title: Psychosocial determinants of HIV testing across stages of change in Spanish population: a cross-sectional national survey.
abstract: The goal of this research is to study the psychosocial determinants of HIV-testing as a function of the decision or change stage concerning this health behavior. The determinants considered in the major ongoing health models and the stages contemplated in the Precaution Adoption Process Model are analysed.
  
  
  
  A cross-sectional survey was administered to 1,554 people over 16 years of age living in Spain by a computer-assisted telephone interview (CATI). The sample design was randomised, with quotas of sex and age. The survey measured various psychosocial determinants of health behaviors considered in the main cognitive theories, the interviewees' stage of change concerning HIV-testing (lack of awareness, decision not to act, decision to act, action, maintenance, and abandonment), and the signal for the action of getting tested or the perceived barriers to being tested.
  
  
  
  Approximately two thirds of the population had not ever had the HIV test. The predominant stage was lack of awareness. The most frequently perceived barriers to testing were related to the health system and to the stigma. We also found that the psychosocial determinants studied differed depending on the respondents' stage of change. Perception of risk, perceived self-efficacy, proximity to people who had been tested, perceived benefits of knowing the diagnosis, and a positive instrumental and emotional attitude were positively associated with the decision and maintenance of testing behavior. However, unrealistic underestimation of the risk of HIV infection, stereotypes about the infection, and the perceived severity of HIV were associated with the decision not to be tested.
  
  
  
  There are various sociocognitive and motivational profiles depending on people's decision stage concerning HIV-testing. Knowing this profile may allow us to design interventions to influence the psychosocial determinants that characterise each stage of change.
authors.affiliation: Spanish Interdisciplinary AIDS Society (Sociedad Española Interdisciplinaria del Sida, SEISIDA), C/Doctor Fleming 3, 28036, Madrid, Spain. mjfuster@psi.uned.es.|Universidad Nacional de Educación a Distancia (UNED), Facultad de Psicología, C/Juan del Rosal, 28040, Madrid, Spain. mjfuster@psi.uned.es.
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Fuster-RuizdeApodaca
authors.affiliation: Universidad Nacional de Educación a Distancia (UNED), Facultad de Psicología, C/Juan del Rosal, 28040, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Laguia
authors.affiliation: Universidad Nacional de Educación a Distancia (UNED), Facultad de Psicología, C/Juan del Rosal, 28040, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Molero
authors.affiliation: Spanish Interdisciplinary AIDS Society (Sociedad Española Interdisciplinaria del Sida, SEISIDA), C/Doctor Fleming 3, 28036, Madrid, Spain.|Plan de VIH/Sida Dirección General de Salud Pública, Gobierno de Aragón. Vía Universitas 36, 5a Planta, 50017, Zaragoza, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Toledo
authors.affiliation: Spanish Interdisciplinary AIDS Society (Sociedad Española Interdisciplinaria del Sida, SEISIDA), C/Doctor Fleming 3, 28036, Madrid, Spain.|Plan del Sida e Infecciones de Transmisión Sexual (AIDS Strategy), Osakidetza-Servicio vasco de salud, Avda. Navarra, 14, 20013, San Sebastián, Spain.
authors.forename: Arantxa
authors.initials: A
authors.lastname: Arrillaga
authors.affiliation: Spanish Interdisciplinary AIDS Society (Sociedad Española Interdisciplinaria del Sida, SEISIDA), C/Doctor Fleming 3, 28036, Madrid, Spain.|Fundació Docència i Recerca Mútua Terrassa, C/Sant Antoni n° 19, 08221, Terrassa, Barcelona, Spain.
authors.forename: Angeles
authors.initials: A
authors.lastname: Jaen
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000523:psychology*; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D010465:Perception; D020377:Self Efficacy; D057545:Social Stigma; D013030:Spain; D011795:Surveys and Questionnaires
keywords: HIV; HIV-testing; Health behavior; Late diagnosis