Assessing trends and social disparities in HIV testing among adults in Tennessee, United States: Behavioral Risk Factor Surveillance System (BRFSS) analysis, 2011 to 2023

Abstract Background Timely HIV testing is essential for early diagnosis, treatment, and prevention of transmission. Despite national guidelines recommending routine HIV screening, disparities in testing uptake persist in Tennessee. This study aimed to assess trends and sociodemographic disparities in HIV testing among adults in Tennessee from 2011 to 2023 using data from the Behavioral Risk Factor Surveillance System (BRFSS). Methods We conducted a cross-sectional analysis of BRFSS data from 2011 to 2023, focusing on adults residing in Tennessee. Weighted descriptive statistics were used to estimate the percentage of individuals ever tested for HIV and tested within the past 12 months. Trends were evaluated using orthogonal contrast tests and Estimated Annual Percentage Change (EAPC). Analyses were stratified by sex, age, race, income, insurance status, education, marital status, employment, and urbanicity. Results The weighted percentage of adults who had ever been tested for HIV showed a modest decline over the study period, with a mean percentage of 45.0% (95% CI 44.3%–45.6%) and an EAPC of − 0.76%, which was statistically significant ( p = 0.05). Testing within the past 12 months also showed minimal overall change, with a mean percentage of 12.9% (95% CI 12.4%–13.4%) and a non-statistically significant trend (EAPC = − 0.34%; p = 0.62). Subgroup analyses revealed persistent disparities. Conclusion While a statistically significant modest decline was found in ever HIV testing rates in Tennessee over the past decade, notable disparities persist and are widening. Targeted interventions are needed to improve testing uptake and reduce inequities among underserved populations.