Trends in HIV Testing Among Adults in the Deep South: Behavioral Risk Factor Surveillance System, 2017–2023

Abstract

HIV testing is an entry point for both HIV prevention and treatment, and the CDC recommends that all adults of reproductive age undergo HIV testing at least once in their lifetime. However, HIV testing rates remain suboptimal. This study analyzed trends in HIV testing using Behavioral Risk Factor Surveillance System data from 2017 to 2023 across nine Deep South states—Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Texas. Descriptive statistics and Joinpoint linear regression were employed to assess lifetime HIV testing and testing within the past 12 months. Findings showed that the overall trend in having ever tested for HIV rose from 43% in 2017 to 47% in 2019 but declined to 40% in 2022, with a slight increase to 41% in 2023. Significant declines in ever testing were observed in North Carolina and among adults aged 25–44, non-Hispanic Black, non-Hispanic multiracial, and those identifying as lesbian or gay. Furthermore, the overall trend in HIV testing in the past 12 months declined significantly from 48% in 2017 to 42% in 2022, with a slight increase to 43% in 2023. Significant declines were found in Florida, Georgia, Louisiana, North Carolina, and South Carolina, and among adults aged 18–34, non-Hispanic White, non-Hispanic Black, male, female, and heterosexual individuals. These trends, observed largely during the COVID-19 pandemic, underscore the need to scale up HIV prevention and care initiatives, particularly in populations and regions experiencing significant declines. Trends should continue to be monitored and examined post-COVID pandemic.