An Investigation of Factors Related to Foreign Birth, English Non-Proficiency, and Lifetime HIV Testing in US from the National Survey for Family Growth 2013-2015 Open Access

Abstract

Background: Despite increased access to HIV testing, lack of testing is still common in the US, particularly among high risk groups. This contributes to the public health burden of HIV since those who do not know they are infected are at increased risk of transmission. This analysis seeks to identify factors that relate to lifetime HIV testing. It pays particular attention to relationships between foreign birth and English proficiency and lifetime HIV testing. 

Methods: We performed a cross-sectional study of individuals interviewed for the National Survey for Family Growth (NSFG) from 2013-2015 stratified by sex. The analysis compared demographics, health behaviors, and risk behaviors for HIV of those who had an HIV test during their lifetime and those who have never had an HIV test. Multivariate logistic regression models were created for men and women to determine which variables were associated with self-reported lifetime HIV testing. A descriptive analysis of reasons for never testing for HIV in lifetime was also investigated.     

Results: Birth outside the US and non-English proficiency were not significantly related to lifetime HIV testing. Lifetime HIV testing varied significantly (p<0.0033) by education, marital status alcoholic intake, sexual history, and talking to a doctor about HIV/AIDS for men. Lifetime HIV testing varied significantly (p<0.0041) by education, marital status, pregnancy status, alcoholic intake, sexual history, and talking to a doctor about HIV/AIDS for women. The primary reason for never testing reported by 70.6% of men and 72.2% of women was that “it is unlikely that you (they) have been exposed to HIV.” 

Conclusions: The findings indicate that there should increased awareness about the importance of HIV testing because many do not perceive themselves at risk. These findings also emphasize the need for more research regarding the relation between foreign births, English non-proficiency, and HIV testing in the US.  

Table of Contents

CHAPTER I: BACKGROUND/LITERATURE REVIEW 1

Introduction 1

Literature Review 3

CHAPTER II: MANUSCRIPT 10

ABSTRACT 10

INTRODUCTION 11

METHODS 14

RESULTS 17

DISCUSSION 21

CONCLUSION 27

CHAPTER III: SUMMARY, PUBLIC HEALTH IMPLICATIONS AND POSSIBLE FUTURE DIRECTIONS 29

Summary 29

Public Health Implications 29

Possible Future Directions 30

REFERENCES 31

APPENDIX 35 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology Health Sciences, Public Health
Keyword	HIV Testing Foreign Birth National Survey for Family Growth Immigrant English Proficiency
Committee Chair / Thesis Advisor	Wall, Kristin, Emory University

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