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

Chandra L Ford1, Sung-Jae Lee, Steven P Wallace

  • 1a Department of Community Health Sciences, Los Angeles (UCLA) Fielding School of Public Health , University of California , Los Angeles , CA , USA.

AIDS Care
|October 11, 2014
PubMed

Insights

Older adults (aged ≥50) are less likely to be tested for human immunodeficiency virus (HIV) than younger adults, even in high-prevalence settings. This disparity contributes to later HIV diagnosis and poorer health outcomes in older populations.

Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Gerontology

Background:

  • Routine human immunodeficiency virus (HIV) testing is recommended in high-prevalence settings.
  • Older adults face worse prognoses with late HIV diagnosis.
  • Screening for younger adults should extend to older adults in these venues.

Purpose of the Study:

  • To examine age-related disparities in recent and ever HIV testing.
  • To compare HIV testing rates between adults aged <50 and ≥50 years.
  • To identify potential barriers to HIV testing in older adults.

Main Methods:

  • A probability sample of 1238 at-risk adults was recruited from needle exchange sites, STD clinics, and Latino community clinics.
  • Multiple logistic regression with generalized estimating equations was used.
  • Associations between age category (<50 vs. ≥50 years) and HIV testing outcomes were estimated, controlling for covariates like injection drug use.

Main Results:

  • Older adults had 40% lower odds of recent (past 12 months) HIV testing (OR=0.6; 95% CI=0.40-0.90).
  • Older adults also had 40% lower odds of ever having been tested for HIV (OR=0.6; 95% CI=0.40-0.90).
  • These disparities persisted after controlling for covariates.

Conclusions:

  • Significant aging-related disparities in HIV testing exist among clients in high-prevalence venues.
  • These disparities may exacerbate known age-related differences in late HIV diagnosis.
  • Targeted interventions are needed to improve HIV testing rates and outcomes for older adults.

Keywords:
AIDS serodiagnosisHIV infections/diagnosisaginghealth services accessibility

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