Abstract
BackgroundThirteen percent of the U.S. population is ages 65 and older, a number projected to reach 20% by 2030. By 2015, 50% of Human Immunodeficiency Virus (HIV)-infected individuals in the U.S. are expected to be ages 50 and older. Current Centers for Disease Control and Prevention guidelines recommend “opt-out” HIV screening for individuals ages 13–64. The purpose of this study was to assess the occurrence and barriers to HIV screening in older adults, and to evaluate the rationale for expanding routine HIV screening to this population.MethodsThe study used 2009 National Health Interview Survey (NHIS) data. A total of 12,366 (unweighted) adults, ages 50 and older, participated in the adult section of the NHIS and answered questions on the HIV/AIDS, Sexually Transmitted Diseases, and Tuberculosis components. Associations between HIV screening, socio-demographic variables, and knowledge of HIV-related disease were examined using logistic regression models.ResultsThe HIV screening rate within this population was 25.4%. Race had no statistically significant effect. Low risk perception of HIV exposure (84.1%) accounted for low likelihood of planned screening (3.5%) within 12 months post survey. A routine medical check-up was the single most common reason for HIV screening (37.6%), with only about half (52.7%) of the tests suggested by a health care provider.ConclusionIt is imperative that practices and policies are developed and implemented to increase HIV awareness and screening in the older adult population. Increased health care provider awareness of the importance of HIV screening, especially for those 65 and older, is critical. Health policies and clinical guidelines should be revised to promote and support screening of all adults.
Highlights
Human Immunodeficiency Virus (HIV) has been a major medical and public health challenge over the past three decades
Current Centers for Disease Control and Prevention (CDC) guidelines recommend ‘‘opt-out’’ HIV screening for individuals ages 13–64 years in all health-care settings [5], [6]
The purpose of this study is to assess the occurrence and barriers to HIV screening in older adults, and to evaluate the value of expanding routine HIV screening to this population
Summary
Human Immunodeficiency Virus (HIV) has been a major medical and public health challenge over the past three decades. Risky sexual behavior is not limited to adolescents and young adults [3] While these demographic groups should remain a focus of sexual health programs, the importance of targeting and screening older adults should not be overlooked. Current Centers for Disease Control and Prevention (CDC) guidelines recommend ‘‘opt-out’’ HIV screening for individuals ages 13–64 years in all health-care settings [5], [6]. These guidelines, established in 2006, recommend that patients be notified that testing will be performed, but be given the option to decline or defer testing [5]. The purpose of this study was to assess the occurrence and barriers to HIV screening in older adults, and to evaluate the rationale for expanding routine HIV screening to this population
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