Testing negative: HIV testing as a predictor of HIV risk perception among americans, 1993-2000

Objectives: This study examines the relationship between of HIV testing and risk perception among Americans from 1993 to 2000. Methods: HIV testing and risk perception data were drawn from the CDC's National Behavioral Risk Factor Surveillance System (BRFSS) from 1993 to 2000 (n= 123,701). Distributed lagged regression models were employed to estimate the relationship of testing behavior on subsequent perceptions of risk of contracting HIV. Results: The model, controlling for previous levels of risk perception, suggests a significant negative association between HIV/AIDS testing and risk perception, where a one unit increase in testing was associated with a -0.49 decrease in risk perception in the following month (p<.001). These findings suggest that HIV/AIDS testing is a strong predictor of risk perception. This effect differed by race, with African Americans exhibiting greater declines in risk perception subsequent to increased testing than Whites. Conclusions: The results suggest that at the aggregate level, being tested for HIV in the previous month was associated with decreased levels of perceived risk. We hypothesize that HIV testing led individuals to assess their risk level based not on their risk behavior, but on recent test results. This may be even more acute for African Americans who report higher levels of testing overall. It is reasonable to assume that the majority of individuals tested for HIV receive a sero-negative result, leading to lower perceived risk of contracting HIV overall. We caution that sero-negative test results are not equivalent to safe behavioral practices and post-testing counseling should emphasize the distinction.