Testing for human immunodeficiency virus among cancer survivors under age 65 in the United States.
BACKGROUND
Knowing the human immunodeficiency virus (HIV) serostatus of patients at the time of cancer diagnosis or cancer recurrence is prerequisite to coordinating HIV and cancer treatments and improving treatment outcomes. However, there are no published data about HIV testing among cancer survivors in the United States. We sought to provide estimates of the proportion of cancer survivors tested for HIV and to characterize factors associated with having had HIV testing.


METHODS
We used data from the 2009 Behavioral Risk Factor Surveillance System to calculate the proportion of cancer survivors under age 65 who had undergone HIV testing, by demographic and health-related factors and by state. Adjusted proportion estimates were calculated by multivariable logistic regression.


RESULTS
Only 41% of cancer survivors in the United States under the age of 65 reported ever having had an HIV test. The highest proportion of survivors tested was among patients aged 25 to 34 years (72.2%), non-Hispanic blacks (59.5%), and cervical cancer survivors (51.2%). The proportion tested was highest in the District of Columbia (68.3%) and lowest in Nebraska (24.1%). Multivariable analysis showed that factors associated with HIV testing included being non-Hispanic black or Hispanic, being younger, having higher education, not being married or living with a partner, not being disabled, and having medical cost concerns. Having an AIDS-related cancer was associated with HIV testing only among females.


CONCLUSIONS
The proportions of HIV testing varied substantially by demographic and health-related factors and by state. Our study points to the need for public health interventions to promote HIV testing among cancer survivors.
Epidemiologist, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F76, Atlanta, GA 30341. Telephone: 770-488-3030. E-mail: ffa2@cdc.gov.
Jun
J
Li
Centers for Disease Control and Prevention, Atlanta, Georgia.
Trevor D
TD
Thompson
Centers for Disease Control and Prevention, Atlanta, Georgia.
Eric
E
Tai
Centers for Disease Control and Prevention, Atlanta, Georgia.
Guixiang
G
Zhao
Centers for Disease Control and Prevention, Atlanta, Georgia.
Alexandra M
AM
Oster
D000293:Adolescent; D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult