HIV testing, risk perception, and behaviour in the British population.

Soazig Clifton,Pam Sonnenberg,Clare Tanton,Anne M Johnson,Anthony Nardone,Wendy Macdowall,Nigel Field,Catherine H Mercer

doi:10.1097/qad.0000000000001006

Abstract

Objective:To examine the relationship between HIV risk behaviour, risk perception and testing in Britain.Design:A probability sample survey of the British population.Methods:We analyzed data on sexual behaviour, self-perceived HIV risk and HIV testing (excluding testing because of blood donation) from 13 751 sexually experienced men and women aged 16–74, interviewed between 2010 and 2012 using computer-assisted face-to-face and self-interviewing.Results:Altogether, 3.5% of men and 5.4% of women reported having an HIV test in the past year. Higher perceived risk of HIV was associated with sexual risk behaviours and with HIV testing. However, the majority of those rating themselves as ‘greatly’ or ‘quite a lot’ at risk of HIV (3.4% of men, 2.5% of women) had not tested in the past year. This was also found among the groups most affected by HIV: MSM and black Africans. Within these groups, the majority reporting sexual risk behaviours did not perceive themselves as at risk and had not tested for HIV. Overall, 29.6% of men and 39.9% of women who tested for HIV in the past year could be classified as low risk across a range of measures.Conclusion:Most people who perceive themselves as at risk of HIV have not recently tested, including among MSM and black Africans. Many people tested in Britain are at low risk, reflecting current policy that aims to normalize testing. Strategies to further improve uptake of testing are needed, particularly in those at greatest risk, to further reduce undiagnosed HIV infection at late diagnoses.

Highlights

Current estimates indicate that approximately 110 000 people are living with HIV in the United Kingdom, with an overall prevalence of 2.8 per 1000 population aged 15–59
Seven hundred and ten men and 8041 women aged 16–74 years reporting sexual experience, ever, answered questions on HIV testing. Of these 1.5% (n 1⁄4 87) men and 1.4% (n 1⁄4 114) women identified as black African ethnicity and reported at least one heterosexual partner in the past 5 years, and 2.6% (n 1⁄4 190) men reported at least one male partner in the past 5 years (‘MSM’)
HIV testing increased with increasing risk perception; the majority (86%) of those with high HIV risk perception had not had an HIV test in the past year (Table 1)

Summary

Introduction

Current estimates indicate that approximately 110 000 people are living with HIV in the United Kingdom, with an overall prevalence of 2.8 per 1000 population aged 15–59. Despite substantial increases in HIV testing in Britain since 2000, and testing being more common among those at greater risk [1], late diagnosis remains a major public health concern, with around a quarter of people living with HIV unaware of their infection [2]. Black African men and women, and MSM, bear a disproportionate burden of HIV infection in the United Kingdom, with 56 per 1000 black Africans and 59 per aResearch Department of Infection and Population Health, University College London, bHIV and STI Department, Public Health England, and cDepartment of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.

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Conclusion