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Testing for human immunodeficiency virus among cancer survivors under age 65 in the United States.

Li J, Thompson TD, Tai E, Zhao G, Oster AM - Prev Chronic Dis (2014)

Bottom Line: Knowing the human immunodeficiency virus (HIV) serostatus of patients at the time of cancer diagnosis or cancer recurrence is prerequisite to coordinating HIV and cancer treatments and improving treatment outcomes.The highest proportion of survivors tested was among patients aged 25 to 34 years (72.2%), non-Hispanic blacks (59.5%), and cervical cancer survivors (51.2%).The proportion tested was highest in the District of Columbia (68.3%) and lowest in Nebraska (24.1%).

View Article: PubMed Central - PubMed

Affiliation: Epidemiologist, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F76, Atlanta, GA 30341. Telephone: 770-488-3030. E-mail: ffa2@cdc.gov.

ABSTRACT

Introduction: Knowing the human immunodeficiency virus (HIV) serostatus of patients at the time of cancer diagnosis or cancer recurrence is prerequisite to coordinating HIV and cancer treatments and improving treatment outcomes. However, there are no published data about HIV testing among cancer survivors in the United States. We sought to provide estimates of the proportion of cancer survivors tested for HIV and to characterize factors associated with having had HIV testing.

Methods: We used data from the 2009 Behavioral Risk Factor Surveillance System to calculate the proportion of cancer survivors under age 65 who had undergone HIV testing, by demographic and health-related factors and by state. Adjusted proportion estimates were calculated by multivariable logistic regression.

Results: Only 41% of cancer survivors in the United States under the age of 65 reported ever having had an HIV test. The highest proportion of survivors tested was among patients aged 25 to 34 years (72.2%), non-Hispanic blacks (59.5%), and cervical cancer survivors (51.2%). The proportion tested was highest in the District of Columbia (68.3%) and lowest in Nebraska (24.1%). Multivariable analysis showed that factors associated with HIV testing included being non-Hispanic black or Hispanic, being younger, having higher education, not being married or living with a partner, not being disabled, and having medical cost concerns. Having an AIDS-related cancer was associated with HIV testing only among females.

Conclusion: The proportions of HIV testing varied substantially by demographic and health-related factors and by state. Our study points to the need for public health interventions to promote HIV testing among cancer survivors.

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Related in: MedlinePlus

Model-adjusted relationship between age and human immunodeficiency virus (HIV) testing among cancer survivors aged 18 to 64 years, United States, 2009, Behavioral Risk Factor Surveillance System. Abbreviation: CI, confidence interval.Age, yPredicted Probability of HIV Test (95% CI)00.15 (0.12–0.18)10.15 (0.13–0.18)20.16 (0.13–0.18)30.16 (0.13–0.19)40.16 (0.14–0.19)50.16 (0.14–0.19)60.17 (0.14–0.19)70.17 (0.14–0.20)80.17 (0.14–0.20)90.17 (0.14–0.20)100.17 (0.15–0.20)110.17 (0.15–0.20)120.17 (0.15–0.20)130.17 (0.15–0.20)140.17 (0.15–0.20)150.17 (0.15–0.20)160.17 (0.14–0.20)170.17 (0.14–0.20)180.17 (0.14–0.20)190.17 (0.14–0.20)200.17 (0.14–0.20)210.17 (0.14–0.19)220.16 (0.14–0.19)230.16 (0.14–0.19)240.16 (0.14–0.19)250.16 (0.13–0.19)260.16 (0.13–0.19)270.16 (0.13–0.19)280.16 (0.13–0.19)290.15 (0.13–0.18)300.15 (0.13–0.18)310.15 (0.12–0.18)320.15 (0.12–0.18)330.15 (0.12–0.18)340.15 (0.12–0.18)350.15 (0.12–0.18)360.14 (0.11–0.18)370.14 (0.11–0.18)380.14 (0.11–0.18)390.14 (0.11–0.18)400.14 (0.11–0.18)410.14 (0.10–0.18)420.14 (0.10–0.18)430.13 (0.10–0.18)440.13 (0.10–0.18)450.13 (0.10–0.18)460.13 (0.10–0.18)470.13 (0.09–0.18)480.13 (0.09–0.18)490.13 (0.09–0.18)500.13 (0.09–0.18)510.12 (0.09–0.17)530.12 (0.08–0.17)540.12 (0.08–0.17)550.12 (0.08–0.17)560.12 (0.08–0.17)570.12 (0.08–0.17)580.12 (0.08–0.17)590.12 (0.08–0.17)620.11 (0.07–0.17)630.11 (0.07–0.17)
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Related In: Results  -  Collection


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Figure 2: Model-adjusted relationship between age and human immunodeficiency virus (HIV) testing among cancer survivors aged 18 to 64 years, United States, 2009, Behavioral Risk Factor Surveillance System. Abbreviation: CI, confidence interval.Age, yPredicted Probability of HIV Test (95% CI)00.15 (0.12–0.18)10.15 (0.13–0.18)20.16 (0.13–0.18)30.16 (0.13–0.19)40.16 (0.14–0.19)50.16 (0.14–0.19)60.17 (0.14–0.19)70.17 (0.14–0.20)80.17 (0.14–0.20)90.17 (0.14–0.20)100.17 (0.15–0.20)110.17 (0.15–0.20)120.17 (0.15–0.20)130.17 (0.15–0.20)140.17 (0.15–0.20)150.17 (0.15–0.20)160.17 (0.14–0.20)170.17 (0.14–0.20)180.17 (0.14–0.20)190.17 (0.14–0.20)200.17 (0.14–0.20)210.17 (0.14–0.19)220.16 (0.14–0.19)230.16 (0.14–0.19)240.16 (0.14–0.19)250.16 (0.13–0.19)260.16 (0.13–0.19)270.16 (0.13–0.19)280.16 (0.13–0.19)290.15 (0.13–0.18)300.15 (0.13–0.18)310.15 (0.12–0.18)320.15 (0.12–0.18)330.15 (0.12–0.18)340.15 (0.12–0.18)350.15 (0.12–0.18)360.14 (0.11–0.18)370.14 (0.11–0.18)380.14 (0.11–0.18)390.14 (0.11–0.18)400.14 (0.11–0.18)410.14 (0.10–0.18)420.14 (0.10–0.18)430.13 (0.10–0.18)440.13 (0.10–0.18)450.13 (0.10–0.18)460.13 (0.10–0.18)470.13 (0.09–0.18)480.13 (0.09–0.18)490.13 (0.09–0.18)500.13 (0.09–0.18)510.12 (0.09–0.17)530.12 (0.08–0.17)540.12 (0.08–0.17)550.12 (0.08–0.17)560.12 (0.08–0.17)570.12 (0.08–0.17)580.12 (0.08–0.17)590.12 (0.08–0.17)620.11 (0.07–0.17)630.11 (0.07–0.17)

Mentions: The multivariable logistic regression analysis (Table 3) revealed that women with an AIDS-related cancer, persons who had ever had a disability, and patients with medical cost concern were more likely to report having had an HIV test than men with cancer and women with non-AIDS–related cancer, those who did not have a disability or those who did not have medical cost concerns. Other significant findings included higher prevalences of testing among non-Hispanic blacks and Hispanics, patients with at least some college education, and patients who were not currently married or living with a partner. After adjusting for all variables, health insurance, emotional support, life satisfaction, employment status, and HIV risk behaviors were no longer significantly associated with HIV testing. There was a significant nonlinear association between age and HIV testing. Increasing age was significantly associated with a decline in HIV testing above age 35 (Figure 1). HIV testing prevalence tended to be slightly higher with increasing time since diagnosis up to around 10 years with slightly lower testing with increasing years since diagnosis beyond 20 years (Figure 2). However, this relationship was not significant (P = .07).


Testing for human immunodeficiency virus among cancer survivors under age 65 in the United States.

Li J, Thompson TD, Tai E, Zhao G, Oster AM - Prev Chronic Dis (2014)

Model-adjusted relationship between age and human immunodeficiency virus (HIV) testing among cancer survivors aged 18 to 64 years, United States, 2009, Behavioral Risk Factor Surveillance System. Abbreviation: CI, confidence interval.Age, yPredicted Probability of HIV Test (95% CI)00.15 (0.12–0.18)10.15 (0.13–0.18)20.16 (0.13–0.18)30.16 (0.13–0.19)40.16 (0.14–0.19)50.16 (0.14–0.19)60.17 (0.14–0.19)70.17 (0.14–0.20)80.17 (0.14–0.20)90.17 (0.14–0.20)100.17 (0.15–0.20)110.17 (0.15–0.20)120.17 (0.15–0.20)130.17 (0.15–0.20)140.17 (0.15–0.20)150.17 (0.15–0.20)160.17 (0.14–0.20)170.17 (0.14–0.20)180.17 (0.14–0.20)190.17 (0.14–0.20)200.17 (0.14–0.20)210.17 (0.14–0.19)220.16 (0.14–0.19)230.16 (0.14–0.19)240.16 (0.14–0.19)250.16 (0.13–0.19)260.16 (0.13–0.19)270.16 (0.13–0.19)280.16 (0.13–0.19)290.15 (0.13–0.18)300.15 (0.13–0.18)310.15 (0.12–0.18)320.15 (0.12–0.18)330.15 (0.12–0.18)340.15 (0.12–0.18)350.15 (0.12–0.18)360.14 (0.11–0.18)370.14 (0.11–0.18)380.14 (0.11–0.18)390.14 (0.11–0.18)400.14 (0.11–0.18)410.14 (0.10–0.18)420.14 (0.10–0.18)430.13 (0.10–0.18)440.13 (0.10–0.18)450.13 (0.10–0.18)460.13 (0.10–0.18)470.13 (0.09–0.18)480.13 (0.09–0.18)490.13 (0.09–0.18)500.13 (0.09–0.18)510.12 (0.09–0.17)530.12 (0.08–0.17)540.12 (0.08–0.17)550.12 (0.08–0.17)560.12 (0.08–0.17)570.12 (0.08–0.17)580.12 (0.08–0.17)590.12 (0.08–0.17)620.11 (0.07–0.17)630.11 (0.07–0.17)
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Related In: Results  -  Collection

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Figure 2: Model-adjusted relationship between age and human immunodeficiency virus (HIV) testing among cancer survivors aged 18 to 64 years, United States, 2009, Behavioral Risk Factor Surveillance System. Abbreviation: CI, confidence interval.Age, yPredicted Probability of HIV Test (95% CI)00.15 (0.12–0.18)10.15 (0.13–0.18)20.16 (0.13–0.18)30.16 (0.13–0.19)40.16 (0.14–0.19)50.16 (0.14–0.19)60.17 (0.14–0.19)70.17 (0.14–0.20)80.17 (0.14–0.20)90.17 (0.14–0.20)100.17 (0.15–0.20)110.17 (0.15–0.20)120.17 (0.15–0.20)130.17 (0.15–0.20)140.17 (0.15–0.20)150.17 (0.15–0.20)160.17 (0.14–0.20)170.17 (0.14–0.20)180.17 (0.14–0.20)190.17 (0.14–0.20)200.17 (0.14–0.20)210.17 (0.14–0.19)220.16 (0.14–0.19)230.16 (0.14–0.19)240.16 (0.14–0.19)250.16 (0.13–0.19)260.16 (0.13–0.19)270.16 (0.13–0.19)280.16 (0.13–0.19)290.15 (0.13–0.18)300.15 (0.13–0.18)310.15 (0.12–0.18)320.15 (0.12–0.18)330.15 (0.12–0.18)340.15 (0.12–0.18)350.15 (0.12–0.18)360.14 (0.11–0.18)370.14 (0.11–0.18)380.14 (0.11–0.18)390.14 (0.11–0.18)400.14 (0.11–0.18)410.14 (0.10–0.18)420.14 (0.10–0.18)430.13 (0.10–0.18)440.13 (0.10–0.18)450.13 (0.10–0.18)460.13 (0.10–0.18)470.13 (0.09–0.18)480.13 (0.09–0.18)490.13 (0.09–0.18)500.13 (0.09–0.18)510.12 (0.09–0.17)530.12 (0.08–0.17)540.12 (0.08–0.17)550.12 (0.08–0.17)560.12 (0.08–0.17)570.12 (0.08–0.17)580.12 (0.08–0.17)590.12 (0.08–0.17)620.11 (0.07–0.17)630.11 (0.07–0.17)
Mentions: The multivariable logistic regression analysis (Table 3) revealed that women with an AIDS-related cancer, persons who had ever had a disability, and patients with medical cost concern were more likely to report having had an HIV test than men with cancer and women with non-AIDS–related cancer, those who did not have a disability or those who did not have medical cost concerns. Other significant findings included higher prevalences of testing among non-Hispanic blacks and Hispanics, patients with at least some college education, and patients who were not currently married or living with a partner. After adjusting for all variables, health insurance, emotional support, life satisfaction, employment status, and HIV risk behaviors were no longer significantly associated with HIV testing. There was a significant nonlinear association between age and HIV testing. Increasing age was significantly associated with a decline in HIV testing above age 35 (Figure 1). HIV testing prevalence tended to be slightly higher with increasing time since diagnosis up to around 10 years with slightly lower testing with increasing years since diagnosis beyond 20 years (Figure 2). However, this relationship was not significant (P = .07).

Bottom Line: Knowing the human immunodeficiency virus (HIV) serostatus of patients at the time of cancer diagnosis or cancer recurrence is prerequisite to coordinating HIV and cancer treatments and improving treatment outcomes.The highest proportion of survivors tested was among patients aged 25 to 34 years (72.2%), non-Hispanic blacks (59.5%), and cervical cancer survivors (51.2%).The proportion tested was highest in the District of Columbia (68.3%) and lowest in Nebraska (24.1%).

View Article: PubMed Central - PubMed

Affiliation: Epidemiologist, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F76, Atlanta, GA 30341. Telephone: 770-488-3030. E-mail: ffa2@cdc.gov.

ABSTRACT

Introduction: Knowing the human immunodeficiency virus (HIV) serostatus of patients at the time of cancer diagnosis or cancer recurrence is prerequisite to coordinating HIV and cancer treatments and improving treatment outcomes. However, there are no published data about HIV testing among cancer survivors in the United States. We sought to provide estimates of the proportion of cancer survivors tested for HIV and to characterize factors associated with having had HIV testing.

Methods: We used data from the 2009 Behavioral Risk Factor Surveillance System to calculate the proportion of cancer survivors under age 65 who had undergone HIV testing, by demographic and health-related factors and by state. Adjusted proportion estimates were calculated by multivariable logistic regression.

Results: Only 41% of cancer survivors in the United States under the age of 65 reported ever having had an HIV test. The highest proportion of survivors tested was among patients aged 25 to 34 years (72.2%), non-Hispanic blacks (59.5%), and cervical cancer survivors (51.2%). The proportion tested was highest in the District of Columbia (68.3%) and lowest in Nebraska (24.1%). Multivariable analysis showed that factors associated with HIV testing included being non-Hispanic black or Hispanic, being younger, having higher education, not being married or living with a partner, not being disabled, and having medical cost concerns. Having an AIDS-related cancer was associated with HIV testing only among females.

Conclusion: The proportions of HIV testing varied substantially by demographic and health-related factors and by state. Our study points to the need for public health interventions to promote HIV testing among cancer survivors.

Show MeSH
Related in: MedlinePlus