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HIV testing rates were higher in the HITS-II, but testing rates decreased among the youngest respondents. Denial of HIV risk factors and fear of being HIV-positive were the principal reasons for not being tested. Availability of new HIV therapies may have contributed to decreased fear of finding out that one is HIV infected as a reason to avoid testing. The increased proportion of persons at risk who did not test because they believed they were unlikely to have been exposed highlights the need for prevention efforts to address risk perceptions.

OBJECTIVE -To examine racial/ethnic and socioeconomic variation in diabetes care in managed-care settings.RESEARCH DESIGN AND METHODS -We studied 7,456 adults enrolled in health plans participating in the Translating Research Into Action for Diabetes study, a six-center cohort study of diabetes in managed care. Cross-sectional analyses using hierarchical regression models assessed processes of care (HbA 1c [A1C], lipid, and proteinuria assessment; foot and dilated eye examinations; use or advice to use aspirin; and influenza vaccination) and intermediate health outcomes (A1C, LDL, and blood pressure control).RESULTS -Most quality indicators and intermediate outcomes were comparable across race/ethnicity and socioeconomic position (SEP). Latinos and Asians/Pacific Islanders had similar or better processes and intermediate outcomes than whites with the exception of slightly higher A1C levels. Compared with whites, African Americans had lower rates of A1C and LDL measurement and influenza vaccination, higher rates of foot and dilated eye examinations, and the poorest blood pressure and lipid control. The main SEP difference was lower rates of dilated eye examinations among poorer and less educated individuals. In almost all instances, racial/ ethnic minorities or low SEP participants with poor glycemic, blood pressure, and lipid control received similar or more appropriate intensification of therapy relative to whites or those with higher SEP.CONCLUSIONS -In these managed-care settings, minority race/ethnicity was not consistently associated with worse processes or outcomes, and not all differences favored whites. The only notable SEP disparity was in rates of dilated eye examinations. Social disparities in health may be reduced in managed-care settings. Diabetes Care 28:2864 -2870, 2005P opulation-based studies suggest that racial and ethnic minorities (1-6) and people of lower socioeconomic position (SEP) (2) experience worse longterm outcomes for diabetes than whites and people of higher SEP. However, it is unclear why these differences persist even among individuals with health insurance. Understanding the relationship of race/ ethnicity and SEP to processes and outcomes of diabetes care in insured populations is critical to reducing health disparities.Previous research found poorer processes of diabetes care (e.g., performance of dilated eye examinations and foot examinations at regular intervals) and intermediate health outcomes (e.g., control of glycemia, blood pressure, or lipid levels) among racial and ethnic minorities and individuals of lower income or education (2,3,(7)(8)(9)(10)(11)(12)(13)(14). As racial and ethnic minorities and poorer people with diabetes are less adequately insured than whites or wealthier people (15,16), differential access to care may contribute to these findings. Research from managed-care settings (17,18) and the Veterans Health Administration (19,20) suggests that racial and ethnic disparities in diabetes processes and outcomes may be reduced in settings offering more uniform ...