Gregory Phillips1, Michele L Ybarra2, Tonya L Prescott2, Jeffrey T Parsons3, Brian Mustanski4. 1. Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. 2. Center for Innovative Public Health Research, San Clemente, California. 3. Hunter College and the Graduate Center of the City University of New York, Center for HIV/AIDS Educational Studies and Training (CHEST), New York, New York. 4. Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Electronic address: brian@northwestern.edu.
Abstract
PURPOSE: Adolescent gay and bisexual men (AGBM) are disproportionately affected by human immunodeficiency virus (HIV), but little is known about testing rates among men aged 18 years and under or about the barriers that they face when contemplating an HIV test. Therefore, we investigate here the testing behaviors and barriers among a diverse national sample of AGBM. METHODS: A total of 302 AGBM aged 14-18 years were recruited via Facebook ads to participate in an mHealth (text messaging-based) HIV prevention program. Recruitment was stratified to ensure approximately 50% were sexually inexperienced. RESULTS: Only 30% of sexually active participants had ever been tested for HIV, and nearly half of them did not know where they could go to get tested for HIV (42.9%). Based on exploratory factor analysis, nine questions assessing potential barriers to HIV testing factored into three subscales: external factors, fear, and feelings of invincibility. Among sexually active participants, those who had never tested for HIV had significantly greater scores on the external factors (odds ratio, 1.63; 95% confidence interval, 1.01-2.66) and fear (odds ratio, 1.88; 95% confidence interval, 1.11-3.19) subscale. Older (16-18 years old) youth were especially likely to be affected by external factor barriers, and fear was associated with never testing among gay-identified individuals. CONCLUSIONS: HIV testing rates were low among AGBM. Several modifiable barriers emerged, especially a lack of knowledge about the closest testing site. Interventions and programs that target high school-age adolescents could address external barriers by introducing HIV testing services into high schools.
PURPOSE: Adolescent gay and bisexual men (AGBM) are disproportionately affected by human immunodeficiency virus (HIV), but little is known about testing rates among men aged 18 years and under or about the barriers that they face when contemplating an HIV test. Therefore, we investigate here the testing behaviors and barriers among a diverse national sample of AGBM. METHODS: A total of 302 AGBM aged 14-18 years were recruited via Facebook ads to participate in an mHealth (text messaging-based) HIV prevention program. Recruitment was stratified to ensure approximately 50% were sexually inexperienced. RESULTS: Only 30% of sexually active participants had ever been tested for HIV, and nearly half of them did not know where they could go to get tested for HIV (42.9%). Based on exploratory factor analysis, nine questions assessing potential barriers to HIV testing factored into three subscales: external factors, fear, and feelings of invincibility. Among sexually active participants, those who had never tested for HIV had significantly greater scores on the external factors (odds ratio, 1.63; 95% confidence interval, 1.01-2.66) and fear (odds ratio, 1.88; 95% confidence interval, 1.11-3.19) subscale. Older (16-18 years old) youth were especially likely to be affected by external factor barriers, and fear was associated with never testing among gay-identified individuals. CONCLUSIONS:HIV testing rates were low among AGBM. Several modifiable barriers emerged, especially a lack of knowledge about the closest testing site. Interventions and programs that target high school-age adolescents could address external barriers by introducing HIV testing services into high schools.
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