Skip to main content
PMC home page
Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2015 Jan 1;106(2):e4–e9. doi: 10.17269/CJPH.106.4625

Individual and jurisdictional factors associated with voluntary HIV testing in Canada: Results of a national survey, 2011

Catherine A Worthington 11,21,✉, Liviana M Calzavara 21,31, Samantha J White 21,31, Dan Allman 21,31, Mark W Tyndall 21,41,51
PMCID: PMC6972219  PMID: 25955665

Abstract

r

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 <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 < 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.

Discussion

Sex differences should be considered when designing interventions to increase testing uptake. Jurisdictional factors, including HIV prevalence and testing modality, should be investigated further.

Key Words: HIV, testing, anonymous testing, Canada

Footnotes

Conflict of Interest: None to declare.

References

  • 1.Public Health Agency of Canada. Summary: Estimates of HIV prevalence and incidence in Canada, 2011, 2012. 2014. [Google Scholar]
  • 2.Sabin CA, Lundgren JD. The natural history of HIV infection. Curr Opin HIV AIDS. 2013;8(4):311–17. doi: 10.1097/COH.0b013e328361fa66. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Branson BM, Handsfield HH, Lampe MA, Janssen RS, Taylor AW, Lyss SB, Clark JE, Centers for Disease ControlPrevention Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recommendations and Reports / Centers for Disease Control. 2006;55(14):1. [PubMed] [Google Scholar]
  • 4.DeMarco RF, Gallagher D, Bradley-Springer L, Jones SG, Visk J. Recommendations and reality: Perceived patient, provider, and policy barriers to implementing routine HIV screening and proposed solutions. Nurs Outlook. 2012;60(2):72–80. doi: 10.1016/j.outlook.2011.06.002. [DOI] [PubMed] [Google Scholar]
  • 5.British Columbia Office of the Provincial Health Officer. HIV testing guidelines for the province of British Columbia. 2014. [Google Scholar]
  • 6.Thornton AC, Delpech V, Kall MM, Nardone A. HIV testing in community settings in resource-rich countries: A systematic review of the evidence. HIV Med. 2012;13(7):416–26. doi: 10.1111/j.1468-1293.2012.00992.x. [DOI] [PubMed] [Google Scholar]
  • 7.Public Health Agency of Canada. HIV screening and testing guide. 2013. [Google Scholar]
  • 8.Houston S, Archibald CP, Strike C, Sutherland D. Factors associated with HIV testing among Canadians: Results of a population-based survey. Int J STD AIDS. 1998;9(6):341. doi: 10.1258/0956462981922377. [DOI] [PubMed] [Google Scholar]
  • 9.EKOS Research Associates Inc. 2012 HIV/AIDS attitudinal tracking survey: Final report (prepared for Public Health Agency of Canada) 2012. [Google Scholar]
  • 10.Kaai S, Bullock S, Burchell AN, Major C. Factors that affect HIV testing and counseling services among heterosexuals in Canada and the United Kingdom: An integrated review. Patient Educ Couns. 2012;88(1):4. doi: 10.1016/j.pec.2011.11.011. [DOI] [PubMed] [Google Scholar]
  • 11.Choudri Y, Cule S. Factors associated with testing for HIV among females and males in Canada. Can J Infect Dis Med Microbiol. 2006;17(SupplementA):42. [Google Scholar]
  • 12.Choudri Y. Patterns in factors associated with testing for HIV among the general population in Canada in the last decade. AIDS 2008- XVII International AIDS Conference: Abstract, no. TUPE0472.
  • 13.Du P, Camacho F, Zurlo J, Lengerich EJ. Human immunodeficiency virus testing behaviors among US adults: The roles of individual factors, legislative status, and public health resources. Sex Transm Dis. 2011;38(9):858–64. doi: 10.1097/OLQ.0b013e31821a0635. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14.Centre for Inner City Research, St. Michael’s Hospital. An evaluation of HIV testing and counselling practices in Ontario. 2010. [Google Scholar]
  • 15.Kassler WJ, Meriwether RA, Klimko TB, Peterman TA, Zaidi A. Eliminating access to anonymous HIV antibody testing in North Carolina: Effects on HIV testing and partner notification. J Acq Imm Def Synd Human Retrovirol: Official Publication of the International Retrovirology Association. 1997;14(3):281. doi: 10.1097/00042560-199703010-00013. [DOI] [PubMed] [Google Scholar]
  • 16.Hertz-Picciotto I, Lee LW, Hoyo C. HIV test-seeking before and after the restriction of anonymous testing in North Carolina. Am J Public Health. 1996;86(10):1446–50. doi: 10.2105/AJPH.86.10.1446. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Public Health Agency of Canada. HIV and AIDS in Canada: Surveillance report to December 31, 2012. Surveillance and Epidemiology Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada. 2013. [Google Scholar]
  • 18.Public Health Agency of Canada. HIV/AIDS epi updates, Chapter 7 Perinatal HIV transmission in Canada. Surveillance and Risk Assessment Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada. 2010. [Google Scholar]
  • 19.International Labour Organization, World Health Organization. Joint ILO/ WHO guidelines on health services and HIV/AIDS. 2005. [Google Scholar]
  • 20.World Health Organization, Joint United Nations Programme on HIV/AIDS. Guidance on provider-initiated HIV testing and counselling in health facilities. Geneva: Switzerland: World Health Organization; 2007. [Google Scholar]
  • 21.Public Health Agency of Canada. HIV/AIDS epi updates, Chapter 3 HIV Testing and Surveillance Systems in Canada. Surveillance and Risk Assessment Division, Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada. 2010. [Google Scholar]
  • 22.Yeager DS, Krosnick JA, Chang L, Javitz HS, Levendusky MS, Simpser A, Wang R. Comparing the accuracy of RDD telephone surveys and internet surveys conducted with probability and non-probability samples. Public Opin Q. 2011;75(4):709–47. doi: 10.1093/poq/nfr020. [DOI] [Google Scholar]
  • 23.DiSogra C, Callegaro M, Hendarwan E. Recruiting probability-based web panel members using an address-based sample frame: Results from a pilot study conducted by knowledge networks. 2009. [Google Scholar]
  • 24.Waxman MJ, Merchant RC, Celada MT, Clark MA. Perspectives on the ethical concerns and justifications of the 2006 Centers for Disease Control and Prevention HIV testing recommendations. BMC Med Ethics. 2011;12(1):24. doi: 10.1186/1472-6939-12-24. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25.Canadian HIV/AIDS Legal Network. Shifting HIV testing policies. Fact Sheet. 2007. [Google Scholar]

Articles from Canadian Journal of Public Health = Revue Canadienne de Santé Publique are provided here courtesy of Springer

RESOURCES