Self Assessment of HIV Risk Among OSU Students
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Date
2013-05
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The Ohio State University
Abstract
Background: HIV testing helps prevent the spread of HIV in at-risk populations, including among students on a college campus. The HIV testing process includes education and behavioral counseling to help individuals make better decisions about high-risk behaviors. HIV is on the rise among adolescents aged 13 to 24 in the U.S, and the college campus environment provides many opportunities to participate in high risk behaviors. Research that examines students' perception of their personal risk of HIV acquisition is needed.
Objectives: The purpose of this study is to evaluate whether Ohio State University (OSU) students (n=1000) who come for HIV testing at OSU's Student Wellness Center (SWC) classify their risk for HIV acquisition differently compared to how their HIV counselor classifies them. This study will provide insight as to which groups of students seeking HIV testing at OSU underestimate their HIV risk. Identifying these students can help the SWC target those who may be discordant with their counselors to encourage them to take advantage of HIV testing and counseling.
Methods: We compared risk assessments reported by students prior to counseling ('low,' 'medium,' or 'high') on a self-administered, paper survey to the risk assessment reported by their counselor (also 'low,' 'medium,' 'high'), and evaluated whether differences in risk perception between students and counselors were associated with demographic or behavioral factors. Participants were not recruited for this study; instead, we utilized a de-identified database provided by the SWC HIV testing and counseling program. The OSU IRB approved this research.
Results: The population included 1000 students seeking HIV testing, the majority of whom were undergraduate (76.1%), male (59.1%), and White (68.8%). Most students (75.5%) self-reported their risk as 'low,' whereas 21.4% selected 'medium' and 3.1% selected 'high.' In contrast, counselors rated students' risk as 'low' for 45.7% of students, 'medium' for 34.7%, and 'high' for 19.5%. Most students (65.2%) had excellent knowledge of HIV transmission routes and risk behaviors, while 27.7% and 6.7% had good and poor knowledge respectively. Most students' risk assessments (51.1%) were concordant with their counselor's risk assessment, while 6.2% and 42.6% were discordant (overestimation) and discordant (underestimation) respectively.
Conclusion: In this study, we looked at whether OSU students who participate in HIV testing and counseling at the SWC assess their risk for HIV in a different way from what their counselor assesses their risk to be. In particular, we focused on students who underestimated their HIV risk. We were interested in determining specific demographic and behavioral characteristics of those students whose risk assessments were discordant with their test counselor's assessment. Our findings suggest that risk discordance between counselors and students is common. The characteristics that were associated with increased odds of risk discordance are being students who do not identify as heterosexual, having sex while under the influence of alcohol in the last 12 months, having 3 or more sexual partners in the last 12 months, and being sexually assaulted in the last 12 months.
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Keywords
HIV, Risk discordance, College Student, Risk assessment, HIV test counseling, Risk perception, OSU