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APHA Scientific Session and Event Listing

Chandra L. Ford, PhD, MPH, MLIS, Department of Social Medicine, University of North Carolina, CB# 7440, School of Medicine, University of North Carolina, Chapel Hill, NC 27599-7440, 919.843.6879, chandra_ford@med.unc.edu

BACKGROUND: Although current clinic-based HIV prevention initiatives emphasize routine HIV antibody testing to increase the proportions of persons who are diagnosed early, it is unknown whether patient-provider racial concordance influences HIV antibody test acceptance among African American women, a group disproportionately affected by HIV. METHODS: We integrated Critical Race Theory concepts and the Andersen Access to Care model to guide a race-conscious, cross-sectional analysis of HIV testing behavior among female sexually transmitted disease (STD) clinic attendees (n=137). Sample inclusion criteria were African American (self-report), age 18 years or older, and newly seeking STD diagnosis. All patients automatically are offered same day HIV antibody tests; we ascertained acceptance/decline of the tests from the clinic lab's daily log of diagnostic tests. Clinician's race and HIV prevention-related constructs such as HIV knowledge were assessed via self-administered questionnaire during the clinical visit. We used logistic regression to obtain odds ratios and 95% CI's. RESULTS: Only 45.60% of participants accepted the offered HIV antibody tests. Most participants (76.8%) were seen by non-black clinicians. In adjusted analyses controlling for levels of patient satisfaction and the presence of STD symptoms, participants seen by non-black clinicians had lower odds of test acceptance (OR=0.31, 95% CI=0.12, 0.79). CONCLUSIONS: Critical Race Theory informed a race-conscious approach to studying clinic-based HIV antibody testing behavior among African American women. HIV antibody test acceptance is higher for African American women seen by black relative to non-black clinicians. Future research should examine these relationships among African American men.

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