When it comes to knowing their HIV status, a newly published study in the July/August edition of the Journal of Women's Health finds that many older women don't feel the need to be tested for the virus that causes AIDS.
The study shows that despite the majority of the older women interviewed having significant risk factors for lifetime exposure to HIV, few had ever been tested or were interested in being tested.
"Across the board, African Americans represent a disproportionate number of HIV cases in women and the prevalence of HIV in women over 50 is on the rise," says Lisa Bernstein, MD, assistant professor of medicine, Emory University School of Medicine, and principal investigator for the study. "HIV prevention messages have targeted populations traditionally considered at risk for this disease. As a result, older women have been overlooked and often don't realize they are at risk for HIV, leading them to consider testing unnecessary."
Dr. Bernstein notes older patients tend to be tested only when they present already symptomatic from the disease, when it is often late in their course.
Dr. Bernstein's research team analyzed data collected from 514 women ranging in age from 50 to 95 who were patients in the Emory General Medical Clinic at Grady Memorial Hospital over an 11-month period between 2001 and 2002.
To assess their knowledge about HIV, their perception of their lifetime HIV infection risk and their interest in HIV testing, the women answered a 68-item questionnaire during a one on one interview with a trained research assistant. Most of the participants were African American and said they were not currently sexually active. The primary objective was to determine the factors and reasons associated with lack of interest in HIV testing, especially in women who had never been tested or who had risk factors for HIV.
Researchers found that two-thirds of the participants had never been tested for HIV, despite the fact that the CDC recommends that all adults residing in a high prevalence community for HIV such as Atlanta should be offered HIV testing.
Previously tested women were more likely to be younger, sexually active and more knowledgeable about HIV, and they were more likely to report being tested at the suggestion of a health care provider. However, overall, fewer than 25 percent recalled a provider ever recommending that they be tested for HIV.
Of the 514 women, only 115, or 22 percent expressed interest in being tested for HIV, many of whom cited curiosity, safety and concern about a current or past sexual partner's behaviors as their reason for being tested.
"Our data found a significant proportion of these women were either at moderate or high risk for contracting HIV based on their behaviors. Even those that were at risk didn't feel they needed to be tested because of poor knowledge or low perception of their own risk of contracting HIV," says Dr. Bernstein.
"The take-home message from this study is that we have to focus our efforts on educating older women so they are more knowledgeable about this disease and can accurately assess their own risk," she says. "By increasing patient and provider awareness, we can increase appropriate testing and hopefully prevent the spread of HIV in this population."
The study, "Factors Associated with Lack of Interest in HIV Testing in Older At-Risk Women," was funded by the Emory Medical Care Foundation and the Robert Wood Johnson Clinical Foundation.