Correlates of HIV Testing Among Rural African American Cocaine Users

Abstract

Andersen's Revised Behavioral Model of Health Services Use (RBM) was used as a framework in this correlational cross-sectional study to examine factors associated with HIV testing among a sample of 251 rural African American cocaine users. All participants reported using cocaine and being sexually active within the past 30 days. Independent variables were categorized according to the RBM as predisposing, enabling, need, or health behavior factors. Number of times tested for HIV (never, one time, two to four times, five or more times) was the outcome of interest. In ordered logistic regression analyses, HIV testing was strongly associated with being female, of younger age (predisposing factors); having been tested for sexually transmitted diseases or hepatitis, ever having been incarcerated in jail or prison (enabling factors); and having had one sex partner the past 30 days (health behavior factor). Other sexual risk behaviors, drug use, health status, and perception of risk were not associated with HIV testing. Our findings confirm the importance of routine testing in all healthcare settings rather than risk-based testing.

HIV Testing in Non-Injection Drug Users: Prevalence and Associated Factors

“…Sociodemographic factors, such as female gender and age, were associated with the outcome, which is in agreement with the results of other studies (24,26,32,45,46). Women have a higher prevalence of HIV testing owing to access through prenatal care services, whereas men have less access to health services (21,47).…”

Acceptability of HIV Testing Sites Among Rural and Urban African Americans Who Use Cocaine

“…A community-based study of mostly AAs who use drugs in Kentucky found that prior treatment for drug use was associated with a greater likelihood of prior HIV testing (45). Another study found that a history of substance abuse treatment was positively associated with the number of self-reported HIV tests in unadjusted analysis, but this association did not remain significant when adjusting for other factors (46). Other research has shown that HIV education included as part of a formal methadone treatment program is effective in improving awareness of HIV risk and reducing risky sexual behaviors (47).…”

Using Anderson's Model of Health Service Utilization to Assess the Use of HIV Testing Services by Sexually Active Men in Ghana

“…The model has been applied in various fields such as sociology, medicine, public health, and psychology. Specifically, it has been used to examine health care services utilization, such as HIV testing among young women in Trinidad and Tobago (33), American women in midlife (34), rural American cocaine users (35), primary care use among HIV-positive Haitian immigrants in Florida (36), racial/ethnic differences in HIV testing (32), and HIV testing service use among men in Haiti (37). Despite its wider application in different disciplines, some scholars have critiqued the model.…”