JMIR Publications

ABSTRACT

Background:

Promoting early human immunodeficiency virus (HIV) testing and patient detection are important public health goals. In Japan, approximately 30% of the population is diagnosed with acquired immunodeficiency syndrome (AIDS). Several studies have investigated the challenges related to HIV diagnosis; however, there are limitations in understanding the characteristics and barriers limiting individuals who are at high risk of HIV but have not yet been tested or have not sought medical consultation.

Objective:

This study aimed to examine the factors associated with medical consultation and HIV-testing behaviors, explore the reasons for not undergoing HIV testing, and evaluate the effectiveness of HIV-related awareness efforts.

Methods:

This retrospective cohort study used data obtained from the artificial intelligence (AI)-based symptom search engine, Ubie (Ubie Inc., Japan). Episodes from individuals who used the AI-based symptom checker to search for their symptoms, subsequently suggested as HIV/AIDS/sexually transmitted infection (STI)-related conditions, were included. Those who answered the first and revisit survey questionnaires were included in the analysis. Multivariable logistic regression analyses were conducted to explore the factors associated with medical consultation in both the overall suggested HIV/AIDS/STI-related condition group and the suggested STI-related condition subgroup. Factors associated with HIV testing in individuals who underwent medical consultations were also explored using multivariable logistic regression analysis. The reasons for not undergoing HIV testing and future intention to undergo testing in the future were described.

Results:

The number of eligible episodes was 424,893 for 332,976 individuals. Of these, medical consultation was performed in 105,365, and HIV testing in 394. Compared with individuals in their 20s, older age groups were associated with a higher tendency to seek medical consultations. Provision of awareness information through the AI-based symptom checker was associated with medical consultation behavior, and 29.0% of the people who had no intention of undergoing HIV testing responded that they would undergo HIV testing after using the AI-based symptom checker. Compared with the internal medicine department, the gynecology department was significantly associated with HIV testing; however, the HIV testing rates were low in the suggested STI-related condition subgroup across major departments, especially in the urology department.

Conclusions:

This study demonstrates that targeted HIV education can be effectively delivered to individuals who actively search for symptoms potentially associated with HIV infection and that such education is associated with increased healthcare-seeking behaviors. To further promote HIV testing, it may be necessary to refine the content and delivery of educational materials and enhance HIV testing literacy among physicians who encounter patients with STIs.