankoff, J., Hopkins, E., Sasson, C., Al-Tayyib, A., Bender, B. (2012). Payer status, race/ethnicity, and acceptance of free routine opt-out rapid HIV screening among emergency department patients. American Journal of Public Health, 102.5, 877-883.

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  • Cody

    June 6th, 2012 at 11:15 AM

    If HIV and AIDS cases are still such a problem, and evidently they are given the large numbers which are cited in this piece, then how can the government not find a way to cover the cost for testing for everyone, especially those patients who are at high risk for the infection but have no insurance to cover the cost of the test? It truly amazes me the things that the US government finds a way to pay for, things that are stupid, but when there is something that is an obvious detriment to society as a whole, there somehow always seems to be a lack of money to cover the cost. I would like to ask them just how many infections and cases and deaths there has to be before this is truly recognized as the serious issue that it is, both in the US and worldwide.

  • Bert

    June 6th, 2012 at 12:36 PM

    I know a lot of guys in my own social circle who don’t get tested for HIV because they are afraid to know the results. They think that if they test positive that it is a death sentence, whereas if they just don’t know they can remain forever blissfully ignorant. I know it’s dumb, but that’s the mondset of way too many of my gay and straight friends. I on the other hand get tested fairly regularly, because I want to know if there is something that I can do to stop HIV in uts tracks if I am ever infected. But for the most part I think that the general population really doesn’t see it as a threat to their health anymore, not in the way we looked at it in the late 1980s.

  • holly fowler

    June 6th, 2012 at 3:41 PM

    Do you mean to tell me that testing is being offered and it is not being accepted? Seriously?!

    So how much does it cost? If it is saving lives should it even matter?

  • Clementine

    June 7th, 2012 at 4:33 AM

    What good is testing if the damage has already been done and someone is already infected with HIV?
    It seems tto me, and surely I am not the only one who thinks this way, that perhaps funding would be better spent to implement education and prevention programs that will actually work instead of only preaching about the need to not have unprotected sex or do IV drugs.
    I know that these are the biggest risks for contracting HIV, but do you think that a campaign to really raise the awareness about safer sexual practices and clean needles wouldn’t be the better approach?
    It is not like you can stop everyone from having sex with risky partners or quitting their drug habits, but we could at least make these habits a little less threatening and dangerous.

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