Online Program

Ecological barriers to HIV testing among black heterosexual men and black men who have sex with men in chicago: Improving HIV testing for a vulnerable population

Wednesday, November 6, 2013

Ramona Bhatia, MD, Department of Preventive Medicine, Northwestern University, Chicago, IL
Nataka Moore, PsyD, Department of Clinical Psychology, Adler University, Chicago, IL
Iman Martin, MPH, MS, PhDc, Institute of Human Genetics, University of Illinois at Chicago School of Public Health, Chicago, IL
Marcus Murray, Project Brotherhood, Woodlawn Health Center, Chicago, IL
Bonnie Thomas, MD, Project Brotherhood, Woodlawn Health Center, Chicago, IL
Thomas Mason, MD, Project Brotherhood, Woodlawn Health Center, Chicago, IL
Courtney Hollowell, Cook County Health and Hospitals System, Chicago
Rick Kittles, PhD, Institute of Human Genetics, University of Illinois at Chicago, Chicago, IL
Adam Murphy, MD, Dept. of Urology, Northwestern University, Chicago, IL
Background: Black heterosexual men (BHM) and Black men who have sex with men (BMSM) are at high risk for HIV and suboptimal HIV testing. Up to 48% of HIV positive Black men do not know their status, resulting in excess morbidity and transmission. We conducted a qualitative study to yield an explanatory description of perceived barriers to HIV testing in BHM and BMSM. Methods: Self-identified BHM and BMSM (ages 18-49, mean = 31) were recruited using convenience sampling at a public health clinic and venues serving BMSM in Chicago. Forty-eight non-HIV infected men completed 70-minute focus groups of approximately 8 men. The ecological framework was used to analyze responses to open-ended questions targeting psychological, social/ interpersonal, and structural barriers to HIV testing. Three reviewers independently coded the transcripts thematically without disagreement. Results: Over 90% of participants had obtained at least 1 HIV test in the past, but most tested inconsistently. Shared barriers included: lack of health insurance, low health literacy, and physician mistrust. BMSM felt that testing was stigmatizing for presumed sexual orientation and promiscuity. BMSM perceived that HIV testing in public health clinics and community events was conducted by BMSM from their social network and risked confidentiality breaches. Young BMSM conceptualized HIV as non-life threatening, which deprioritized testing. Conclusions: Psychological, social/interpersonal, and structural barriers limit HIV testing amongst BHM and BMSM. For BMSM, future efforts should focus on reducing stigma from HIV testing, addressing the potential confidentiality breaches, and educating young men about health threats still associated with HIV/AIDS.

Learning Areas:

Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Chronic disease management and prevention
Diversity and culture
Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Identify perceived barriers to HIV testing in African-American men who have sex with men

Keyword(s): HIV/AIDS, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was heavily involved with all aspects of this work and am the PI.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5006.0: Barriers to HIV prevention