December 2015

HIV Testing Behaviors Among Adults in Southeastern Pennsylvania 

HIV infection continues to impact a large number of Americans.  The CDC estimates that over 1.2 million people in this country are now living with HIV and about 50,000 become infected every year¹. Despite increased availability of HIV testing, it is estimated that 13% of persons who have HIV do not know they are infected². Increased access to HIV testing is important for several reasons: the risk of AIDS-related complications is greatly reduced when HIV infection is detected and treated early; treating pregnant women greatly reduces the chance that their babies will be infected; and persons who are receiving treatment are much less likely to pass the infection to someone else. Using data from Public Health Management Corporation’s Community Health Data Base’s 2015 Southeastern Pennsylvania Household Health Survey, this article examines HIV testing behaviors among adults age 18 and older in Southeastern Pennsylvania (SEPA), specifically looking at characteristics among those who have recently been tested for HIV and those who have never been tested.

Adults Ever Tested for HIV

More than one-third (37%) SEPA adults 18 years of age or older have ever been tested for HIV, which represents an estimated 31,500 adults in the region.

• A greater percentage of younger adults have ever been tested compared with older adults. For example, 53% of adults 18-34 have had an HIV test in the past year compared with 15% of adults age 65 and over.
• Latino (89%), Asian (57%), and Black (51%) adults are more likely than White (33%) adults to have ever been tested.
• A greater percentage of adults with less than a high school diploma report ever having an HIV test compared with adults with further educational attainment; for example, 52% of adults with less than a high school diploma were tested, as compared with 45% of those with a high school degree and 31% of those with a post-graduate degree.
• One-half of adults (50%) living below 100% of the Federal Poverty Level have ever been tested, representing approximately 4,800 adults, compared with one-third of adults (35%) living at or above 100% of the Federal Poverty Level.

Demographics of Adults Never Tested for HIV

Nearly one half of adults (47%) age 18 and older in the SEPA region have never been tested for HIV. Those more likely to report never having an HIV test include adults who are:

• White and Asian: Over one half of White (56%) and Asian (56%) adults have never been tested compared with 30% of Latino and 26% of Black adults. (Figure 1)
• Educated beyond high school: Adults with a college degree or more are more likely than those with less than a high school education to have never been tested (49% compared with 41% respectively).
• Heterosexual or straight: Nearly one half (47%) of heterosexual or straight adults have never been tested for HIV compared with 23% of homosexual, gay, or lesbian adults and 20% of bisexual adults. (Figure 1)
• Living at or above 100% poverty guidelines: One half of adults living at or above 100% of the Federal Poverty Level (50%) have never been tested for HIV compared with one quarter of adults living below 100% of the Federal Poverty Level (27%). (Figure 1)
• Age 60 or older: Older adults are more likely than younger adults to report never having been tested for HIV: 66% of adults age 60-74 and 81% of adults age 75+ have never been tested compared with 32% of adults age 18-39, 33% of adults age 40-49, and 49% of adults age 50-59.

Access to Care Indicators among Adults Never Tested for HIV

In addition to examining the demographics and socioeconomic status of these adults, it is important to look at the access to a regular source of care, the number of visits to a healthcare professional and/or the emergency room, and the insurance status of adults who have never been tested for HIV.  These data indicate that many adults who have a regular source of care and visited a healthcare professional in the past year have never been tested for HIV.  Adults in Philadelphia and surrounding suburbs who have never been tested for HIV tend to report their health as “good” to “excellent” (70%), have a regular source of care (65%), and have made at least one visit to their doctor or healthcare professional in the past year (64%).

The following data present the differences in access to care among those who have never been tested for HIV:

• Regular source of care: Nearly half of adults who do not have a regular source of health care (46%) and 65% of adults with a regular source of care have never been tested for HIV.
• Healthcare visits: Adults with one or more visits to a doctor or healthcare professional in the past year are less likely to have never been tested for HIV than those with no visits (64% and 55% respectively).  
• Insurance status: Among uninsured adults 18-64 years of age, more than three–quarters (79%) have never been tested for HIV; 47% of insured adults have never been tested.

Conclusion/Implication of Data Findings

These data show that there is a need for increased awareness about the importance and availability of HIV testing within the SEPA region.  Primary care physician offices are often a logical venue for targeted health messaging and campaigns, and the majority of adults who have never been tested for HIV do have a regular source of care.  In addition, while they also report their health as good to excellent, most adults who have never been tested for HIV have in fact made at least one healthcare visit in the past year. These findings suggest that most adults have at least one healthcare visit during which they could learn more about HIV testing.  Future awareness campaigns in the region should be tailored to a target audience that is educated and older, and should consider selecting additional venues and media channels and that this population uses, such as local supermarkets, retirement communities and senior centers, newspapers, and news websites.

For more information about these findings, please contact Lisa R. Kleiner at This email address is being protected from spambots. You need JavaScript enabled to view it..

[1] Centers for Disease Control and Prevention.  HIV in the United States: At a Glance.  Accessed online, December 2015.

[2] Centers for Disease Control and Prevention.  HIV in the United States: At a Glance.  Accessed online, December 2015.