Assessing students' barriers to being tested for HIV on Historically Black College and University campuses

BACKGROUND: To better implement HIV testing programs at Historically Black Colleges and Universities (HBCUs) we assessed African-American students' perception of risk for acquiring HIV, willingness to be tested, and perceived barriers to testing on campus.

METHODS: We conducted 8 gender-specific focus groups with students from 6 HBCU campuses currently offering HIV rapid testing.

RESULTS: Many students did not consider HIV/AIDS a topic of major concern but believed that risk of HIV infection on campus was increased because of behaviors of others, including “promiscuous” freshman women and “down low” men (those with female and surreptitious male partners). Still, most students admitted having multiple partners and unprotected sex over the previous year.

Students identified personal, structural, and organizational barriers to HIV testing on campuses. Obstacles included fear of others' reaction should they test positive; reluctance to be tested at student health centers because of concerns about confidentiality and stigma from being labeled a high-risk person; and lack of student awareness about HIV testing availability on campuses.

All students thought being tested regularly was important. However, one-third had never been tested and few were tested regularly. Most students voiced a willingness to be tested if requested by a committed partner and to be tested with peers. Students agreed that offering incentives would encourage more students to be tested for HIV.

CONCLUSIONS: At HBCUs, HIV testing efforts addressing personal, structural, and organizational barriers, and those emphasizing community and personal risks might be more successful for increasing African-American students' willingness to be tested for HIV.