Relationship between high adverse childhood experience score, HIV risk behavior, and previous HIV testing in the...

Identifying HIV risk factors is important for screening. High adverse childhood experience (ACE) scores (≥ 4) reflect childhood trauma and are associated with HIV risk behaviors. Studies examining ACE and HIV testing are limited, with mixed results. We performed a retrospective cross-sectional study examining ACE score, HIV risk behaviors, and previous HIV testing utilizing the S.C Behavioral Risk Factor Surveillance System over six years. We separately compared individuals <35/≥35 years old, with/without risk behaviors, and with/without previous testing. Using logistic regression, we determined factors associated with risk behaviors and previous testing. Of 55,087 surveyed, 15% reported high ACE. High ACE was associated with risk behaviors (aOR 2.652, 95% CI: 1.987-3.538) and previous testing (aOR 2.340, 95% CI: 2.031-2.696). Female respondents had lower odds of risk behaviors (aOR 0.442, 95% CI: 0.336-0.581) and previous testing (aOR 0.822, 95% CI: 0.736-0.919). Individuals <35 years old more often reported high ACE score (25% vs 14%, p < 0.001), risk behaviors (13% vs 2.5%, p < 0.001), and previous testing (46% vs 30%, p < 0.001). Women, who make up 20% of HIV diagnoses, were less likely to report risk behaviors and testing, suggesting traditional risk factors underestimate risk. ACE score could be evaluated prospectively to identify high-risk women.