Factors associated with testing for HIV in people aged ≥50 years: a qualitative study

Abstract

BackgroundDespite a decline in the number of new HIV infections in the UK overall, the number and proportion of new HIV diagnoses in people aged ≥50 years continues to increase. People aged ≥50 years are disproportionately affected by late diagnosis, which is associated with poorer health outcomes, increased treatment complexity and increased healthcare costs. Late HIV diagnosis also has significant public health implications in terms of onward HIV transmission. It is not fully understood what factors affect the decision of an older person to test for HIV. The aim of this study was to identify factors associated with testing for HIV in people aged ≥50 years who tested late for HIV.MethodsWe interviewed 20 people aged ≥50 years diagnosed late with HIV to identify factors associated with HIV testing. Interviews were audio recorded, transcribed verbatim and thematically analysed.ResultsSeven themes associated with HIV testing in people aged ≥50 years were identified: experience of early HIV/AIDS campaigns, HIV knowledge, presence of symptoms and symptom attribution, risk and risk perception, generational approaches to health and sexual health, stigma, and type of testing and testing venue.ConclusionSome factors associated with testing identified in this study were unique to older individuals. People aged ≥50 years often do not perceive themselves to be at risk of HIV. Further, stigma and a lack of knowledge of how to access HIV testing suggest a need for health promotion and suggest current sexual health services may need to adapt to better meet their needs.

Epidemiological Features and Risk Factors for Acquiring Hepatitis B, Hepatitis C, and Syphilis in HIV-Infected Patients in Shaanxi Province, Northwest China

“…Subjects ≥50 years old usually do not perceive themselves at risk of HIV infection [46]. Further, shyness and lack of knowledge on how to get a HIV test may cause late detection and late diagnosis [47], and indicate that current sexual health services should be adjusted to better meet their needs.…”

Substantial gap in primary care: older adults with HIV presenting late to care

“…The majority of the data on risk factors for acquiring HIV and targeted testing strategies have focused on younger population demographics, and those thought to be at highest risk for acquiring HIV, such as individuals who use injection drugs and young MSM [ 12 ]. Older age groups have historically been considered to be “lower risk”, with some studies suggesting that older adults themselves do not perceive themselves to be at risk for HIV [ 14 ].…”

The social network context of HIV stigma: Population-based, sociocentric network study in rural Uganda

“…Other sociodemographic variables collected were age, religion, sex, and marital/partnership status, all of which have been shown prior literature to be associated with HIV-related (Mugoya & Ernst, 2014;Nabukenya & Matovu, 2018;Treves-Kagan et al, 2017;Youssef et al, 2018). We categorized religion into the two most common religions, Protestant or Catholic, and a third category of all other responses.…”