The relationship of 1988 state HIV testing policies to previous and planned voluntary use of HIV testing

This study analyzed whether state HIV testing policies were related to individuals' previous and planned voluntary use of HIV testing. Testing plays an important role in the prevention and treatment of HIV infection, yet little is known about how policies are related to testing use. Most states mandate the conditions under which testing is performed, but states vary widely in their policies. This cross-sectional study analyzed individual-level data from the 1988 AIDS Knowledge and Attitudes Survey, which was merged with state-level data on testing policies and incidence of AIDS cases. A multivariate regression model was used to assess the relationship of state policies to testing use, holding state AIDS incidence and individual characteristics (sociodemographics, AIDS knowledge, and risk status) constant. Individuals in states with policies protective of individual rights (i.e., early adoption of comprehensive antidiscrimination laws restricting screening by insurers and employers; provision of voluntary, anonymous testing) were significantly more likely to have been tested than individuals in comparison states (odds ratio = 1.5). Individual characteristics such as risk status, however, had the strongest relationships to testing use. No evidence was found that name-reporting requirements were related to previous or planned use of testing. Future research must address emerging testing issues such as policies covering the use of new testing technologies.