vention objectives for the year 2000 call ... stand client needs, knowledge, and pref- erences. This study ... tional Center for Chronic Disease Preven- tion and ...
American Adults' Knowledge of HIV Testing Availability
Ronald 0. Valdisemi, MD, MPH, David R Holtgrave, PhD, and Robert M. Brackbill PhD, MPH
Introdudion Human immunodeficiency virus (HIV) counseling and testing is an impor-
tant component of HIV prevention program activities. These client-centered services are available in a wide variety of clinical and public health settings.' National health promotion and disease prevention objectives for the year 2000 call for an expansion of HIV counseling and testing efforts.2 In order to provide accessible services, it is important to understand client needs, knowledge, and preferences. This study presents the results of the 1990 Behavioral Risk Factor Survey of American adults, in which respondents were asked about where they could go for HIV testing.
Methods The Behavioral Risk Factor Surveillance System was implemented by the National Center for Chronic Disease Prevention and Health Promotion to collect prevalence data on personal behaviors that affect health. In 1990, 44 states and the District of Columbia participated in the system. Participating states conducted monthly random-digit dialing telephone surveys using a standardized protocol and questionnaire. Survey subjects had to be willing to participate, live in a private residence that had a telephone, and be at least 18 years of age. The median percentage of respondents completing interviews was 82% in 1990. The independent variables of gender, race/ethnicity, age, marital status, employment status, education, and annual income were provided by respondents during the interview. The independent variable of annual acquired immunodefi-
ciency syndrome (AIDS) rate was obtained from ongoing HIV/AIDS surveillance activities conducted by the Centers for Disease Control and Prevention. In 1990, the total annual AIDS rate was 16.6 cases per 100 000 population.3 Respondents were categorized according to whether they lived in a state that had a rate lower or higher than the US average. The dependent variable was obtained during the interview as a spontaneous response to the open-ended question. "Where could you go to be tested for the AIDS virus infection?" Client demographics were analyzed in bivariate analyses (X2 tests) with declared location for HIV testing. Relevant variables were entered, stepwise, into two multivariate logistic models.
Results Figure 1 shows the distribution of 81 557 respondents' answers to the question "Where could you go to be tested for the AIDS virus infection?" Private doctor or health maintenance organization (HMO) was the most common response (42%), followed in frequency by hospital or emergency room (23%). Twelve percent of the respondents indicated that they "didn't The authors are with the National Center for Prevention Services and the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga. Requests for reprints should be sent to Ronald 0. Valdiserri, MD, MPH, Deputy Director (H1V), National Center for Prevention Services, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mailstop E07, Atlanta, GA 30333. This paper was submitted to the Journal February 19, 1992, and accepted with revisions October 22, 1992.
American Journal of Public Health 525
Valdsmi et aL
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* Hospital, Emergency Room 23%
E,] Don't Know/Not Sure 12% Y. :lr .' QR
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Health Department
11%
Community Health Center,
Primary Care Clinic 4%
l] AIDS Clinic, AIDS Testing Site
12%
E Blood Bank, Plasma Center, Red Cross 2% Other responses (
