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

Washington, Thomas Alex; DʼAnna, Laura Hoyt; Meyer-Adams, Nancy; Malotte, C. Kevin

doi:10.3390/healthcare3040933

Cited by 17 publications

(26 citation statements)

References 47 publications

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“…The present study is a pilot study with a small sample size, and, as such, these results should be interpreted with caution; however, they provide preliminary support for findings that could be further evaluated by larger scale studies. In previous research, these barriers have been identified as places of weakness in the HIV continuum of care, particularly for the most vulnerable communities (eg, BMSM), for whom the burden of undetected HIV infection strongly persists [2,35,36]. Arguably, these barriers may have been lessened because of the Web-based nature of this study.…”

Section: Discussionmentioning

confidence: 93%

A Test of Concept Study of At-Home, Self-Administered HIV Testing With Web-Based Peer Counseling Via Video Chat for Men Who Have Sex With Men

Maksut¹,

Eaton²,

Siembida³

et al. 2016

JMIR Public Health Surveill

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BackgroundMen who have sex with men (MSM), particularly MSM who identify as African-American or Black (BMSM), are the sociodemographic group that is most heavily burdened by the human immunodeficiency virus (HIV) epidemic in the United States. To meet national HIV testing goals, there must be a greater emphasis on novel ways to promote and deliver HIV testing to MSM. Obstacles to standard, clinic-based HIV testing include concerns about stigmatization or recognition at in-person testing sites, as well as the inability to access a testing site due to logistical barriers.ObjectiveThis study examined the feasibility of self-administered, at-home HIV testing with Web-based peer counseling to MSM by using an interactive video chatting method. The aims of this study were to (1) determine whether individuals would participate in at-home HIV testing with video chat–based test counseling with a peer counselor, (2) address logistical barriers to HIV testing that individuals who report risk for HIV transmission may experience, and (3) reduce anticipated HIV stigma, a primary psychosocial barrier to HIV testing. MethodsIn response to the gap in HIV testing, a pilot study was developed and implemented via mailed, at-home HIV test kits, accompanied by HIV counseling with a peer counselor via video chat. A total of 20 MSM were enrolled in this test of concept study, 80% of whom identified as BMSM.ResultsAll participants reported that at-home HIV testing with a peer counseling via video chat was a satisfying experience. The majority of participants (13/18, 72%) said they would prefer for their next HIV testing and counseling experience to be at home with Web-based video chat peer counseling, as opposed to testing in an office or clinic setting. Participants were less likely to report logistical and emotional barriers to HIV testing at the 6-week and 3-month follow-ups.ConclusionsThe results of this study suggest that self-administered HIV testing with Web-based peer counseling is feasible and that MSM find it to be a satisfactory means by which they can access their test results. This study can serve as a general guideline for future, larger-scale studies of Web-based HIV test counseling for MSM.

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Section: Discussionmentioning

confidence: 93%

A Test of Concept Study of At-Home, Self-Administered HIV Testing With Web-Based Peer Counseling Via Video Chat for Men Who Have Sex With Men

Maksut¹,

Eaton²,

Siembida³

et al. 2016

JMIR Public Health Surveill

View full text Add to dashboard Cite

show abstract

“…Black and Latino MSM are among the most challenging groups for the scale-up of PrEP. Barriers could include limited access to quality healthcare, poverty, lack of or poorer health insurance coverage, and higher rates of incarceration [51,52,53]. A study by Oster et al, however, found that similar rates of newly diagnosed Black and White MSM had health insurance, saw a provider, and received HIV screening tests [54].…”

Section: Discussionmentioning

confidence: 99%

Estimated Impact of Targeted Pre-Exposure Prophylaxis: Strategies for Men Who Have Sex with Men in the United States

Elion

Kabiri²,

Mayer

et al. 2019

IJERPH

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Pre-exposure prophylaxis (PrEP) effectively reduces human immunodeficiency virus (HIV) transmission. We aimed to estimate the impact of different PrEP prioritization strategies among Black and Latino men who have sex with men (MSM) in the United States, populations most disproportionately affected by HIV. We developed an agent-based simulation to model the HIV epidemic among MSM. Individuals were assigned an HIV incidence risk index (HIRI-MSM) based on their sexual behavior. Prioritization strategies included PrEP use for individuals with HIRI-MSM ≥10 among all MSM, all Black MSM, young (≤25 years) Black MSM, Latino MSM, and young Latino MSM. We estimated the number needed to treat (NNT) to prevent one HIV infection, reductions in prevalence and incidence, and subsequent infections in non-PrEP users avoided under these strategies over 5 years (2016–2020). Young Black MSM eligible for PrEP had the lowest NNT (NNT = 10) followed by all Black MSM (NNT = 33) and young Latino MSM (NNT = 35). All Latino MSM and all MSM had NNT values of 63 and 70, respectively. Secondary infection reduction with PrEP was the highest among young Latino MSM (53.2%) followed by young Black MSM (37.8%). Targeting all MSM had the greatest reduction in prevalence (14.7% versus 2.9%–3.9% in other strategies) and incidence (49.4% versus 9.4%–13.9% in other groups). Using data representative of the United States MSM population, we found that a strategy of universal PrEP use by MSM was most effective in reducing HIV prevalence and incidence of MSM. Targeted use of PrEP by Black and Latino MSM, however, especially those ≤25 years, had the greatest impact on HIV prevention.

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“…These beliefs have impeded treatment efforts among HIV-positive individuals because of their desire for secrecy or reluctance to disclose to partners (Earnshaw & Chaudoir, 2009). Among those with unknown status, fear of receiving a positive HIV test result remains a potent disincentive to seeking HIV testing (Valdiserri, Holtgrave, & West, 1999; Obermeyer & Osborn, 2007; Otto-Salaj et al, 2008; Washington et al, 2015). HIV stigma has the potential to impede the uptake of a novel and highly effective HIV biomedical prevention methods, specifically post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) (van der Straten et al, 2014; Calabrese & Underhill, 2015).…”

Section: Discussionmentioning

confidence: 99%

HIV-Related Communication and Safe Sex Practices among Heterosexual Black Men: A Qualitative Report

Bond¹,

Frye²,

Cupid³

et al. 2018

Journal of Black Sexuality and Relationships

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HIV prevention efforts have given limited attention to the influence of social norms on the process of communicating about safer sex practices among heterosexual Black men. To address this and inform the development of an HIV prevention behavioral intervention for heterosexual African American men, we conducted computerized, structured interviews with 61 men living in high HIV prevalence neighborhoods in New York City to participate in either one of the five focus group interviews and/or an in-depth qualitative interview. Participants had a mean age of 33 years, 25% held less than a high school education, 66% earned an annual income of $10,000 or less, and 86% had a history of incarceration Qualitative analysis was used to identify emergent themes within the domains of condom use communication, HIV status disclosure with sexual partners, and general HIV knowledge among peers. Thematic analyses revealed that communication was hindered by (1) low perception of risk of sex partners (2) relationship insecurities and (3) HIV stigma within the community and between sex partners. Most communication related to condom use was based on their perception of their sex partner’s HIV risk and fear of contracting HIV and/or a partner’s reaction to proposing or using condoms. Discussions related to HIV status elicited concerns of being labeled as HIV-positive or leading to unprotected sex. Communication among peers was rare due in part to the stigma of HIV in the Black community. Effective HIV interventions for heterosexual should include communication strategies that address the cultural norms that influence safe sex practices.

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

Cited by 17 publications

References 47 publications

A Test of Concept Study of At-Home, Self-Administered HIV Testing With Web-Based Peer Counseling Via Video Chat for Men Who Have Sex With Men

A Test of Concept Study of At-Home, Self-Administered HIV Testing With Web-Based Peer Counseling Via Video Chat for Men Who Have Sex With Men

Estimated Impact of Targeted Pre-Exposure Prophylaxis: Strategies for Men Who Have Sex with Men in the United States

HIV-Related Communication and Safe Sex Practices among Heterosexual Black Men: A Qualitative Report

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