Between 35,000 to 40,000 people become infected with HIV every year in the United States (1).  While there are about 1.2 million people living with HIV in this country, about 240,000 (20%) do not know that they are HIV positive (2).

In observation of World AIDS Day (December 1st), this article presents data from PHMC’s 2010 Household Health Survey on HIV testing among adults 18 years of age and older in the Southeastern Pennsylvania (SEPA) region. This survey is a random digit dial telephone survey of over 10,000 households in the five-county SEPA region of Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties.

HIV Testing: Tested Within the Past Year

In Southeastern Pennsylvania (SEPA), 21.5% of adults have been tested for HIV within the past year, representing an estimated 619,000 adults in the region.

• Nearly one-third of adults living in Philadelphia (30.4%) received an HIV test within the previous year, representing about 333,000 adults. In the surrounding suburban SEPA counties, smaller percentages of adults have been recently tested for HIV: 20.8% of adults in Delaware County (83,000 adults), 15.4% of adults in Bucks County (70,000 adults), 14.7% of adults in Montgomery County (84,000 adults), and 13.8% of adults in Chester County (49,000) have been tested for HIV in the previous year.
• The likelihood of being tested within the previous year for HIV decreases with age: 35.1% of 18-39 year olds, 20.7% of 40-49 year olds, 15.7% of 50-59 year olds, 10.3% of 60-74 year olds and 8.3% of 75 year olds and older have been tested within the past year.
• Men (21.9%) and women (21.2%) were similarly as likely to have been tested for HIV within the past year.
• About one-third of adults with less than a high school education (29.0%) received an HIV test within the previous year compared with 24.1% of high school graduates, 23.0% of adults with some college, 19.5% of college graduates, and 14.9% of adults with post-college schooling.
• Over two-fifths of Black adults (41.2%) received an HIV test within the previous year, followed by Latino (37.5%), Asian (16.2%), and White (13.9%) adults in the region (Figure 1).
• More than one-third of adults living below 150% of the Federal Poverty Level (34.9%) have been tested for HIV in the previous year compared with less than one-fifth of non-poor adults (18.4%).

HIV Testing—Never Tested

While the Centers for Disease Control and Prevention (CDC) recommends HIV testing as part of routine medical exams for adolescents and adults in the US, in Southeastern Pennsylvania (SEPA) nearly one-half of adults (48.4%) have never been tested for HIV, representing an estimated 1.4 million adults in the region.

• While 38.5% of Philadelphia adults have never been tested for HIV, more than one-half of adults living in Montgomery (55.6%), Bucks (55.3%), Chester (55.3%), and Delaware (50.9%) Counties have never been tested.
• The likelihood of having never been tested for HIV increases with age—29.5% of 18-39 year olds, 37.4% of 40-49 year olds, 53.8% of 50-59 year olds, 71.2% of 60-74 year olds, and 83.1% of adults 75 and older have never been tested.
• HIV testing slightly varies by educational attainment. Over one-half of high school graduates and people with post-college schooling have never been tested for HIV (50.4% and 51.4%, respectively), compared with 43.0% of adults with less than a high school degree, 46.7% of adults with some college, and 46.6% of college graduates.
• White and Asian adults are more likely to have never been tested (57.0% and 50.6%, respectively) for HIV, compared with more than one-quarter of Black (27.2%) and Latino (28.6%) adults (Figure 2).
• About one-third of adults living below 150% of the Federal Poverty Level (34.1%) have never been tested for HIV, while 51.6% of non-poor people have never been tested.

Conclusion

A large proportion of residents in SEPA have never been tested for HIV, and testing disparities exist particularly by race/ethnicity and educational attainment. Additionally, there are differences in receiving an HIV test within the previous year by county, age, race/ethnicity and poverty status. The CDC recommends HIV testing as part of routine medical exams for adolescents and adults in the US. HIV status awareness is one important way to reduce HIV transmission. Several organizations in the Philadelphia and surrounding areas offer free HIV tests, including ActionAIDS and GALAEI.

For more information on World AIDS Day, visit their website at www.worldaidscampaign.org/en/.

For more information about the findings presented in this article, please contact Sarah Ingerman at singerman@phmc.org.

References:

(1) CDC. 2008. Diagnoses of HIV Infection and AIDS in the United States and Dependent Areas.

http://www.cdc.gov/hiv/surveillance/resources/reports/2008report/index.htm (2) CDC. 2011. HIV surveillance—United States, 1981-2008. MMWR 60(21: 698-693.