Mistrust of government often deters older adults from HIV testing

One out of every four people living with HIV/AIDS is 50 or older, yet these older individuals are far more likely to be diagnosed when they are already in the later stages of infection. Such late diagnoses put their health, and the health of others, at greater risk than would have been the case with earlier detection.

According to the Centers for Disease Control and Prevention, 43 percent of HIV-positive people between the ages of 50 and 55, and 51 percent of those 65 or older, develop full-blown AIDS within a year of their diagnosis, and these older adults account for 35 percent of all AIDS-related deaths. And since many of them are not aware that they have HIV, they could be unknowingly infecting others.

Various psychological barriers may be keeping this older at-risk population from getting tested. Among them are a general mistrust of the government - for example, the belief that the government is run by a few big interests looking out for themselves - and AIDS-related conspiracy theories, including, for example, the belief that the virus is man-made and was created to kill certain groups of people.

Now, a team of UCLA-led researchers has demonstrated that government mistrust and conspiracy fears are deeply ingrained in this vulnerable group and that these concerns often - but in one surprising twist, not always - deter these individuals from getting tested for HIV. The findings are published in the peer-reviewed journal The Gerontologist.

"Our work suggests that general mistrust of the government may adversely impact peoples' willingness to get tested for HIV/AIDS," said Chandra Ford, an assistant professor of community health sciences at the UCLA Fielding School of Public Health and the study's primary investigator. "HIV/AIDS is increasing among people 50 and older, but there's not a lot of attention being paid to the HIV-prevention needs of these folks. Older adults are more likely to be diagnosed only after they've been sick, and as a result, they have worse prognoses than younger HIV-positive people do.

"Also, the CDC recommends that anyone who's in a high-risk category should be tested every single year," she said. "These findings mean that the CDC recommendations are not being followed."

The researchers sought to test the association between mistrust of the government, belief in AIDS conspiracy theories and having been tested for HIV in the previous year. For the cross-sectional study, they worked with data from 226 participants ranging in age from 50 to 85. Participants were recruited from three types of public health venues that serve at-risk populations: STD clinics, needle-exchange sites and Latino health clinics.

Of the participants, 46.5 percent were Hispanic, 25.2 percent were non-Hispanic blacks, 18.1 percent were non-Hispanic whites and 10.2 percent were of other races or ethnicities. The data were collected between August 2006 and May 2007.