Friday, December 25, 2015

From Their Voices: Barriers to HIV Testing among Black Men Who Have Sex with Men Remain

HIV testing continues to be a major priority for addressing the epidemic among young Black men who have sex with men (BMSM).

This study explored barriers to HIV testing uptake, and recommendations for motivating HIV testing uptake among Black men who have sex with men (BMSM) aged 18 to 30. BMSM (N = 36) were recruited through flyers and social media for six focus groups.

From the perspectives and experiences of young BMSM, participants recommended that information be included in HIV testing messages that would help young BMSM do self HIV-risk appraisals. Particularly, participants recommended that more knowledge about Pre-Exposure Prophylaxis (PrEP) and the role of PrEP in safer-sex practices be provided. This information is important to help those untested, or who infrequently test, better understand their risk and need for testing. Likewise, participants recommended that more information about a person being undetectable and the risk of condomless sex with an HIV negative sex partner; this information will be helpful for both the HIV negative and HIV positive sex partner for making safer sex decisions. Participants also recommended that interventions should focus on more than drug use as risk; the risk posed by the use of alcohol before and during sex deserves attention among young BMSM.

These findings may inform new HIV testing interventions being tailored for young BMSM. The interventions should also consider revisiting street-based peer-outreach approaches for those young BMSM with limited access to social media campaigns due to limited access or infrequent use of social media.

Anxiety and Substance Use
Responses revealed that a major barrier to HIV testing uptake was anxiety about receiving an HIV positive test result. Participants in all groups emphasized that for themselves, and for their friends, they believe the hesitance was the fear of learning that they might be HIV positive and were not ready to deal with it. This finding was similar for the majority of those in the group untested for HIV within the past 24 months, those who had tested and self-reported a negative HIV status, and those who were HIV positive. The HIV positive group discussed that they had anxiety about testing, and most were motivated to test after having had a friend or sex-partner disclose that they tested positive for HIV. A participant from the group of men who were untested for HIV in the past 24 months, stated:

“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.”

Another participant stated:

“…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.”

An auxiliary finding related to anxiety about receiving an HIV positive result was that many of the men reported engaging in other behaviors that might be related to risky sexual practices, such as using alcohol and/or drugs before or during condomless sex. Substance use with sex was a commonly reported issue. A participant stated:

“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.”

Another participant stated:

“…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.”
Full article at:

1School of Social Work, California State University, 1250 Bellflower Blvd, Long Beach, CA 90840, USA
2Center for Health Equity Research, California State University, Long Beach (CSULB), CA 90840, USA
Laura D’Anna: ude.blusc@annad.arual; Nancy Meyer-Adams: ude.blusc@smada-reyem.ycnan; C. Kevin Malotte: ude.blusc@ettolam.nivek
*Author to whom correspondence should be addressed; Email: ude.blusc@notgnihsaw.xela; Tel.: +1-562-985-7775

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