Frequency of human immunodeficiency virus testing among rural US residents and why it is done
A. G. Mainous 3rd, R. A. Neill and S. C. Matheny
Department of Family Practice, University of Kentucky, Lexington.
OBJECTIVE: To examine the frequency with which rural residents' undergo
human immunodeficiency virus (HIV) antibody testing and the reasons why.
DESIGN: Data are from the 1991 National Health Interview Survey's
supplemental questions on knowledge and attitudes about acquired
immunodeficiency syndrome. SUBJECTS: The respondents were 42,725 adults
(aged > or = 18 years), representing a nationwide sample of the
civilian, noninstitutionalized population of the United States. Rural (n =
9903) and urban (n = 32,822) respondents were compared. RESULTS: Although
7.1% of rural and 7.9% of urban respondents are at high risk for
contracting HIV (P = .06), 25.2% of rural and 33.0% of urban respondents
had been tested for HIV (P = .001). Excluding blood donations, 10.7% of
rural and 17.2% of urban respondents had been tested for HIV (P = .001).
The primary reason between the two groups for not getting tested was a
belief of being at low risk for contracting HIV. Rural respondents were
less likely than urban respondents (6.6% vs 10.4%) (P = .001) to be tested
for HIV in the next 12 months. Rural respondents were less informed about
HIV risks than were urban respondents. Urban residence is a significant
predictor of having had an HIV test even after controlling for actual risk
status, perceived risk status, age, education, income, sex, perceived
health status, and a scale of knowledge of acquired immunodeficiency
syndrome risk factors (odds ratio, 1.54; 95% confidence interval, 1.37 to
1.73). CONCLUSIONS: Rural residents are less knowledgeable about HIV risk
factors and are less likely to have been tested for HIV. With the
increasing rates of infection in rural areas, specific and focused efforts
for counseling and testing for HIV antibodies in rural areas might prevent
and control HIV infection and acquired immunodeficiency syndrome.
