Heterosexuals at high risk for HIV: Comparing gender differences in HIV testing patterns and correlates among those recruited in a high-risk area in New York City

Background

Heterosexuals at high risk (HHR) for HIV are those linked to high-risk areas (HRAs) with elevated poverty and HIV prevalence, and include disproportionately high numbers of racial/ethnic minorities. Yet HHR are under-studied. We explored gender differences in HIV testing rates and correlates among African-American/Black and Latino/Hispanic HHR, for whom annual testing is recommended.

Methods

Participants were recruited using respondent-driven sampling. Participants engaged in a one-hour structured assessment using reliable/valid measures on factors that promote/impede HIV testing. Variables significantly associated with testing in bivariate analyses were included in multivariable analyses.

Results

Initial “seeds” were recruited in a HRA (N=49); seeds recruited 1139 peers over 14 recruitment waves (total N=1188). Most (76%) were African-American/Black (24% Hispanic); 55% were male. Males were older than females (median 40 vs. 35 years; p < .01). Most (91.2%) had been tested over their lifetimes (median number of tests = 5). Females were more likely than males to be tested in the past year (58.3% vs. 51.0%; p < .05).  Among males, past year incarceration, perceived HIV testing access, and lifetime sexually transmitted infection (STI) testing were significantly associated with past year HIV testing in the multivariable model. Among females, access to health care, perceived HIV testing access, and lifetime STI testing were significant in the multivariable model.

Conclusions

Rates of HIV testing in the past year are lower among HHR than other risk groups. Past year HIV testing is mainly associated with structural factors related to testing and health care access, with females evidencing better access than males.