Understanding barriers to utilization of HIV prevention services for Men who have Sex with Men in Tennessee

CDC estimates that as many as 18% of those infected with HIV do not know their status.  CDC also reports that men who have sex with men (MSM) represent about 4% of the male population in the United States, but accounted for 78% of the new HIV infections among males and 63% of all new infections in 2010.  In Tennessee, MSM represent 48% of all HIV infections through 2012.  The purpose of this work was to ascertain barriers to utilization of HIV prevention services for MSM in Tennessee.

Three community based organizations in rural and urban geographic locations across Tennessee recruited HIV positive and negative high-risk MSM to participate in 73 focus groups from April 2009 to October 2009.  Each participant signed a release allowing the group’s conversation to be recorded and received a $15 incentive for their participation.  A semi-structured interview guide was consistently used by an interviewer for each focus group.  Recordings were transcribed and analyzed for emergent themes.  All information shared was kept strictly anonymous.

517 MSM of diverse backgrounds participated in 73 focus groups across Tennessee.  Topics including negative HIV representation in the media, the clash between faith and HIV, lack of comprehensive sex education in schools, lack of knowledge about current HIV treatment, and social stigma that is still coupled with HIV/AIDS emerged as barriers to HIV screening.

Health departments can develop approaches that reduce stigma, facilitate community building among MSM, and adopt policies that are LGBTQ inclusive to encourage utilization of HIV prevention services.