Researchers led by the UCLA Fielding School of Public Health examined HIV testing trends among adults ages 50 through 64 both before and after 2006, when the Centers for Disease Control and Prevention (CDC) recommended that most doctors automatically screen all patients for HIV regardless of whether they have symptoms.

The researchers found that gains in HIV testing were not sustained over time. Levels of engagement in HIV risk behaviors remained constant, yet testing decreased among this age group from 5.5 percent in 2003 to 3.6 percent in 2006. It increased immediately after the CDC's recommendation to about 4.5 percent, but then fell to 3.7 percent after 2009. Testing increased over this period only among non-Hispanic blacks and those with a recent doctor visit.

This is one of two recent studies by the same group of researchers into HIV testing among older adults. The previous study found that HIV testing prevalence was less than 5 percent, varied by race and ethnicity, and decreased with age, with the oldest older adults, whites, and older women least likely to be tested.

Overall these studies highlight the fact that more than 90 percent of people in this age group, with whom they are most likely to develop sexual or social relationships, are not receiving HIV screening as the CDC recommends. The key message for adults age 50 and older is that they may need to advocate for themselves during doctor visits in order to receive the HIV screening CDC considers essential for nearly all adults. This may be especially important for people who are not in high risk groups, as prior evidence shows that a substantial minority of such persons are living with undiagnosed HIV infection.