title: Individual and jurisdictional factors associated with voluntary HIV testing in Canada: Results of a national survey, 2011.
abstract: OBJECTIVE
  HIV testing remains a central strategy for HIV prevention for its ability to link those who test positive to treatment and support. In Canada, national guidelines have recently changed as part of standard primary care to recommend voluntary HIV testing for those aged 16-64 years. Using results from a nationally representative survey, we examined individual and jurisdictional factors associated with voluntary testing.
  
  
  METHODS
  A total of 2,139 participants were sampled using a regionally stratified, two-stage recruitment process. English or French interviews (by phone or online) were conducted during May 2011. Voluntary testing was defined as testing at least once for reasons other than blood donation, insurance purposes, immigration screening or research participation. Weighted logistic regression analysis (including socio-demographic, sexual activity, HIV/AIDS knowledge and jurisdictional factors of HIV prevalence and anonymous testing availability) were conducted for the overall sample, and stratified by sex.
  
  
  RESULTS
  Twenty-nine percent (29%) of survey participants reported at least one lifetime voluntary HIV test. For the full-sample model, the following were associated with increased odds of testing: age &lt;60 years, female sex, sexual minority status, perceived HIV knowledge, casual sex partner in previous year, and living in a higher-prevalence jurisdiction. For men, the strongest factor related to testing was sexual minority status (OR = 5.15, p &lt; 0.001); for women, it was having a casual sex partner in the previous year (OR = 2.57, p = 0.001). For both men and women, residing in a jurisdiction with lower HIV prevalence decreased odds of testing.
  
  
  CONCLUSIONS
  Sex differences should be considered when designing interventions to increase testing uptake. Jurisdictional factors, including HIV prevalence and testing modality, should be investigated further.
authors.affiliation: University of Victoria and The CIHR Social Research Centre in HIV Prevention. worthing@uvic.ca.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Worthington
authors.forename: Liviana M
authors.initials: LM
authors.lastname: Calzavara
authors.forename: Samantha J
authors.initials: SJ
authors.lastname: White
authors.forename: Dan
authors.initials: D
authors.lastname: Allman
authors.forename: Mark W
authors.initials: MW
authors.lastname: Tyndall
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002170:Canada / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012737:Sex Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D019529:Sexuality / Q000706:statistics & numerical data; D035141:Voluntary Programs / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Canada; HIV; anonymous testing; testing