Comparison of HIV-antibody prevalence in patients consenting to and declining HIV-antibody testing in an STD clinic
H. F. Hull, C. J. Bettinger, M. M. Gallaher, N. M. Keller, J. Wilson and G. J. Mertz
New Mexico Health and Environment Department, Santa Fe 87504-0968.
All patients attending a sexually transmitted disease (STD) clinic were
offered voluntary, anonymous human immunodeficiency virus (HIV)-antibody
testing and counseling as part of routine clinical evaluation. During a
three-month evaluation period, 82% of patients accepted HIV testing.
Testing was accepted equally by men and women and by heterosexual and
homosexual men. Black men were more likely to refuse testing than men from
other ethnic groups. Eight (0.7%) of 1146 STD clinic patients tested were
infected with HIV. A blinded study of 237 patients who refused testing
identified nine (3.8%) additional HIV-infected patients. Men who refused
testing were 5.3 times more likely to be infected than men who accepted
testing. Male homosexuals and black and Hispanic men who refused testing
were 7.3 and 8.8 times, respectively, more likely to be infected with HIV
than were their counterparts who accepted testing. Human immunodeficiency
virus testing and counseling should be routinely offered to STD clinic
patients. Male STD clinic patients, especially homosexual or minority men,
who refuse voluntary HIV testing should be counseled regarding reducing
their risk for HIV transmission.
