Barriers to early HIV testing for African-born immigrants and Latinos in Minnesota: A qualitative study

background:

In Minnesota, Latinos and African-born immigrants are more likely than most populations to be late testers.  Late testing in these rapidly growing populations in the Midwest has important implications for clinical, public health, and economic outcomes.  Little is known about these populations’ barriers to testing.  This qualitative study aims to clarify barriers to early testing for these two populations.

methods:

Data were collected in 2014 through in-depth, semi-structured key informant interviews (n=13) with immigrant HIV-testing providers working in either clinical or community-based settings in Minnesota.  A systematic literature review identifying known barriers was conducted and helped to inform interview questions.  Verbatim interview transcripts were coded and verified and both thematic and content analyses were conducted.

results:

Twelve of the 13 informants perceived late testing as a problem.  African and Latino informants identified similar barriers in the following thematic categories: stigma, gender and relationships, attitudes toward HIV, knowledge, immigration status, access to health care, and behavioral health.  The most commonly mentioned barriers included concerns about the confidentiality of an HIV test result, fear of a partner’s reaction to an HIV-positive test result, the belief that an HIV diagnosis is a death sentence, lack of knowledge of HIV transmission, and the real or perceived cost of health care or HIV services.  

conclusions:

Latinos and African immigrants face a variety of similar barriers to HIV testing in Minnesota. This study highlights the overlap suggesting that strategies to reduce barriers to testing through outreach and access to care should consider similarities across populations.