999. Gender, Race, and Self-Perceived Health Status Influence Tuberculosis Testing Beliefs and Behavior in an Urban HIV-Infected Population
Session: Poster Abstract Session: Clinical Studies of Tuberculosis
Saturday, October 22, 2011
Room: Poster Hall B1
Background: HIV positive individuals are at high risk for active disease following latent infection tuberculosis infection (LTBI). Frequent testing for LTBI is indicated in this population but in many settings remains suboptimal. We assessed correlates of self-reported testing and beliefs regarding tuberculosis screening and treatment among attendees of a clinic serving an urban HIV-infected population. Methods: As part of a larger interview-based survey, 373 randomly selected HIV-infected individuals attending the clinic answered a 12-item survey instrument assessing self-reported testing for LTBI, preference for skin testing or blood testing, as well as knowledge and beliefs related to tuberculosis infection. Data on clinic attendance, self-perceived health status, and socio-demographic data were also collected and analyzed. Results: 373 individuals were interviewed.  66.8% reported receiving a test for LTBI within the last 12 months (n=249), and 92% reported ever receiving a test (n=343). The majority (66.8%) reported testing at the clinic where they receive HIV care, and 82% reported returning to have the test read. 16.1% reported a history of positive skin testing, and 14.2% reported receipt of medications for tuberculosis. 89% believed skin testing to be an accurate assessment of LTBI. Women were less likely than men to agree that HIV-infected individuals are more likely to become ill from tuberculosis (85.9% vs. 93%, p=0.038). Men demonstrated a stronger preference for skin testing versus blood testing for LTBI compared with women (58.0% vs. 47.9%, p=0.035) and were more likely to believe result (49.5% vs. 38.4%, p=0.031). Race also was associated with preference for skin testing versus blood testing for LTBI (67.0% for white respondents vs. 50.2% for black/African-American and 31.6% for other race, p=0.005). Individuals with poorer self-perceived health status were less likely to return for skin test assessment (93% of those reporting “excellent” health vs. 72.2% reporting “poor” health p=0.016). Conclusion: Gender, race, and self-perceived health status may influence beliefs and preferences for LTBI testing. Further investigation of these factors may improve interventions for LTBI screening in the HIV-positive population.

Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

Susanne Doblecki-Lewis, M.D.1, Gabriel Cardenas, MPH2, Yves Jeanty, MPH2, Allan Rodriguez, MD1, Savita Pahwa, MD3 and Lisa Metsch, PhD2, (1)Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, (2)Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL, (3)Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL


S. Doblecki-Lewis, None

G. Cardenas, None

Y. Jeanty, None

A. Rodriguez, None

S. Pahwa, None

L. Metsch, None

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