Post-HIV Testing Behavior Practices and Disclosure Patterns among Black/African American Heterosexual Men Living in Rural Florida

BACKGROUND

In the United States, black/African American (black) men bear the greatest burden of human immunodeficiency virus (HIV) infection, accounting for 42% of new infections in 2012. In Florida, heterosexual HIV transmission has increased among black men.  Few studies have examined post-HIV-testing behaviors and disclosure patterns for black, heterosexual men (BHM).  This study describes HIV behaviors and disclosure patterns of BHM in rural Florida after receiving HIV test results.

METHOD

We conducted 12 focus groups (4-7 participants per group) in three rural Florida counties with BHM 3-6 months after participation in an HIV testing randomized trial. Interviews were professionally transcribed; data were analyzed using NVivo 10.  The qualitative analysis was informed by the strengths perspective (i.e., emphasis on abilities rather than risks) and used a thematic analytical approach to identify main themes. 

RESULTS

Sixty-seven men participated (median age 41.5 years; range 18-64); 62% earned a monthly income of less than $500, 10%  attained education beyond high school, 55% were married, 60% reported practicing monogamy; all tested negative for HIV infection. We identified three primary themes based on self-reported actions after testing: 1-behavior change (e.g., more consistent condom use, fewer sex partners); 2-sexual health communications with partner(s) (e.g., negotiated HIV testing with sex partners, disclosed test results); 3-health communication with peers and family (e.g., encouraged others to get tested).  

CONCLUSION

Among BHM, HIV testing facilitated changes in protective behaviors and communications for HIV prevention. Incorporating the strengths perspective in HIV prevention interventions for BHM may encourage routine testing and sustained risk reduction.