Gender differences in behavioural and psychosocial predictors of HIV testing and return for test results in a high-risk population

J A Stein,A Nyamathi

doi:10.1080/09540120050043007

Abstract

We assessed gender differences in psychosocial and behavioural predictors of HIV testing and returning for results in a high-risk sample of 1,049 predominately minority, impoverished, homeless and/or drug-abusing women (n = 621) and men (n = 428). Predictors included latent variables representing injection drug use, self-esteem, social support, AIDS knowledge, poor access to health services, perceived risk for AIDS, sexual risk behaviour and the mediators of positive and negative coping styles. Significant predictors of test and return for women included injection drug use, greater social support, more AIDS knowledge, a higher perceived risk for AIDS and a positive coping style. Significant predictors for the men included injection drug use, greater AIDS knowledge, a higher perceived risk for AIDS and a positive coping style. Although greater social support was not significant for the men, the significant predictors of HIV testing and return were generally similar for the men and women. However, the men evaluated their risk of AIDS significantly lower than the women, although they reported more sexual risk behaviours and equally risky injection drug use behaviours. Results suggest that interventions designed to increase AIDS knowledge, to raise the perception of risk and to promote a positive coping style would be effective in encouraging more HIV testing for both men and women, but raising perceptions of what constitutes personal risk behaviours may need special emphasis when delivering prevention programmes to men.

Highlights

The purpose of this study was to determine whether there were gender differences in signi cant behavioural and psychosocial predictors of human immune de ciency virus (HIV) testing and returning for test results in a high-risk sample of heterosexual men and women
A nding of substantial differences would suggest the necessity of tailoring interventions speci cally by gender among at-risk populations to encourage more HIV testing and returning for results and counselling
Wanted doctor Doesn’t know where to go Can’t afford Confused Wait long time Perceived risk Done plenty (1–5) Never do anything (R) (1–5) Chances are great (1–5) Don’t think at risk (R) (1–5) Chances of getting AIDS (1–4) Sexual risk behaviour Number of partners** Frequency—oral sex (0–7) Frequency-vaginal sex (0–7) Sex without condom (1–2) Positive coping (1–5) Became informed Take it easy Thought what to do Talked to others Made action plan Negative coping (1–5) Withdrew from people Eat, drink, drugs Take out on others Time alone Slept more Scaled HIV test (0–2)***

Summary

Introduction

The purpose of this study was to determine whether there were gender differences in signi cant behavioural and psychosocial predictors of human immune de ciency virus (HIV) testing and returning for test results in a high-risk sample of heterosexual men and women. A nding of substantial differences would suggest the necessity of tailoring interventions speci cally by gender among at-risk populations to encourage more HIV testing and returning for results and counselling. Of the estimated 900,000 HIV-positive individuals in the USA, it is speculated that one-third do not know that they are HIV-positive (Centers for Disease Control and Prevention (CDC), 1997). HIV testing has been promoted as an important step in detecting, treating and preventing HIV infection (Norton et al 1997).

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Conclusion