142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Getting Comfortable while Getting Tested: YMSM's Reflections on HIV/STI testing sites in Southeast Michigan

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 9:30 AM - 9:45 AM

Stephen Sullivan, B.A. , Center for Sexuality and Health Disparities, University of Michigan School of Public Health, Ann Arbor, MI
Emily Pingel, MPH , Center for Sexuality and Health Disparities (SexLab), University of Michigan School of Public Health, Ann Arbor, MI
Alanna Butler, MPH , Center for Sexuality and Health Disparities, University of Michigan School of Public Health, Ann Arbor, MI
Patricia Dittus, PhD , Division of STD Prevention, Center for Disease Control and Prevention, Atlanta, GA
José Arturo Bauermeister, MPH, PhD , Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI
Background: Regular HIV/STI testing among young men who have sex with men (YMSM) ages 15-24 continues to be an important HIV/STI prevention strategy (CDC, 2013); however, researchers have documented that YMSM experience widespread discrimination within medical settings due to a lack of lesbian, bisexual, gay, transgender, and queer (LGBTQ) cultural competency. It is imperative that we explore what helps YMSM feel a sense of comfort in testing situations.

Methods: Using a “secret shopper” methodology, we conducted an evaluation of 47 HIV/STI testing sites across Southeast Michigan. Each site was visited twice by a racially diverse, gay-identified YMSM (N=5) between the ages of 22 and 31. Participants recorded a total of 97 observations over four months, providing written reflections about their experiences within the site environment, as well as their interactions with HIV/STI staff and providers. We used open coding and thematic analysis to identify the overarching domains that shaped participants’ sense of comfort during testing sessions.

Results: Among the salient domains related to establishing comfort were staff demeanor, sex positivity, LGBTQ friendliness, and issues surrounding confidentiality/privacy. Evaluators described a spectrum of experiences, from egregious errors by test counselors to rewarding and affirming interactions.   The diversity of testing accounts, both positive and negative, challenged the assumption of LGBTQ sensitivity in HIV/STI testing sites. 

Conclusions: Based on our analyses, we underscore the need for LGBTQ cultural sensitivity across the testing process and discuss strategies to improve YMSM’s HIV/STI initiatives. Such initiatives may help safeguard YMSM from potentially harmful experiences while seeking care.

Learning Areas:

Diversity and culture
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
Describe policies and procedures that testing sites can adopt to increase the comfort of young men who have sex with men who are clients. Describe the importance of LGBTQ cultural sensitivity in HIV/STI testing contexts. Discuss the benefits and disadvantages of conducting “secret shopper” style evaluations of HIV/STI testing sites.

Keyword(s): HIV/AIDS, STDs/STI

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a graduate level public health student at the University of Michigan School of Public Health. I have several years of experience conducting qualitative research and led the data analysis for this project.
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.