HIV SEROPREVALENCE AND REASONS FOR REFUSING AND ACCEPTING HIV TESTING

Background and Objectives: We sought to evaluate the HIV seropositivit y of patients who refused or accepted human immunodeficiency virus (HI V) testing in a South Carolina sexually transmitted diseases (STD) cli nic, and the patients' reasons for refusing or accepting testing. Stud y Design: A serologic and self-administered survey done Jan. 9 through June 1, 1989. For those who refused HIV testing, a routine syphilis s erology sample was tested blindly for HIV. Results: Of 1,929 patients in the study, 398 (21%) refused HIV testing. HIV test refusers were 2. 2 times more likely to be HIV antibody positive than HIV test accepter s (3.0% versus 1.4%, prevalence ratio = 2.2, CI95 1.1-4.4), with this difference mainly occurring among males. Seven of eight patients repor ting that they refused testing because they were HIV positive were fou nd to be HIV negative. The principal reason indicated for test refusal was not feeling at risk for HIV infection. The principal reasons indi cated for test acceptance were wanting to know the results for their o wn health status and wishing to prevent spread of the virus to partner s. Conclusion: We conclude that: (1) a higher seropositivity exists am ong HIV test refusers than accepters; (2) patient reporting HIV seropo sitivity should be viewed with caution; (3) many STD patients deny the ir risk for HIV; and (4) STD patients are concerned about transmission of HIV to their partners.