HIV testing among clients in high HIV prevalence venues: disparities between older and younger adults

Abstract

The Centers for Disease Control and Prevention recommends routine human immunodeficiency virus (HIV) testing of every client presenting for services in venues where HIV prevalence is high. Because older adults (aged ≥50 years) have particularly poor prognosis if they receive their diagnosis late in the course of HIV disease, any screening provided to younger adults in these venues should also be provided to older adults. We examined aging-related disparities in recent (past 12 months) and ever HIV testing in a probability sample of at-risk adults (N = 1238) seeking services in needle exchange sites, sexually transmitted disease clinics, and Latino community clinics that provide HIV testing. Using multiple logistic regression with generalized estimating equations, we estimated associations between age category (<50 years vs. ≥50 years) and each HIV testing outcome. Even after controlling for covariates such as recent injection drug use, older adults had 40% lower odds than younger adults did of having tested in the past 12 months (odds ratio [OR] = 0.6; 95% confidence interval [CI] = 0.40–0.90) or ever (OR = 0.6; 95% CI = 0.40–0.90). Aging-related disparities in HIV testing exist among clients of these high HIV prevalence venues and may contribute to known aging-related disparities in late diagnosis of HIV infection and poor long-term prognosis.

Keywords:

• AIDS serodiagnosis
• aging
• HIV infections/diagnosis
• health services accessibility

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Corrigendum

Acknowledgments

The authors acknowledge insightful comments from Jessica Gipson and Deborah Mindry.

Funding

This research was supported by a seed grant from the UCLA Center for Healthy Aging in Minority Elders, which is supported by the National Institute on Aging's Resource Centers on Minority Aging Research [grant number P30-AG02-1684], and by funding from the National Institute on Mental Health [grant number R01MH69087] awarded to Cunningham (PI) and Newman (Co-PI). Dr Cunningham received partial support for his time from the National Institute on Drug Abuse [grant number R01 DA030781], the National Institute of Mental Health [grant number R34 MH089719], National Institute on Minority Health and Human Development UCLA/Charles R. Drew University Project EXPORT [grant number P20 MD000182], and the National Institute on Aging [grant number P30 AG021684]. Dr Lee's time for this manuscript was supported by the National Institute of Mental Health [grant number 5K01MH085503]. Additional support came from the California Center for Population Research, which is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development [grant number 5R24HD041022]. The contents of this paper are the sole responsibility of the authors and do not necessarily represent the official views of these Institutes.

Additional information

Funding

Funding: This research was supported by a seed grant from the UCLA Center for Healthy Aging in Minority Elders, which is supported by the National Institute on Aging's Resource Centers on Minority Aging Research [grant number P30-AG02-1684], and by funding from the National Institute on Mental Health [grant number R01MH69087] awarded to Cunningham (PI) and Newman (Co-PI). Dr Cunningham received partial support for his time from the National Institute on Drug Abuse [grant number R01 DA030781], the National Institute of Mental Health [grant number R34 MH089719], National Institute on Minority Health and Human Development UCLA/Charles R. Drew University Project EXPORT [grant number P20 MD000182], and the National Institute on Aging [grant number P30 AG021684]. Dr Lee's time for this manuscript was supported by the National Institute of Mental Health [grant number 5K01MH085503]. Additional support came from the California Center for Population Research, which is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development [grant number 5R24HD041022]. The contents of this paper are the sole responsibility of the authors and do not necessarily represent the official views of these Institutes.