The moderating effects of alcohol use on the association between sexual orientation and HIV testing: results from the 2013–2018 National Health Interview Study

Routine screening and testing for HIV are recommended for all adolescents and adults. However, only one-third of the U.S. population has been tested for HIV. Women, sexual minorities, and people who use alcohol are more likely to be tested for HIV, but less is known about how alcohol use and sexual orientation impact the likelihood of HIV testing synergistically. Examining both alcohol use and sexual orientation is especially relevant, because sexual minorities are at increased risk for alcohol use, including heavy drinking. This study tested an alcohol x sexual orientation interaction effect on HIV testing through logistic regression modeling with a nationally representative sample. Results of the significant interaction identify demographic groups that are particularly at-risk for not being tested for HIV. These groups include lesbian women who currently use alcohol or previously used alcohol; bisexual men who have not used or previously used alcohol; and gay men who previously used alcohol. Although efforts to test all adolescents and adults are warranted, these findings highlight the importance of assessing alcohol and sexual orientation and augmenting testing efforts for highrisk groups.