High rates of HIV testing despite low perceived HIV risk among African-American sexually transmitted disease patients

Purpose: In the current diagnosis-based, human immunodeficiency virus (HIV) prevention climate, previous testing among persons at elevated HIV risk has cost and efficacy implications, as it signals continued behavioral risk, limited HIV knowledge or overuse of services. This study sought to determine the proportion of African Americans newly seeking sexually transmitted disease (STD) diagnosis who previously had obtained HIV counseling and testing. Methods: This was a clinic-based, cross-sectional survey of African-American adults (N=408) seeking STD diagnosis at a public STD clinic located in a high-HIV and STD prevalence city in the U.S. south. Main findings: Eighty-four percent of respondents had previously obtained HIV counseling and testing; 68% had previously obtained care at the clinic. Sixty-five percent of respondents perceived themselves as having low or no HIV risk. Seventy-two percent correctly answered ≥3 of 4 HIV knowledge items. Conclusions: Although diagnosis-based HIV prevention initiatives promote HIV counseling and testing for both primary and secondary HIV prevention, these findings suggest that many African-American STD patients remain at risk following testing. Future research should explore how the counseling portion of standard HIV counseling and testing influences subsequent knowledge, attitudes, risk perceptions and behaviors.