HIV / STI
National HIV Testing Trends Among U.S. Adults, 2018-2023 Deesha Patel* Deesha Patel Weston O. Williams Carolyn Wright
HIV testing allows persons to become aware of their HIV status and to seek subsequent care. HIV screening is recommended for the general population, and more frequent HIV testing is recommended for groups at higher risk for HIV acquisition.
2018-2023 data from the Behavioral Risk Factor Surveillance System were analyzed to calculate percentages of ever tested for HIV and tested for HIV in past 12 months, overall and by age, sex, and race/ethnicity. A test for linear trends was conducted using logistic models, accounting for complex survey weights. To provide a meaningful description for linear trends, estimated annual percentage changes (EAPC) were calculated from model estimates. Sensitivity analysis was conducted to assess trends adjusting for the COVID-19 pandemic (i.e., years 2020 and 2021).
Overall, ever tested for HIV decreased from 40.2% in 2018 to 38.9% in 2023 (EAPC -1.6%, p<.0001). Decreases were observed for majority of subgroups, with the largest declines observed among persons aged 18-24 and 25-34 years (EAPC -3.8% for both) and Black/African American persons (EAPC -3.1%) (all p<.0001). Increases were observed among persons aged 45-64 years (EAPC +0.6%, p=.013) and ≥65 years (EAPC +1.9%, p<.0001). Overall, tested for HIV in the past 12 months decreased from 11.8% in 2018 to 11.3% in 2023 (EAPC -3.2%, p<.0001). Decreases were observed for most subgroups, with the largest declines observed among persons aged 18-24 (EAPC -6.6%) and 25-34 years (EAPC -4.7%) and Black/African American (EAPC -6.1%) (all p<.0001). No meaningful differences in estimates were found between primary and sensitivity analyses.
From 2018-2023, percentages of ever tested and tested in past 12 months generally declined for U.S. adults, including in groups that are at greater risk for HIV acquisition. HIV screening can be strengthened by expanding opt-out screening in healthcare settings and promoting HIV testing through non-traditional settings (e.g., self-test kits, mobile outreach).