Allison Mathews1,2, Samantha Farley3, Donaldson F Conserve4, Kimberly Knight5, Alston Le'Marus6, Meredith Blumberg3, Stuart Rennie7, Joseph Tucker5,8. 1. Department of Social Medicine, School of Medicine, The University of North Carolina at Chapel Hill, 333 South Columbia Street, MacNider Hall, Room #348 / CB #7240, Chapel Hill, NC, 27599-7240, USA. mathewsallison@gmail.com. 2. Institute for Global Health and Infectious Disease, School of Medicine, The University of North Carolina at Chapel Hill, 333 South Columbia Street, MacNider Hall, Room #348 / CB #7240, Chapel Hill, NC, 27599-7240, USA. mathewsallison@gmail.com. 3. Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 4. Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, The University of South Carolina, Columbia, SC, USA. 5. Institute for Global Health and Infectious Disease, School of Medicine, The University of North Carolina at Chapel Hill, 333 South Columbia Street, MacNider Hall, Room #348 / CB #7240, Chapel Hill, NC, 27599-7240, USA. 6. Department of Clinical Psychology, Fielding Graduate University, Santa Barbara, CA, USA. 7. Department of Social Medicine, School of Medicine, The University of North Carolina at Chapel Hill, 333 South Columbia Street, MacNider Hall, Room #348 / CB #7240, Chapel Hill, NC, 27599-7240, USA. 8. London School of Hygiene & Tropical Medicine, London, UK.
Abstract
BACKGROUND: HIV testing programs in the United States aim to reach ethnic minority populations who experience high incidence of HIV, yet 40% of African Americans have never been tested for HIV. The objective of this study is to identify community-based strategies to increase testing among African Americans in both urban and rural areas. METHODS: This study conducted focus group discussions (FGDs) informed by community-based participatory research principles to examine African American's concerns and ideas around HIV testing and HIV self-testing. Participants included highly affected (i.e., PLWH, MSM, PWID, low-income, teens and young adults) populations from African American communities in North Carolina, aged 15 years and older. We digitally transcribed and analyzed qualitative data using MAXQDA and axial coding to identify emergent themes. RESULTS: Fifty-two men and women between 15 to 60 years old living in urban (n=41) and rural (n=11) areas of North Carolina participated in focus group discussions. HIV testing barriers differed by HIV testing setting: facility-based, community-based, and HIV self-testing. In community-based settings, barriers included confidentiality concerns. In facility-based settings (e.g., clinics), barriers included negative treatment by healthcare workers. With HIV self-testing, barriers included improper use of self-testing kits and lack of post-test support. HIV testing facilitators included partnering with community leaders, decentralizing testing beyond facility-based sites, and protecting confidentiality. CONCLUSIONS: Findings suggest that HIV testing concerns among African Americans vary by HIV testing setting. African Americans may be willing to test for HIV at community events in public locations if client confidentiality is preserved and use HIV self-testing kits in private if post-test social support and services are provided. These community-identified facilitators may improve African American testing rates and uptake of HIV self-testing kits.
BACKGROUND: HIV testing programs in the United States aim to reach ethnic minority populations who experience high incidence of HIV, yet 40% of African Americans have never been tested for HIV. The objective of this study is to identify community-based strategies to increase testing among African Americans in both urban and rural areas. METHODS: This study conducted focus group discussions (FGDs) informed by community-based participatory research principles to examine African American's concerns and ideas around HIV testing and HIV self-testing. Participants included highly affected (i.e., PLWH, MSM, PWID, low-income, teens and young adults) populations from African American communities in North Carolina, aged 15 years and older. We digitally transcribed and analyzed qualitative data using MAXQDA and axial coding to identify emergent themes. RESULTS: Fifty-two men and women between 15 to 60 years old living in urban (n=41) and rural (n=11) areas of North Carolina participated in focus group discussions. HIV testing barriers differed by HIV testing setting: facility-based, community-based, and HIV self-testing. In community-based settings, barriers included confidentiality concerns. In facility-based settings (e.g., clinics), barriers included negative treatment by healthcare workers. With HIV self-testing, barriers included improper use of self-testing kits and lack of post-test support. HIV testing facilitators included partnering with community leaders, decentralizing testing beyond facility-based sites, and protecting confidentiality. CONCLUSIONS: Findings suggest that HIV testing concerns among African Americans vary by HIV testing setting. African Americans may be willing to test for HIV at community events in public locations if client confidentiality is preserved and use HIV self-testing kits in private if post-test social support and services are provided. These community-identified facilitators may improve African American testing rates and uptake of HIV self-testing kits.
Entities:
Keywords:
African Americans; Community engagement; HIV; HIV self-testing
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