Trends and predictors of human immunodeficiency virus antibody testing by homosexual and bisexual adolescent males, 1989-1994
M. Povinelli, G. Remafedi and G. Tao
Mayo Medical School, Rochester, Minn, USA.
OBJECTIVE: To identify temporal trends and predictors of human
immunodeficiency virus (HIV) antibody testing in homosexual and bisexual
youth, using the Health Belief Model as a conceptual framework. DESIGN:
Cross-sectional survey. SUBJECTS: Five hundred one male volunteers, 13 to
21 years old, self-identified as homosexual, bisexual, or as having sex
with men, were enrolled from June 1, 1989, to May 30, 1994. METHODS:
Structured reviews and written instruments, including measures of perceived
susceptibility to and severity of HIV disease, benefits and barriers to
testing, and cues to action. Based on significant (P < .001) bivariate
association, variables were selected for forward stepwise logistic
regression analysis. OUTCOME MEASURES: Self-reported HIV antibody testing.
RESULTS: Forty-five percent of the subjects had undergone HIV antibody
testing, with no significant differences between annual cohorts. Predictors
of testing were having discussed same-sex feelings or experiences with a
physician or counselor, a history of unprotected receptive anal
intercourse, substance abuse, younger age at self-identification as
bisexual or homosexual, ever having had a steady male partner, having many
friends who understand sexual orientation, living away from family, and
older age. CONCLUSIONS: Testing practices did not change significantly
across time. Human immunodeficiency virus testing was related to age, risky
behaviors, living situation, bisexual or homosexual acculturation, and
contacts with health professionals, corresponding to Health Belief/Model
dimensions of perceived susceptibility, barriers, and cues to action.
