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Ogunboye I, Momah R, Myla A, Davis A, Adebayo S. HIV screening uptake and disparities across socio-demographic characteristics among Mississippi adults: Behavioral Risk Factor Surveillance System, (BRFSS) 2022. HPHR. 2024;88. https://doi.org/10.54111/0001/JJJJ3
HIV is a significant public health concern in Mississippi, marked by high rates of new infections and AIDS-related mortality. Despite national initiatives promoting HIV testing, Mississippi lags in HIV screening, with disparities across socio-demographic groups exacerbating the epidemic. Understanding existing disparities in the rate of HIV testing is crucial for targeted interventions.
Data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), encompassing 4,239 adults in Mississippi, were analyzed. The prevalence of HIV screening was assessed across nine demographic variables using SPSS Statistics version 29.0.1.0 with a complex sampling module. Pearson’s Chi-square of Independence was used for sub-group comparisons.
Overall, 38.1% (95% CI:36.1-40.1) of Mississippi adults reported ever being tested for HIV. Significant disparities were observed by race, age category, marital status, health insurance status, and metropolitan status (p<0.05). Black individuals (49.8%) had higher screening rates compared to Whites (30.5%), and uninsured persons had a 50.0% HIV screening rate as against 37.2% among the insured.
The findings underscored variations in screening uptake across socio-demographic characteristics. Younger age groups and non-married individuals exhibited higher testing rates. Screening rates are similar in urban and rural areas, with no significant difference by income or education.
Efforts to improve HIV screening in Mississippi must target older adults, the elderly, insured individuals, and non metropolitan residents. Public health campaigns promoting routine opt-out HIV testing and reducing barriers to accessing health care services are critical for mitigating the low HIV testing uptake and combating the HIV epidemic in Mississippi.
The screening of HIV, primarily through opt-out programs, remains critical in the U.S. for HIV prevention and care.1,2 Timely HIV testing is intricately linked to highly favorable outcomes, including early diagnosis, reduced transmission rates, decreased HIV-related mortality, and reduced all-cause mortality among individuals diagnosed with HIV infection.3,4,35 Evidence indicates that HIV testing rates are suboptimal in the United States,34 underscoring persistent challenges in achieving comprehensive testing coverage.17 HIV infection impacts specific population subgroups more than others.48 Presently, there are nearly 1.2 million individuals living with HIV in the US, with the burden higher among African Americans and sexual minority groups.48 In 2022, new HIV infections were estimated at 31,800 cases, and men who have sex with men (MSM) were disproportionately affected.48 MSM accounted for 67% of the new HIV infections in 2022, among which Hispanic/Latino and African Americans were the majority. Similarly, regional disparity in the rates of newly diagnosed HIV in the United States is a concern.48 The South region, which includes Mississippi, accounted for almost half (49%) of new HIV infections in 2022.48 Yet, Mississippi presents a more concerning scenario: with high rates of new HIV infections and AIDS-related deaths and one of the largest populations living with HIV nationwide.5,6 The rates of HIV infections are higher among minority groups, with MSM, African Americans, and young adults between the ages of 25-34 years suffering a tremendous burden of HIV in the state.8,43 People in rural areas, particularly those residing in the Mississippi Delta,49 have the highest rates of new HIV infection.44 Studies suggested that high rates of HIV infection and associated public health consequences primarily stem from a lack of knowledge regarding individual HIV status.5 Over 17% of Mississippians with HIV do not know their HIV status compared to 12.8% nationally in 2022.8
A recent study indicated that between the years 2016 and 2017, only 40.2% of adults in Mississippi had ever tested for HIV, which was narrowly higher than the US rate of 38.9% for the same period.7 However, the proportion of people living with HIV in Mississippi (401.2 in every 100,000 persons) was higher than the US average (386.6 per 100,000 persons) in 2022.8 Also, mortality rates among adults with HIV in the state ranked among the highest in the US, at 7.9 per 100,000 individuals, compared to the national average of 6.7 per 100,000 people in 2022.8 Notably, HIV deaths disproportionally impact the black race by more than twice as much as HIV deaths among whites.8 A Mississippian with HIV faces nearly double the likelihood of mortality compared to an average American with the same infection.5
Prior studies reveal that approximately 80% of HIV transmissions occur among people who are either unaware of their HIV-positive status or are not engaged in regular medical care.9,10 This may reflect low HIV testing rates in the population and an under-performing HIV care continuum in the state because HIV screening is the entry point into the HIV care continuum.51 In 2022, linkage to care among newly diagnosed HIV infections was 52.5% in Mississippi as against 81.6% for the US average.8 Those who eventually received HIV medical care among individuals who were diagnosed and linked to care were less than half (49.9%) compared to 75.6%, the national average.8 Those who attained viral suppression following medical care were 59.6% in Mississippi, as opposed to 65.1% in the United States.8 This indicates a considerable gap in HIV prevention in Mississippi and the need to increase efforts.
Additionally, a significant proportion of persons diagnosed with HIV in Mississippi encounter barriers that impede access to required medical care.5 About half of the people diagnosed with HIV fail to receive appropriate medical attention.5 Such barriers include limited access to health services, denial of HIV-positive status, apprehension, poverty, and pervasive stigma associated with HIV/AIDS.5,49 Further aggravated the poor uptake of HIV testing in the United States was the COVID-19 pandemic.35,39,40 The negative impact of COVID-19 on HIV screening is worst in the Southeastern region, where Mississippi is situated.12,39 The region represents the highest concentration of individuals unaware of their HIV status.12 The gap in HIV screening in the region is associated with various socioeconomic factors, including poverty, low socioeconomic status, unemployment, limited HIV knowledge, and awareness, as well as limited access to HIV screening services, among other determinants.12,13 Specifically, the disparity in access to medical care is one major factor that underpins poor health outcomes among socially disadvantaged groups such as MSM, rural dwellers, and African Americans in Mississippi.26
The Centers for Disease Control and Prevention (CDC), Mississippi State Department of Health (MSDH), and various partners have collaborated to advance HIV testing, prevention, and care through different programs and initiatives. In 2019, the United States federal government launched the Ending the HIV Epidemic (EHE) initiative, which aims to achieve a 75% reduction in new HIV infections by 2025 and 90% by 2030.13,46 An essential component of the initiative is prompt diagnosis of individuals with HIV infection and immediate implementation of strategies to prevent transmission to others.17 Likewise, the “TakeMeHome” program implemented in 2020 is another step the federal government undertook to expand access to HIV testing.9 It provides HIV rapid test kits to groups with high risk of HIV, such as MSM, to support self-administered screening at homes.9 The efforts constitute a proactive measure to broaden accessibility to HIV testing services and extend testing opportunities to individuals who may harbor reservations about seeking conventional clinic- or community-based testing.9 The deployment of HIV testing services within retail pharmacies and community outreach initiatives represents prevalent strategies intended to augment testing uptake across the United States.17,18 Also, the current CDC guidelines advocate universal HIV testing, mandating that all individuals between the ages of 13 and 64 get HIV screening at least once as part of routine healthcare, and individuals deemed to be at elevated risk are advised to undergo HIV testing at more frequent intervals.19 Further, the Ryan White HIV/AIDS Program (RWHAP) is an encouragement towards taking HIV tests in the state by providing equitable, high-quality HIV care, treatment, and support services for poor Mississippians with HIV.45 The program supported direct healthcare and support services for 5,492 individuals in Mississippi with HIV in 2022 compared to 4,392 in 2018, which implies increased engagement with the program.45 It is pertinent for people to know their HIV status by undergoing HIV testing without fear of how they will obtain quality medical care and support services.
Therefore, to achieve the EHE’s goals and objectives of reducing HIV transmission by 90% in Mississippi, it is critical to understand how HIV screening uptake is distributed across demographic characteristics. This is necessary to define the gap in HIV testing and indirectly assess the performance of current public health efforts. Prior studies have shown that HIV screening rates differ across demographic strata; however, there is no current evidence to ascertain such an assertion in Mississippi, a high HIV-burdened and low-resource population. Therefore, this study aims to examine the prevalence of HIV screening and disparities across demographic characteristics among adults in Mississippi. Insights from this study hold the potential to identify population subcategories that require unique interventions and highlight evidence-based strategies to address such gaps in HIV screening uptake and mitigate the HIV epidemic in Mississippi.
Data for this study was derived from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) national dataset, encompassing 4,239 adults aged 18 years and older in Mississippi. The BRFSS is a state-level, random telephone survey targeting the non-institutionalized civilian population of the United States aged 18 and older and is known for providing high-quality and reliable data pertinent to behavioral health risk assessment.20 It is administered across all the U.S. states, the District of Columbia, and some U.S. territories.21 Data collection for the BRFSS is performed through landline and cellular telephone interviews, employing complex sampling techniques and weighting procedures to enhance representativeness.21 To address our research questions, this study examines the variable “ever tested for HIV” from the 2022 BRFSS dataset. Respondents were asked, “Including fluid testing from your mouth, but not including tests you may have had for blood donation, have you ever been tested for HIV?” The responses to this question were categorized as “tested,” “not tested,” or “I don’t know/not sure.”
This study includes respondents whose responses were “tested” or “not tested.” Responses of “I don’t know” or “not sure/refused” were excluded from covariate analyses, and missing data was deemed invalid. The prevalence of HIV screening was estimated across nine sociodemographic characteristics: sex, age group, marital status, race, income, education level, health insurance status, urban status, and metropolitan status. Sex was measured as male or female as the sex of respondents in the interview. In contrast, marital status was measured as married, divorced, widowed, separated, never married, and member of an unmarried couple. We regrouped divorced and widowed and separated as one group: those who had never married and those who were members of an unmarried couple as another group. This was necessary to increase statistical power at the subgroup level. Race was measured initially in BRFSS to include the following races: white only, black only, American Indian or Alaskan native only, Asian only, Native Hawaiian or other Pacific Islander only, multiracial, and other races only. However, we excluded other races apart from whites and blacks due to low counts. Health insurance status was dichotomized as “yes” for people with any form of health insurance and “no” for those without health insurance. The significance level for this study was set at p < 0.05.
Data analysis was conducted using SPSS Statistics version 29.0.1.0.50 All estimates were calculated using the Complex Samples module of the statistical software. Sociodemographic characteristics were estimated with descriptive statistics. The prevalence of HIV screening was assessed across the nine covariates using descriptive statistics (frequency), and subgroup comparisons were performed with Pearson’s Chi-Square test of independence. The results are tabulated and presented in the results section.
The 2022 BRFSS survey of adults in Mississippi shows that 52.4% of the participants were female, and the racial majority was white, at 57.9%. A significant majority, 89.8%, had access to healthcare services, and 76.6% of the respondents were urban residents. More than half of the surveyed population (56.9%) live in non-metropolitan counties, and nearly one-fourth of the participants (23.2%) were elderly (Table 1).
The HIV testing rate in Mississippi was 38.1% (95% CI: 36.1 – 40.1). Females demonstrated a slightly higher rate of 39.8% (95% CI: 37.0 – 42.7) compared to 36.2% (95% CI: 33.3 – 39.2) among males. However, the difference in HIV screening uptake between the two genders was insignificant (p=0.087). The analysis also found a racial disparity in HIV screening uptake. The Blacks (African Americans) had a higher HIV testing rate than their White counterparts, that is, 49.8% (95% CI: 46.5 – 53.2) for Blacks, compared to 30.5% (95% CI: 28.1 – 33.1) for whites (p< 0.001). See Tables 2 and 3 for details of the results.
The prevalence of HIV screening rates varied significantly among participants in different age groups (p<0.001). The highest uptake was among individuals aged 35-44 at 54.4% (95% CI: 49.2 – 59.4) and those aged 25-34 at 53.3% (95% CI: 48.0 – 58.8). Respondents in the 45–54 age category had uptake at 48.6% (95% CI: 43.9 – 53.3). The HIV screening rates among the age groups (25-34, 35-44, and 45-54 years) are similar, with overlaps in confidence intervals. Meanwhile, those in the 55–64-year age group had an HIV testing rate of 35.3% (95% CI: 30.6 – 40.3), which is significantly different from the rates in the three age groups mentioned earlier. The lowest uptake was among the elderly participants (65 years and older), at 17.6% (95% CI: 14.5 – 21.1), which differs significantly from a rate of 27.7% (95% CI: 21.7 – 34.7) for participants aged 18-24 years. Similarly, variation was observed in HIV testing prevalence between people who are currently married and individuals who are not married (p=0.001). Those who are married exhibited the lowest uptake rate at 34.1% (95% CI: 31.3 – 37.1), while participants who are divorced, separated, or widowed had a screening rate of 40.4% (95% CI: 36.2 – 44.7), and persons who have never married or are members of an unmarried couple had the highest rate, at 42.5% (95% CI: 38.8 – 46.3).
Based on access to healthcare, HIV screening rates were significantly different between people with health insurance and uninsured adults in Mississippi (p<0.001). The uninsured individuals had HIV screening rate of 50.0% (95% CI: 42.9 – 57.0), whereas those who were insured had HIV screening rate of 37.2% (95% CI: 35.1 – 39.4). Furthermore, participants who reside in metropolitan counties exhibited a significantly higher rate of 43.2% (95% CI: 39.7 – 46.7) compared to 34.3% (95% CI: 32.0 – 36.6) among those who reside in non-metropolitan counties (p<0.001). Lastly, urban dwellers had a screening uptake of 38.8% (95% CI: 36.5 – 39.4), and people who live in rural areas had a slightly lower rate of 35.7% (95% CI: 31.8 – 39.7). Nevertheless, the difference is statistically insignificant (p=0.173).
The prevalence of HIV testing is highest among individuals with an income below $25,000, with a screening rate of 43.7% (95% CI: 39.0 – 48.6). Persons within the income brackets of $25,000 – $49,999 and $50,000 – $99,999 exhibited comparable screening rates of 39.1% (95% CI: 35.3 – 43.1) and 39.6% (95% CI: 35.1 – 43.1), respectively. Individuals earning $100,000 and above had the lowest uptake at 34.9% (95% CI: 30.1 – 40.0). The observed difference in HIV screening rates across income groups is statistically insignificant (p=0.121). Likewise, the distribution of HIV screening uptake across educational levels mirrors that observed with income levels. Individuals whose education is less than a high school had an HIV screening rate of 41.0% (95% CI: 33.4 – 47.9), while those with college or technical school education exhibited a screening rate of 39.0% (95% CI: 35.6 – 42.4). Respondents who are college or technical school graduates and high school certificate holders had comparable screening rates, at 37.0% (95% CI: 33.6 – 40.5) and 36.7% (95% CI: 33.0 – 40.6), respectively. Yet the rate differences are insignificant (p=0.562).
Our analysis shows that only 38.1% of adults in Mississippi had ever tested for HIV in 2022. This represents a decline in HIV screening among adults in Mississippi from 40.2% reported between 2016 and 2017.7 We observed a higher rate of HIV screening among females than males, with an insignificant difference of 3.6%. This finding aligns with existing studies.22,23,25 Generally, women tend to have better health-seeking behavior and greater access to reproductive and sexual health care than men, which may explain gender differences in HIV screening uptake.25,33 However, the burden of new HIV infections is higher among males than females.25,33 In 2022, the rates of new HIV infections were approximately five times higher among males than females, with MSM having the highest impact in Mississippi.48 Likewise, HIV screening uptake was significantly higher among Black individuals compared to Whites. Similar findings were documented in other studies across the United States.18,22,23 Higher uptake among the black population may be attributed to the higher incidence and prevalence of HIV among African Americans, higher risk perception for HIV, and the success of community outreach programs targeted at reducing HIV infections among minority groups African Americans have been disproportionately affected by the HIV/AIDS epidemic than any other races in the country and currently have the highest risk of HIV infections.25,33 Therefore, it is imperative to increase efforts to enhance HIV testing among African Americans,33 and sexual minorities.
Moreover, we found significant variations in HIV screening rates across different age groups (p<0.001). HIV testing rates were similar among individuals in the age categories 35-44 years (54.4%), 25-34 years (53.3%), and 45-54 years (48.6%). These findings are consistent with the literature.24.25,43 People within the age group 25-35 years have the highest risk of HIV, rates of new HIV diagnoses, and, fortunately, higher uptake of HIV.43 The observed high HIV screening rates in these three age categories (25-34, 35-44, and 45-54 years) are driven by increased health awareness and risk perception and targeted public health interventions among these age groups.24,43 Participants aged 55-64 had a significantly lower screening rate (35.3%) than younger cohorts. The level of HIV screening among the 55-64-years age group may reflect a lower perceived risk of HIV infection or less aggressive health promotion targeting this group. Further, the lowest screening rate was among the elderly (65 years and older), at 17.6%. The lower rates of HIV testing among the elderly are concerning and might suggest a potential gap in public health outreach and education. Finally, the youngest cohort (18-24 years) had a higher screening rate (27.7%) than the elderly, indicating better engagement with screening programs likely due to targeted educational campaigns and interventions aimed at younger adults.
Disparities in HIV screening rates based on marital status were observed (p=0.001). Married individuals had the lowest screening rate of 34.1%, which might suggest a lower perceived risk of HIV infection within monogamous relationships.43 However, this perception could be a barrier to testing and might necessitate tailored interventions to encourage screening among married couples. Conversely, individuals who were divorced, separated, or widowed had a higher screening rate of 40.4%. Heightened awareness of HIV risk in the post-relationship phase43 or increased engagement with healthcare services during life transitions may explain this level of uptake in this group. Similarly, those who have never married or are part of an unmarried couple showed a significantly higher screening rate (42.5%) than married individuals. Our results are consistent with prior studies.24,25,43 There is a strong relationship between divorce, separated, widowed, and never-married individuals and HIV/AIDS-related death compared to those who are married.43 This is related to the broader sexual network among divorced, separated, widowed, and never-married individuals and consequentially higher risk of HIV infection and HIV/AIDS death.43 Hence, the never-married and individuals who are members of an unmarried couple and those previously married may perceive a higher risk of HIV infection, thereby engaging in health-promoting behaviors.
We also confirmed that HIV screening uptake differs significantly between individuals with health insurance coverage and those without (p<0.001). The uninsured respondents (50%) had HIV screening rate that was 12.8% higher than the insured (37.2%). These findings agree with past studies.22,27,36 Lo et al. found an inverse association between HIV testing and having health coverage among whites.22 This could be a strategy to protect their employment since most health insurance engagements are employment-based.22 We anticipated higher screening rates among the insured due to better access to healthcare services. This reverse relationship between health insurance and HIV testing could indicate unwillingness by the insured to utilize HIV screening services as a protective measure against loss of employment since most health insurance plans are employment-based.27 Also, the higher uptake among those who are not insured could be explained by heightened perceived risk,27,36 and the impacts of RWHAP, which provides free quality medical care for low-income individuals living with HIV/AIDS in the state.47
Furthermore, our results suggest that individuals residing in metropolitan counties exhibit significantly higher HIV screening uptake, exceeding that of non-metropolitan residents by over 8.9%. This finding aligns with a study conducted in Texas, where metropolitan dwellers’ screening rates were seven times higher than the rates for non-metropolitan residents.24 The observed disparity in Mississippi likely reflects better access to HIV screening services and greater awareness in metropolitan counties. However, HIV screening rates show no significant difference between urban and rural areas, which contradicts observation by prior studies.7,37 The studies found significantly higher HIV screening rates in urban areas than in rural areas.7,37 Therefore, our results may indicate a significant improvement due to targeted interventions (such as RWHAP) designed to enhance screening rates and reduce stigma in rural areas over time.47
Lastly, this study reveals no statistically significant difference in HIV screening rates based on educational and income levels. These findings are intriguing, considering that educational and income levels can influence health behaviors, including the risk of HIV infection and access to healthcare services.27,38 Evidence suggests that poverty or the inability to purchase healthcare services is a significant deterrent to seeking healthcare.28,38 Contrary to our results, Gerbi and colleagues found that individuals with higher income levels had a lesser likelihood of being tested for HIV.25 Another study observed men with higher education are more likely to report being screened for HIV, while among women, educational attainment is insignificant.33 Regardless of educational level or economic status, adult Mississippians demonstrated similar attitudes toward HIV screening. Therefore, our results may imply a similar perceived risk of HIV or awareness levels across educational and income strata. These findings underscore the need for Mississippi to adopt strategies that will lead to full implementation of routine opt-out HIV testing protocol, which is presently under-implemented statewide.29,49
The strength of this study lies in its utilization of data derived from BRFSS, which is renowned for its data quality and reliability. Moreover, our analysis was based on a large sample size, which affords statistical robustness across different subcategories. Meanwhile, it is essential to interpret the findings in this study with an understanding of the inherent potential limitations. Firstly, the study relied on secondary data, which may not have been collected originally, to comprehensively address our specific research inquiries. Secondly, the exclusion of a considerable number of observations due to incomplete or missing data could introduce bias, thereby impacting the veracity of the study’s outcomes. BRFSS does not include data for incarcerated persons who have a higher risk of HIV infection, especially among men. Therefore, our study might have underestimated the rates of HIV screening in the state. Finally, we did not examine the prevalence of HIV screen rates by sexual orientation and transmission categories due to limited data.
The findings indicate the need for full implementation of routine HIV screening and specific group-tailored strategies to improve HIV screening rates. More aggressive public health campaigns that address misconceptions about HIV risk, increase awareness, and promote the health benefits of routine HIV screening are required across all demographic divides. Integrating HIV screening with other routine health checks could improve HIV screening uptake. Likewise, educational initiatives emphasizing the importance of regular HIV testing irrespective of marital status, making screening services more accessible, and reducing HIV/AIDS-associated stigma are critical steps.
Overall, the HIV testing rate in Mississippi was 38.1% (36.1-40.1) in 2022. This rate shows a decline from the 40.2% reported between 2016 and 2017.7 Our study underscores significant socio-demographic-related disparities in HIV screening rates in Mississippi. It highlights the importance of full implementation of routine HIV screening in medical settings in Mississippi. Routine HIV testing can improve HIV uptake and eliminate existing HIV screening disparities, increase HIV diagnosis and linkage to care, and lower HIV transmission following viral suppression with anti-retroviral medications.41,49 In addition, tailored public health interventions (such as mobile and outreach HIV screening, HIV-related stigma reduction interventions, and anti-homophobia programs) and rigorous awareness campaigns on the importance of HIV testing among racial and sexual minority groups can contribute to better health outcomes.41,42,47 The Ending Stigma through Collaboration and Lifting All To Empowerment (ESCALATE) is a vital stigma reduction program that must be built upon to improve sociocultural behaviors toward people living with HIV/AIDS and sexual minorities in the state. ESCALATE can facilitate HIV screening uptake among people with undiagnosed HIV infections by eliminating the fear of social rejection if the HIV testing outcome is positive.42 Future research should explore the underlying factors for these disparities to develop more effective strategies to improve HIV screening across all demographics. Such investigations hold promise for fostering a more comprehensive understanding of socio-demographic impacts on HIV screening behaviors.
Characteristic | Weighted % (95% CI) |
Sex | |
Male | 47.6 (45.7 – 49.6) |
Female | 52.4 (50.4 – 54.3) |
Age group | |
18 – 24 | 12.9 (11.5 – 14.4) |
25 – 34 | 16.6 (15.1 – 18.2) |
35 – 44 | 15.9 (14.5 – 17.3) |
45 – 54 | 15.3 (14.0 – 16.6) |
55 – 64 | 16.1 (14.8 – 17.6) |
65 and older | 23.2 (21.7 – 24.8) |
Race | |
White | 62.8 (60.9 – 64.7) |
Black | 37.2 (35.3 – 39.1) |
Health Insurance Status | |
Insured | 89.8 (88.4 – 91.0) |
Non-insured | 10.2 (9.0 – 11.6) |
Urban/Rural Status | |
Urban | 76.6 (75.0 – 78.0) |
Rural | 23.4 (22.0 -25.0) |
Metropolitan Status | |
Metropolitan Counties | 43.1 (41.4 – 44.7) |
Non-Metropolitan Counties | 56.9 (55.3 – 58.6) |
Marital Status | |
Married | 46.7 (44.7 – 48.6) |
Divorced, Separated & Widowed | 22.7 (21.2 – 24.4) |
Never Married & Member of Unmarried Couple | 30.6 (28.8 – 32.4) |
Annual Income | |
< $25,000 | 23.1 (21.3 – 25.0) |
$25,000 – $49, 999 | 33.0 (31.0 – 35.1) |
$50,000 -$ 99,999 | 27.2 (25.2 – 29.2) |
$100,000 and above | 16.7 (15.2 – 18.3) |
Education Level | |
Did Not Graduate from High School | 14.5 (12.9 – 16.3) |
Graduated High School | 30.2 (28.4 – 32.1) |
Attended College or Technical School | 34.2 (32.4 – 36.1) |
Graduated College or Technical School | 21.0 (19.7 – 22.4) |
Demographic Characteristic | Unweighted Count for Ever Tested HIV | Weighted % for Ever Tested HIV (95% CI) | P-value |
Mississippi | 1373 | 38.1 (36.1-40.1) | |
Sex | |||
Male | 585 | 36.2 (33.3-39.2) | |
Female | 788 | 39.8 (37.0-42.7) | 0.086 |
Health Insurance Status | |||
Insured | 1166 | 37.2 (35.1-39.4) | |
Non-insured | 151 | 50 (42.9-7.0) | < 0.001 |
Urban/Rural Status | |||
Urban | 1033 | 38.8 (36.5-41.2) | |
Rural | 340 | 35.7 (31.8-39.7) | 0.183 |
Metropolitan Status | |||
Metropolitan Counties | 501 | 43.2 (39.7-46.7) | |
Non-Metropolitan counties | 872 | 34.3 (32.0-36.6) | < 0.001 |
Race | |||
White | 643 | 30.5 (28.1-33.1) | |
Black | 672 | 49.8 (46.5-53.2) | < 0.001 |
Metropolitan County is a county within the Metropolitan Statistical Area (MSA). MSA must have at least one urban area with 50,000 residents or more.30 The state of Mississippi has five MSAs: Jackson MSA, Gulfport-Biloxi MSA, Memphis MSA, Pascagoula MSA, and Hattiesburg MSA.31 For instance, Jackson MSA comprises six counties- Copiah, Hinds, Madison, Rankin, Simpson, and Yazoo.32
Demographic Characteristic | Unweighted Count for Ever Tested HIV | Weighted % for Ever Tested for HIV (95% CI) | P-value |
Age Group | |||
18 – 24 years | 95 | 27.7 (21.7 – 34.7) | < 0.001 |
25 – 34 years | 250 | 53.3 (48.0 – 58.6) | |
35 – 44 years | 299 | 54.4 (49.2 – 59.4) | |
45 – 54 years | 311 | 48.6 (43.9 – 53.3) | |
55 – 64 years | 246 | 35.3 (30.6 – 40.3) | |
65 years and older | 172 | 17.6 (14.5 – 21.1) | |
Marital Status | |||
Married | 562 | 34.1 (31.3 – 37.1) | 0.001 |
Divorced, Separated & widowed | 355 | 40.4 (36.2 – 44.7) | |
Never Married & Member of Unmarried Couple | 448 | 42.5 (38.8 – 46.3) | |
Income per annum | |||
< $25,000 | 296 | 43.7 (39.0 – 48.6) | 0.121 |
$25,000 – $49, 999 | 387 | 39.1 (35.3 – 43.1) | |
$50,000 -$ 99,999 | 302 | 39.6 (35.1 – 44.3) | |
$100,000 and above | 192 | 34.9 (30.1 – 40.0) | |
Education Level | |||
Did not graduate from high school | 128 | 41.0 (34.4 -47.9) | 0.562 |
Graduated High school | 339 | 36.7 (33.0 – 40.6) | |
Attended college or technical school | 455 | 39.0 (35.6 – 42.4) | |
Graduated college or technical school | 447 | 37.0 (33.6 – 40.5) |
Dr. Igbekele Ogunboye is a graduate student in the Department of Epidemiology and Biostatistics, Jackson State University. His research areas include epidemiology of chronic diseases, infectious diseases and cost-effectiveness modeling. He received his formal training as medical doctor at University of Benin, Nigeria, and MSc in Health Planning, Policy and Financing at London School of Hygiene and Tropical Medicine and London School of Economic and Political Science, UK.
Dr. Rita Momah obtained a bachelor’s degree in biomedical sciences from the University of Nigeria, a Master of Public Health degree from Louisiana State University-Shreveport, LA, and a Doctor of Public Health degree from Jackson State University. She serves in numerous capacities including as an adjunct professor at Louisiana State University- Shreveport, LA, the principal investigator on the Ryan White Ending the HIV Epidemic grant for the State of Mississippi, and the international medical mission’s director for Saints Specialist Services International. Her research interests include implementation science, evaluation strategies for public health projects, HIV prevention and care strategies, health literacy, and health promotion in rural settings. She has also published several peer-reviewed manuscripts.
Dr. Anitha Myla is an Epidemiologist and Data Manager with the office of HIV/STD at the Mississippi State Department of Health, Jackson, MS. Dr. Anitha’s research interests include studies on environmental health, epidemiology, and the impact of endocrine-disrupting chemicals, etc. Dr. Anitha’s academic achievements include a Doctor of Philosophy in Environmental Sciences and a Master of Public Health in Biostatistics from Jackson State University. She also holds a Master of Business Administration in Human Resource Management from Dravidian University and a Bachelor of Dental Surgery from Bangalore University.
Ayana Davis obtained a BS in Health, Physical Education and Therapeutic Recreation from Jackson State University. She is currently a student of Master of Public Health in Epidemiology and Biostatistics at Jackson State University. Her research interests focus on HIV/STD’s and Cardiovascular diseases in minority and disadvantaged populations. Other research areas include the role of genetics in autism spectrum disorder.
Dr. Shileayo Idowu Peter Adebayo obtained a MPH degree in Epidemiology from Jackson State University, and an MB.BS. from the University of Benin, Nigeria. His research areas include cardiovascular and infectious diseases epidemiology. Currently, he is serving as an epidemiologist at Mississippi State Health Department, Department of communicable disease, Jackson, Mississippi.
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