AIDS and Behavior · 2010 · 43 citations · 33 references
Public HealthEmergency MedicineHealth EducationHealth Services ResearchHiv ControlHiv PreventionHiv DiagnosisHiv EpidemiologyHiv TestingInfectious Disease ScreeningPopulation ScreeningRetention In CareHealth RefusalHiv Risk PerceptionHiv Testing BarriersHiv Testing CounselingMultivariate Correlates AnalysisRoutine Hiv TestingRoutine Screening
HIV screening studies in the emergency department (ED) have demonstrated rates of HIV test refusal ranging from 40-67%. This study aimed to determine the factors associated with refusal to undergo routine rapid HIV testing in an academic ED in Boston. HIV counselors offered routine testing to 1,959 patients; almost one-third of patients (29%) refused. Data from a self-administered survey were used to determine independent correlates of HIV testing refusal. In multivariate analysis, women and patients with annual household incomes of $50,000 or more were more likely to refuse testing, as were those who reported not engaging in HIV risk behaviors, those previously HIV tested and those who did not perceive a need for testing. Enrollment during morning hours was also associated with an increased risk of refusal. Increased educational efforts to convey the rationale and benefits of universal screening may improve testing uptake among these groups.
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