From Their Voices: Barriers to HIV Testing among Black Men Who Have Sex with Men Remain
Abstract
:1. Introduction
2. Methods
2.1. Participants
Group Criteria | Sub-Sample Size | Number of Focus Groups |
---|---|---|
Unknown status or Untested in last 24 months | n = 14 | 2 Groups |
Tested positive within last 24 months (self-reported) | n = 11 | 2 Groups |
Tested negative within last 24 month (self-reported) | n = 11 | 2 Groups |
2.2. Procedure
2.3. Coding and Analysis
Variable | Percent (n) | |
---|---|---|
Age | ||
<Mean Age 23 | 53 (19) | |
≥Mean Age 23 | 47 (17) | |
Educational Level | ||
High School or less | 64 (23) | |
At least Some College | 36 (13) | |
Employment Status | ||
No Employment | 36 (13) | |
Part/Fulltime Employment | 64 (23) | |
Had HIV Test past 2 yrs | ||
No | 39 (14) | |
Yes | 61 (22) | |
Receptive Anal Sex Risk ** | ||
No | 47 (17) | |
Yes | 53 (19) | |
Insertive Anal Sex Risk ** | ||
No | 61 (22) | |
Yes | 39 (14) | |
Seek Sex on the Internet | ||
No | 28 (10) | |
Yes | 72 (26) | |
Drug Use Risky Sex ** | ||
No | 30 (11) | |
Yes | 70 (25) | |
Alcohol Use Risky Sex ** | ||
No | 17 (04) | |
Yes | 83 (20) | |
Drinking Settings * | ||
Clubs/Bars | 40 (14) | |
Home | 75 (27) | |
Car | 83 (29) | |
Public | 60 (22) | |
HIV Related Stigma | ||
Low | 36 (13) | |
High | 64 (23) | |
HIV Knowledge | ||
Low | 47 (17) | |
High | 53 (19) |
3. Results
3.1. Background Characteristics of the Sample
3.2. Barriers to HIV Testing Uptake from the Voices of BMSM
3.3. Lack of Knowledge for Self HIV Risk Appraisal
“I need to know more about HIV in general…like if a dude is undetectable—what does that mean exactly? Does that mean I can have fun with him, do it with no cover [condom]? How can I tell if a guy is sick [HIV positive] that I did it with…so I’ll know if I need to get tested?”
“How do I know when I should get tested? I’m not sure if what I do…I think what I do is okay [safe] and no need to be worried. But, then again, I’m not really sure.”
“Do the pills they have for negative people mean they can do it free [have condomless sex] and keep them from getting it [HIV]…why do they need to test [for HIV]?”
3.4. Anxiety and Substance Use
“Fear of what happens if I get a positive result…will I be able to manage… anxiety about the possibility of if I have a positive result should I get tested.”
“…I’m afraid to get tested ‘cause I know I been doing some stuff that ain’t safe, and I might be [HIV] positive. I don’t know how I will handle it if I found out…I ain’t got no money for the medicine and going to the doctors.”
“Knowing I sometimes hit the booze, smoke weed or blow clouds [meth], and ain’t use no condom from time to time make me afraid that I might have got it [HIV], so sort of afraid to test.”
“…me too, [laughter], sometimes freak out too and scared to get tested…when I think about it…especially cause I been fuckin with 4–20 [marijuana] and drinkin. I don’t always use something [condom], just fuck without it…but I pull out, but still freak out later when I know I should get tested.”
3.5. Lack of Peer Support
“I’ve been out with friends and we see the big white van [HIV testing van], but it’s funny cause it’s like the big elephant in the room…walk on by it many times. If one of them would say let’s stop and do it [test], I would so go for it.”
“Man, it would be cool to have somebody to go [get tested] with. We never talk about it though. Only thing we say stuff like who you sleeping with, or say I heard he got it [HIV]. That dude got the bug [HIV]. Never say you should get tested, or go with me [to test].”
3.6. Stigma
“…was with a group of friends I usually go hang out with, like we go to the clubs, play ball, and stuff together. We were driving to [club name removed], my friend [A] said he found out that the dude he was fooling with had HIV. My other buddy [B] said, “I hope you ended it right then.” So, my buddy [A], said hell yeah, ain’t got time; I ain’t gonna be getting sick and shit. They don’t know I got HIV…I was quiet…didn’t know what to do…what they think about me if I told it.”
“If I got positive [for HIV], then, if my family found out, I would be so ashamed that they know. My mama already think all gay people get HIV from being in the gay lifestyle.”
3.7. Perceptions about HIV Testing and Treatment Facilities
“I know people wonder, just like I used to wonder, if I take the test and positive, what type of place will I go for treatment…people will know why I’m there…I don’t have no way to go to a private docs. But, the place I actually go to is a nice clinic…they see only people with HIV—it’s part of a hospital, but got its own area…not as bad now. But I did used to wonder.”
“Man, the [HIV] testing van is out in the open. Shoot, if I get a bad [positive] result, where I can go. Man I be out on way to have fun—that won’t be nowhere to go to be private if I got bad news like that.”
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Washington, T.A.; D’Anna, L.; Meyer-Adams, N.; Malotte, C.K. From Their Voices: Barriers to HIV Testing among Black Men Who Have Sex with Men Remain. Healthcare 2015, 3, 933-947. https://doi.org/10.3390/healthcare3040933
Washington TA, D’Anna L, Meyer-Adams N, Malotte CK. From Their Voices: Barriers to HIV Testing among Black Men Who Have Sex with Men Remain. Healthcare. 2015; 3(4):933-947. https://doi.org/10.3390/healthcare3040933
Chicago/Turabian StyleWashington, Thomas Alex, Laura D’Anna, Nancy Meyer-Adams, and C. Kevin Malotte. 2015. "From Their Voices: Barriers to HIV Testing among Black Men Who Have Sex with Men Remain" Healthcare 3, no. 4: 933-947. https://doi.org/10.3390/healthcare3040933