Background

Factors such as healthcare access, stigma, socioeconomic factors, and perceived risk are associated with HIV testing behaviors. In recent years, California has aimed to improve HIV testing by reducing barriers to screening, yet awareness of HIV status remains low, indicating potentially persistent gaps in testing.

Methods

Data from the 2024 Behavioral Risk Factor Surveillance System (BRFSS) were used to examine prevalence and correlates of past-year HIV testing among California adults. Past-year testing was defined using self-reported test dates. Independent variables included age, race/ethnicity, sex, education, insurance coverage, marital status, self-reported general health, and HIV risk behaviors (e.g. injection drug use, sex work, or recent STI diagnosis). Survey weights using iterative proportional fitting were applied. Multivariable logistic regression models estimated adjusted association with past-year testing

Results

Thirteen percent of respondents reported receiving an HIV test in the past year. In survey-weighted models (N=5,799), those reporting HIV risk behaviors had higher odds of past-year testing (OR=2.75, 95% CI: 2.04–3.71). Adults aged 18–34 (OR=3.59, 95% CI: 2.56, 5.02) and 35–54 (OR=2.66, 95% CI: 1.88, 3.76) were more likely to test than those ≥55. Black (OR=2.90, 95% CI: 1.93, 4.34) and Hispanic (OR=1.42, 95% CI: 1.10, 1.83) respondents had greater odds of recent testing compared to White respondents. Being single (OR=1.63, 95% CI: 1.29, 2.05) and insured (OR=2.21, 95% CI: 1.43, 3.40) and in fair/poor health (OR=1.37, 95% CI: 1.04, 1.81) were also associated with past-year testing.

Conclusions

HIV risk was strongly associated with past-year HIV testing and structural factors–such as insurance coverage and demographic differences–were found to be significantly associated with testing. Findings highlight disparities and a need to expand routine HIV testing beyond younger and high-risk populations to identify and/or prevent new infections.