Preference for HIV Testing Methods and Factors Associated with Choice of an HIV Test Among Urban Adolescents

Background:
Improved identification of HIV positive youth requires increased testing rates, but little is known about adolescent preferences for HIV test methods or factors influencing choice of a specific method.

Objective:
To determine preference for particular HIV testing methods and factors associated with selection of an HIV test.

Method:
Sexually active adolescents (N=200) age 13-22 years recruited from an urban hospital-based primary care clinic completed a theory-driven 99-item survey, assessing preferences for aspects of HIV tests (e.g. time to receive results and method of sample collection), benefits, and barriers to testing. Testing was offered; those who agreed received standardized counseling regarding 3 available methods (venipuncture ELISA, rapid fingerstick, or rapid oral fluid) and selected the test they received. Using Chi-square and Mann-Whitney U analyses, we examined associations between choice of testing method and preferences for specific test characteristics, benefits, and barriers to testing.

Result:
Most participants were female (82%) and African-American (87%). Mean age was 17.4 years. Forty percent reported prior HIV testing, and 50% tested at the study visit: 51% chose rapid oral testing, 30% venipuncture ELISA, and 19% rapid fingerstick. Compared to those who chose traditional testing, those who chose rapid testing reported that the following test characteristics were of greater importance: oral sampling instead of venipuncture (p=0.005) and ability to receive same-visit results (p=0.002). Benefits were not associated with choice of test method. One barrier, not testing “because needles hurt”, was rated significantly higher by those who chose rapid testing vs. traditional testing (p=0.038).

Conclusion:
Adolescents preferred rapid oral testing to other methods. Our findings suggest that this preference may be driven by the desire to avoid venipuncture and obtain same-visit results.

Implications:
Improved understanding of adolescent preferences may lead to offering HIV testing methods that are more acceptable to this age group, thus increasing testing rates.