Here are several things that you should always know the status of: whether you are married, whether your toilet is overflowing, whether your hair is on fire, and whether you have HIV. Not knowing these can affect not only you but others around you.
Yet, a study published in the Morbidity and Mortality Weekly Report (MMWR) revealed that over 62% of Americans have never been tested for HIV (human immunodeficiency virus). For this study, a team from the Centers for Disease Control and Prevention (CDC) that consisted of Marc A. Pitasi, MPH, Kevin P. Delaney, PhD, John T. Brooks, MD, Elizabeth A. DiNenno, PhD, Shacara D. Johnson, MSPH, and Joseph Prejean, PhD, analyzed data collected in 2016 and 2017 via the BRFSS. BRFSS may sound like the noise you would make if you tried to say “breakfast” with your mouth stuffed with scrambled eggs. However, the BRFSS stands for Behavioral Risk Factor Surveillance System and consists of an annual phone survey of a nationally representative sample of Americans who are 18 years and older. Included in the survey were questions about HIV testing.
The research team found that only 38.9% of all adults who gave responses had ever been HIV tested. This ain’t good since the “CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care.” According to the CDC, around 162,500 Americans who are HIV positive don’t even realize that they are HIV positive, and close to 40% of new HIV infections result from people transmitting the virus when they have no idea that they are infected.
The CDC also recommends that those with certain risk factors for HIV should get tested at least once a year. But among the 15,701 people with such risk factors (which represented 3.2% of those who gave responses to the survey), only 64.8% had ever been tested and just 29.2% had been tested in the year before.
The team also looked at how these percentages varied geographically. For example, even in the 50 local jurisdictions in America with the most reported HIV infections, only 46.9% had ever gotten HIV tested. Among those with HIV risk factors in these 50 local jurisdictions, just 34.3% had been tested in the past year. Of the 50 jurisdictions, the one with the lowest percentage of people who had ever gotten HIV tested was Maricopa County, Arizona, with 36.5%. Talk about a need for Raising Arizona. The one with the highest was the District of Columbia (70.7%). Among people with HIV risk factors, the jurisdiction with the lowest percentage of receiving testing in the past year was Alameda County (8.1%), and the one with the highest was Bronx County, New York (31.3%).
What does all of this mean for the ongoing battle against HIV? When either making scrambled eggs or battling an infectious disease, you can’t beat what you can’t find. President Donald Trump’s declared in his February 5, 2019, State of the Union Address that his administration would aim to end the HIV epidemic in the United States within a decade. But for this to even be possible, HIV testing rates cannot remain this low. Heck how are you going to even know if you are getting close to ending the epidemic if you don’t even know how many people still have HIV? That would be like trying to review Aquaman without ever actually watching the movie and saying that you are going to the beach instead.
There are probably three major reasons for these low HIV testing rates. One is people assuming that they aren’t infected without having any scientific evidence to support this belief. I know, I know, you are shocked that people could actually believe something without having supporting scientific evidence. Nevertheless, an HIV infection is not like Bieber Fever. You can’t simply know whether you have it or not without formally getting tested. While practicing safe sex, taking precautions while handling blood, and avoiding health or wellness places that don’t practice good infection control can greatly reduce your risk, the risk never goes to zero. Why not get tested?
This brings us to a second reason: not wanting to know the result. As they say, denial is not a river in Egypt. Moreover, some may be worried about the stigma that an HIV positive diagnosis may bring. It may seem like a coincidence that “stigma” and “stupid” begin with the same letters, but stigmatizing people with any medical issue (except for perhaps stigmatizing those who have the excessive need to stigmatize others) really serves no practical purpose and keeps people from getting proper care.
The third big reason is poor access to health care. When a person doesn’t have a regular doctor and doesn’t have insurance to pay for health care, he or she is much less likely to get HIV tested. According to the Henry J. Kaiser Family Foundation, 44 million Americans below the age of 65 years old was over 44 million in 2013. This number fell below 27 million in 2016. But since 2017, this number has been going the wrong direction. That year the number of uninsured people jumped by close to 700,000 people. If the Trump administration is serious about ending the HIV epidemic, improving health care and health care coverage needs to be priorities.
If you are at higher risk, get tested each year. Otherwise, you really should get tested whenever a life change occurs that may affect your risk such as having a new sexual partner. Getting tested for HIV is important to protect not only you but those who come into sexual contact and health care contact with you. After all, wouldn’t you want to know if you are married or if your hair is on fire, not that the two are related in any way?