Differences in HIV testing among sexual orientation subgroups in the United States: A national cross-sectional study

Holly Gurnik; Curtiss W. Engstrom; Sean Esteban McCabe; Rebecca J. Evans-Polce

Preventive Medicine Reports (Aug 2023)

Differences in HIV testing among sexual orientation subgroups in the United States: A national cross-sectional study

Holly Gurnik,
Curtiss W. Engstrom,
Sean Esteban McCabe,
Rebecca J. Evans-Polce

Affiliations

Holly Gurnik: Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI 48109, USA; School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
Curtiss W. Engstrom: Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI 48109, USA; Program in Survey and Data Science, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA
Sean Esteban McCabe: Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI 48109, USA; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI 48109, USA; Center for Sexuality and Health Disparities, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI 48109, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA
Rebecca J. Evans-Polce: Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI 48109, USA; Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA; Corresponding author at: Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, 400 North Ingalls Building, Ann Arbor, MI 48109-5482, USA.

Journal volume & issue: Vol. 34
p. 102230

Abstract

Read online

Understanding differences in HIV testing among US adults is a crucial step for HIV prevention. This study used cross-sectional data to assess whether HIV testing varies across sexual orientation subgroups and by important psychosocial factors. Data were from the National Epidemiological Survey on Alcohol and Related Conditions-III (NESARC-III; n = 36 309, response rate = 60.1%), a nationally representative survey of the US non-institutionalized adult population. Using logistic regression, we examined HIV testing among heterosexual concordant, heterosexual discordant, gay/lesbian, and bisexual adults. Psychosocial correlates included adverse childhood experiences (ACEs), discrimination, educational attainment, social support, and substance use disorders (SUDs). Bisexual (77.0%) and gay/lesbian (65.4%) women had a greater prevalence of HIV testing than concordant heterosexual women (51.6%), and bisexual women had a significantly higher testing prevalence than discordant heterosexual women (54.8%). Gay (84.0%) and bisexual (72.1%) men also had a significantly higher testing prevalence than discordant (48.2%) and concordant (49.4%) heterosexual men. In multivariable models, bisexual men and women (AOR = 1.8; 95% CI = 1.3–2.4) and gay men (AOR = 4.7; 95% CI = 3.2–7.1) had significantly greater odds of HIV testing than heterosexual concordant adults. A higher number of ACEs, greater social support, history of SUDs, and higher educational attainment were positively associated with HIV testing. HIV testing prevalence varied across sexual orientation subgroups; discordant heterosexual men had the lowest prevalence. Health care providers should consider a person’s sexual orientation, ACEs, educational attainment, social support, and history of SUDs when evaluating HIV testing needs in the US.

Published in Preventive Medicine Reports

ISSN: 2211-3355 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine
Website: http://www.journals.elsevier.com/preventive-medicine-reports/

About the journal

Abstract

Keywords