HIV Testing in the United States, 2002

Advance Data 363. HIV Testing in the United States, 2002. 32 pp. (PHS) 2006-1250.
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A new report shows national estimates of HIV testing from the National Survey of Family Growth (NSFG) and two other CDC surveys. The data show both marked progress since the earlier survey in 1995, and a significant number of persons at risk of HIV who appear to need testing and counseling for HIV. They also show the status of testing in the United States just before the 2003 CDC initiative to increase testing and counseling as part of HIV prevention efforts.

The main source of the data in the report is the 2002 National Survey of Family Growth (NSFG), a national survey of 12,571 men and women 15-44 years of age in the United States. The findings in this report include the most detailed and specific portrait of HIV testing in the U.S. population ever published using a national sample.

Highlights of findings

Trends: The proportion of women who were tested in the year before the 1995 and 2002 surveys was quite similar (15 percent in 1995 and 16 percent in 2002). But the proportion of women who had ever been tested was only 35 percent in 1995, and rose sharply to 55 percent in 2002 (table A).

Proportion tested: About one-half (51 percent) of those 15-44 have been tested for HIV (not counting blood donations) at some time in their lives. In the 12 months before the survey, 15 percent (over 18 million) had been tested.

Testing by HIV risk: One significant innovation in this report is a direct, specific measure of behavioral risk of HIV.* If someone reported any of several recent behaviors in the self-administered part of the survey, they were classified as “at risk of HIV.” Of those at risk of HIV, 28 percent were tested in the last year, compared with 14 percent of those not at risk of HIV. Similarly, 66 percent of those at risk of HIV had been tested at some time in their lives. This means that about 4.8 million people (2.8 million men and 2.0 million women) at risk of HIV had never been tested for HIV in 2002 (tables 1–3 and table E).

Reasons for being tested: The report also shows that about one-third of women tested for HIV in the last 12 months were tested because they were pregnant. The other leading reason, also reported by about one-third of those tested, was “to find out if I was infected.” Testing because of hospitalization or surgery, or applying for insurance or for a marriage license was reported by small percentages of those tested (table 4).

Where the test was done: Of those tested in the last year, just under half (45 percent) were tested at a private doctor’s office or health maintenance organization (HMO). Another 22 percent were tested at public clinics such as community clinics and family planning clinics, and 12 percent at hospitals and hospital clinics (table 7 and table B).

Men were twice as likely as women (30 percent vs. 15 percent) to obtain their tests from “other” sources, such as worksites, employer or company clinics, urgent care facilities, and others. This suggests that extending testing for men and for women may need to be done through different sources.

HIV counseling: Of those who received a test in the last 12 months, only 29 percent recalled talking to a doctor, nurse, or other medical provider after their test. Among those at risk of HIV, 42 percent were counseled compared with 26 percent of those not at risk (table C). Among men at risk of HIV, 48 percent were counseled compared with 35 percent of women at risk of HIV. In addition, 44 percent of those who were tested at a clinic were counseled compared with 26 percent of those tested at a private doctor (table C). These findings suggest that in 2002, there were opportunities for expanding counseling, particularly to the one-half or more of men and women at risk of HIV who had not been counseled after they were tested.

Topics covered in HIV counseling: Regardless of where they were tested and their degree of risk of HIV, most of those who talked to a doctor about HIV were counseled on how HIV is transmitted, how to prevent transmission, other sexually transmitted diseases, safe sex practices, and correct condom use (table 10). It appears, however, that those who were tested at public clinics may have been more likely to be counseled about abstinence (50 percent) than at private doctors (37 percent) (table 10).

Testing during prenatal care: About 2 of 3 women (69 percent) were tested for HIV during a pregnancy in the year before the survey, including 83 percent of those at risk of HIV, and 67 percent of others.

*The measure includes whether the person entered into a computer answers indicating that they had five or more sex partners in the last year, exchange of sex for money or drugs, had sex with an injecting drug user, had male-to-male sex, or injected drugs themselves.

This page last reviewed October 15, 2008