Readiness for HIV testing among midlife women

Background: Midlife and older women have the lowest levels of HIV testing and are more likely to be diagnosed late and to die earlier from HIV yet have seldom been included in studies of HIV testing. The purpose was to identify predictors of the readiness of midlife women to have an HIV test. Methods: This cross-sectional study used a survey mailed to a random sample of women ages 50 to 59 in MA (n = 369, 11% Hispanic, 8% Black). The survey instrument was validated in a pilot test and included four outcome measures of readiness to have an HIV test. Results: Three of four women (75%) were likely to have an HIV test if one were recommended by their primary care provider (PCP), with only 38% likely to test given an opportunity, and 12% intending to have an HIV test. 44% of women had been tested for HIV and women who had discussed HIV testing with their PCP were more likely to have had an HIV test. Only 6% of never-tested women had ever been offered an HIV test. Except when recommended by a PCP, readiness to have an HIV test varied significantly based on race/ethnicity, income, education, marital status, and prior HIV testing. Conclusions: PCP recommendation of routine HIV testing has the potential to increase HIV testing among midlife women. Multiple outcome indicators help to identify contextual differences when readiness to act rather than actual behavior is measured.