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HIV Testing of Males in Physician Offices

MMWR; 2016 Jun 24; Ham, Huang, et al

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While males aged 15 to 39 years had an average of 1.35 visits to physicians’ offices each year from 2009 to 2012 in the US, <1.1% of those visits included an HIV test, despite recommendations by the Centers for Disease Control and Prevention (CDC) for HIV testing of adults and adolescents. This according to data analyzed from the 2009-2012 National Ambulatory Medical Care Survey (NAMCS) and US Census data to estimate rates of health care at US physicians’ offices and HIV testing at these visits. The study further revealed:

• White males visited physicians’ offices more often (1.6 visits per person) than black males (0.9 visits per person) and Hispanic males (0.8 visits per person).

• Overall, an HIV test was performed at 1.0% of visits made by young males to physicians’ offices, with higher testing rates among black males (2.7%) and Hispanic males (1.4%), compared to white males (0.7%).

• While higher proportions of black and Hispanic males received HIV testing compared to white males, this benefit is likely attenuated by a lower rate of health care visits.

The authors concluded that interventions to routinize HIV testing at US physicians’ offices could be implemented to improve HIV testing coverage.

Citation: Ham DC, Huang Y, Gvetadze R, Peters PJ, Hoover KW. Health Care Use and HIV Testing of Males Aged 15–39 Years in Physicians’ Offices—United States, 2009–2012. MMWR Morb Mortal Wkly Rep. 2016;65:619–622. doi:10.15585/mmwr.mm6524a3.

Commentary: Eighty-one percent of new HIV infections in the US occur in males and only about a third of males aged >18 report ever having had an HIV test. In addition, approximately 15% of all males with HIV are undiagnosed. The low rate of HIV testing in males reported in this study is not surprising, as most males seen during the year are seen for problem-oriented acute visits, not for preventive health visits. While it is easy to recommend testing for HIV at all of these visits, that is a recommendation that is challenging to implement without patients actually scheduling health maintenance visits. The study is a good reminder of the CDC recommendation for routine HIV testing of adults and the particular importance of HIV testing in young males, but integrating this into practice remains challenging.1 —Neil Skolnik, MD

1. Centers for Disease Control and Prevention. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. 2006;55(No. 14).

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