Year of Publication

2014

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Richard Crosby, PhD

Committee Member

Christina Studts, PhD

Committee Member

Ramona Stone, PhD

Abstract

Human Immunodeficiency Virus (HIV) infection can lead to a chronic condition, Acquired Immunodeficiency Syndrome (AIDS), but can be well managed with a combination of medications, treatments, and remedies.1 The emergence of HIV in the United States in 1981 created an atmosphere unlike any other at that time. Overtime, the science community has worked diligently to combat this disease through research, practice, and intervention. Although many efforts have been put forth over the past thirty years, millions of Americans still remain infected with HIV.2 Among those who are infected with HIV/AIDS we see disproportionate rates among specific races and gender. Research shows that nearly 75% of all HIV/AIDS cases in the United States are among men, more specifically Black men who have sex with men (MSM).2 Additionally, we see a disproportionate amount of Black and African American individuals becoming infected with HIV year after year.3 African Americans represent around 12% of the national population, but represent nearly 45% of all new HIV infections across the United States.3 In 2010, the U.S. government issued the first National Strategy for HIV/AIDS in the United States. Several approaches to the reduction of HIV are discussed in the strategic plan, including the recommendation of those at risk of infection to be tested annually and know their status.2 The Centers for Disease Control and Prevention (CDC) recommends that everyone between the ages of 13 and 64 get tested at least once as part of a routine healthcare check up from their regular provider.4 Unfortunately, nearly one in five people in the United States who have HIV do not know they are infected. These people unknowingly contribute to the spread of HIV.4 Unfortunately, many issues still remain with HIV vaccine research.5 According to researchers, there are many biological HIV and Education 3 components to the virus that make it extremely difficult to vaccinate against HIV, but are hopeful that there will be a vaccine in the future.5 Since a vaccination for HIV is unlikely in the near future, HIV testing remains a critical part of preventative sexual health.2,4,5 Education plays a significant role in the adherence to an overall healthy lifestyle. Researchers often take into account an individual’s education level and how education impacts one’s risk for contracting disease. Researchers have shown that low literacy has a strong tie to multiple adverse health outcomes.6 Applying this idea about health behavior outcomes and education level to HIV testing is more difficult, however. Increasing HIV testing in individuals remains a mutli-factorial issue. Stigma, education, and age all play a part in increasing the rates of testing each year.2.4 The information from the U.S. National HIV/AIDS Strategy as well as the recommendations from the CDC allow us to assume that obtaining a test for HIV is a preventative and healthy choice 2,4 Applying this idea of education and health outcomes to HIV testing, one would anticipate that the higher level of education one has then the more likely one would be to obtain a test for HIV as well as other sexually transmitted diseases. The study attempted to answer if an individual’s educational attainment and age impact the obtainment of HIV testing services. We hypothesized that individuals with higher education levels and age would be more likely to obtain HIV testing services. Although there are multiple studies that have previously explored the association of HIV testing rates and general educational attainment among women, there is a lack of research in this specific area on men in the United States. Exploring the literature allows you to perceive an obvious gap in this area. Previous studies are limited to studying HIV and Education 4 women in foreign nations, but it is important to note that each study echoes the hypothesis for this study of men in the United States. One study of a group of women in Kenya, Zambia and Zimbabwe revealed that there was an increase of HIV testing rates among women who had higher levels of education.7 An additional study, taking place in Northeast China, revealed that there was an increase in willingness to accept HIV testing, however, multiple factors influenced one’s willingness—including age, location, and education.8 This study will explore the association of HIV testing, educational attainment, and age among Black and Non-Black men ages of 15 and 44 using nationally representative data from the National Survey of Family Growth between year 2006 and 2010 (Figure 1).

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