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Does the Centers for Disease Control and Prevention’s Recommendation of Opt-Out HIV Screening Impact the Effect of Stigma on HIV Test Acceptance?

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Abstract

HIV/AIDS-related stigma is a key factor impeding patient utilization of HIV testing services. To destigmatize HIV testing, the Centers for Disease Control and Prevention recommended an ‘opt-out’ screening strategy aimed at all patients in all clinical settings, regardless of HIV risk. This study assessed whether opt-out screening as compared to opt-in screening was associated with increased uptake of HIV testing among patients with HIV/AIDS-related stigma concerns. This study included 374 patients attending two Los Angeles ambulatory care clinics. Stigma items were grouped into three constructs: Blame/isolation, abandonment, and contagion. Individuals endorsing the blame/isolation subscale (AOR = 0.52; 95 % CI 0.29–0.92; p < 0.05) and abandonment subscale (AOR = 0.27; 95 % CI 0.13–0.59; p < 0.01) were significantly less likely to accept an HIV test. Additionally, the opt-out model did not counter the negative effects of stigma on HIV test acceptance. These findings indicate that stigma remains a barrier to HIV testing, regardless of the opt-out screening approach.

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Acknowledgments

This research was supported by Gilead Sciences, Inc. (Grant # 20083013 AP Mahajan - PI), California HIV/AIDS Research Program, The Robert Wood Johnson Foundation Clinical Scholars Program, and the Centers for Disease Control and Prevention Expanded Testing Initiative Grant (# 07768). A. P. Mahajan also received support from the Centers for AIDS Research and UCLA AIDS Institute (Grant 5P30 AI028697) and UCLA Clinical and Translational Science Institute (Grant 1UL1RR033 176). WE Cunningham received partial support for this manuscript from NIDA (R01 DA030781), NIMH (R34 MH089719, NCMHD (P20MD000182) and NIA (P30AG021684). MF Shapiro also received partial support for this manuscript from NCMHD (P20MD000182).

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Authors and Affiliations

  1. Department of Health Services, Los Angeles County, 313 N. Figueroa St., Room 901, Los Angeles, CA, 90066, USA

    Anish P. Mahajan, Lakshmi Makam & Jennifer N. Sayles

  2. Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, CA, USA

    Anish P. Mahajan, Janni J. Kinsler, William E. Cunningham & Martin F. Shapiro

  3. Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA

    William E. Cunningham & Martin F. Shapiro

  4. Department of Public Health, Los Angeles County, Los Angeles, CA, USA

    Saloniki James

  5. HealthBegins, Los Angeles, CA, USA

    Rishi Manchanda

Authors
  1. Anish P. Mahajan
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  2. Janni J. Kinsler
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  3. William E. Cunningham
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  4. Saloniki James
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  5. Lakshmi Makam
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  7. Martin F. Shapiro
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  8. Jennifer N. Sayles
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Correspondence to Anish P. Mahajan.

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Mahajan, A.P., Kinsler, J.J., Cunningham, W.E. et al. Does the Centers for Disease Control and Prevention’s Recommendation of Opt-Out HIV Screening Impact the Effect of Stigma on HIV Test Acceptance?. AIDS Behav 20, 107–114 (2016). https://doi.org/10.1007/s10461-015-1222-8

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  • DOI: https://doi.org/10.1007/s10461-015-1222-8

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