Race/Sex Interactions and HIV Testing Among College Students.

OBJECTIVES: The primary aim of the study was to examine race/sex interactions and other behavioral and demographic covariates of past-year HIV testing among college students attending a racially diverse historically black university. The relationship between race/sex interactions and engaging with multiple sex partners during the past year was also examined. PARTICIPANTS: The sample included 566 students who identified as Black or White and engaged in vaginal, oral, or anal sex during the past 12 months.
METHODS: A total of 113 undergraduate classes were randomly selected, stratified by time of day. Surveys were administered by project team members who were assisted by peer health educators to increase the cultural competency of the study. The response rate was 94 %.
RESULTS: The sample of 566 participants included Black women (54 %), Black men (26 %), White women (13 %), and White men (7 %). The mean age was 25 (median = 22 years), and 42 % resided on campus. Nearly half (46 %) reported two or more sex partners in the past year, and 9 % of participants were diagnosed with STD in the past year. Sixty-nine percent reported being tested for HIV, 58 % had been tested in the past year, and 18 % had been tested for HIV on two or more occasions during the past year. In multivariable analysis, Black men (AOR = 0.43; 95 % CI = 0.27, 0.69), White women (AOR = 0.25; 95 % CI = 0.14, 0.47), and White men (AOR = 0.22; 95 % CI = 0.10, 0.49) were significantly less likely than Black women to be tested for HIV in the past year. Residing off campus (AOR = 1.88; 95 % CI = 1.18, 2.99) and engaging with two or more sex partners in the past year (AOR = 2.59; 95 % CI = 1.70, 3.95) significantly increased the likelihood of HIV testing in the past year. Students who engaged only with heterosexual partners (AOR = .25; 95 % CI = 0.09, 0.76) or were female and bisexual (AOR = 0.17; 95 % CI = 0.04, 0.69) were less likely to be tested for HIV in the past year compared to men who have sex with men/men and women. In a separate model, Black men (AOR = 1.87; 95 % CI = 1.18, 2.97) were significantly more likely than Black women to engage with two or more sex partners during the previous year. Compared to Black women, White women (AOR = 0.51; 95 % CI = 0.26, 0.98) were less likely to report two or more sex partners in the past year. Students involved in a relationship during the past 30 days (AOR = 0.33; 95 % CI = 0.22, 0.49) were less likely than other students to engage with two or more sex partners in the past year.
CONCLUSIONS: Over half (58 %) of the students had been tested for HIV in the past year-a promising outcome. However, 42 % of sexually active students had not been tested. Campus prevention initiatives need to reinforce the importance of frequent HIV testing. In particular, targeted prevention efforts need to be focused on heterosexual Black male college students.