Low Perceived Risk and High HIV Prevalence Among a Predominantly African American Population Participating in Philadelphia's Rapid HIV Testing Program

Nunn, Amy; Zaller, Nickolas; Cornwall, Alexandra; Mayer, Kenneth H.; Moore, Elya E.; Dickman, Samuel; Beckwith, Curt G.; Kwakwa, Helena

doi:10.1089/apc.2010.0313

Cited by 60 publications

(53 citation statements)

References 16 publications

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“…[16][17][18][19][20] Despite engaging in high-risk HIV related behaviors including substance use, concurrency, improper or non-condom usage, many indiviudals have perceived their risk for contracting HIV as low. This low perceived risk has been associated with African Americans not seeking HIV testing despite their actual risk profile.…”

Section: Factors Impacting Hiv Testingmentioning

confidence: 99%

A Multi-Level Approach for Promoting HIV Testing Within African American Church Settings

Stewart

2015

AIDS Patient Care and STDs

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The African American church is a community-based organization that is integral to the lives, beliefs, and behaviors of the African American community. Engaging this vital institution as a primary setting for HIV testing and referral would significantly impact the epidemic. The disproportionately high HIV incidence rate among African Americans dictates the national priority for promotion of early and routine HIV testing, and suggests engaging community-based organizations in this endeavor. However, few multilevel HIV testing frameworks have been developed, tested, and evaluated within the African American church. This article proposes one such framework for promoting HIV testing and referral within African American churches. A qualitative study was employed to examine the perceptions, beliefs, knowledge, and behaviors related to understanding involvement in church-based HIV testing. A total of four focus groups with church leaders and four in-depth interviews with pastors, were conducted between November 2012 and June 2013 to identify the constructs most important to supporting Philadelphia churches' involvement in HIV testing, referral, and linkage to care. The data generated from this study were analyzed using a grounded theory approach and used to develop and refine a multilevel framework for identifying factors impacting church-based HIV testing and referral and to ultimately support capacity building among African American churches to promote HIV testing and linkage to care.

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Section: Factors Impacting Hiv Testingmentioning

confidence: 99%

A Multi-Level Approach for Promoting HIV Testing Within African American Church Settings

Stewart

2015

AIDS Patient Care and STDs

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“…25,48,51 Further, previous HIV educational campaigns that primarily focus on relatively infrequent hightransmission behaviors (e.g., IDU) might give the impression that frequent low-transmission behaviors (e.g., unprotected sex among heterosexuals who are not IDUs) are an unimportant factor in HIV/AIDS transmission. 25 Regardless of the reason for incongruency, the repercussions of incongruency seem apparent in a recent study by Nunn et al 52 that found that 67% of seropositive outpatient clinics patients in Philadelphia identified their self-perceived risk as zero or low.…”

Section: Self-perceived Hiv Risk In Lower-risk Patientsmentioning

confidence: 99%

Is Self-Perceived HIV Risk Congruent with Reported HIV Risk Among Traditionally Lower HIV Risk and Prevalence Adult Emergency Department Patients? Implications for HIV Testing

Pringle

Merchant

Clark

2013

AIDS Patient Care and STDs

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Because reliance on patients' self-perceived risk for HIV might mislead emergency department (ED) clinicians on the need for HIV testing, we aimed to measure congruency between self-perceived and reported HIV risk in a traditional lower prevalence, lower-risk cohort. A random sample of 18-to 64-year-old patients at a large academic urban ED who were by self-report not men-who-have-sex-with-men (MSM) or injection-drug users (IDUs) were surveyed regarding their self-perceived and reported HIV risk. Sixty-two percent of participants were white non-Hispanic, 13.8% Black, and 21.2% Hispanic; and 66.9% previously had been tested for HIV. Linear regression models were constructed comparing self-perceived to reported HIV risk. Among the 329 female ED patients, 50.5% perceived that they were ''not at risk'' for HIV, yet only 10.9% reported no HIV risk behaviors, while among the 175 male ED patients, 50.9% perceived that they were ''not at risk'' for HIV, yet only 12.6% reported no HIV risk behaviors. Only 16.9% of women and 15.7% of men who had no self-perceived risk for HIV also reported no HIV risk behaviors. Multivariable linear regression demonstrated a weak relationship between self-perceived and reported risk. Congruency between self-perceived risk and reported HIV risk was low among these non-MSM, non-IDU ED patients.

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“…Philadelphia recently implemented a rapid HIV testing program in public health clinics to diagnose more people living with HIV/AIDS. Approximately 15,000 people have undergone rapid testing for HIV in the program since mid-2007; 88% are African American; HIV prevalence among this population is approximately 1.1% [24]. …”

Section: Study Settingmentioning

confidence: 99%

Concurrent sexual partnerships among African American women in Philadelphia: results from a qualitative study

Nunn¹,

Dickman²,

Cornwall³

et al. 2012

Sex. Health

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Background African American women are disproportionately affected by HIV/AIDS. Concurrent sexual partnerships may contribute to racial disparities in HIV infection. Little is known about attitudes and practices related to concurrency among African American women and the social, structural and behavioral factors that influence concurrency. Methods We recruited 19 heterosexual African American women engaging in concurrent sexual partnerships from a public health clinic in Philadelphia in 2009. We conducted in-depth interviews exploring social norms, attitudes and practices about concurrency, and the structural, social and behavioral factors influencing concurrent sexual partnerships. Grounded theory guided interview protocols and data analysis. Results Seventeen women reported one main and one or more non-main partners; two reported no main partners. Many women used condoms more frequently with non-main than main partners, noting they trust main partners more than non-main partners. Social factors influencing concurrency included social normalization of concurrency, inability to negotiate partners’ other concurrent partnerships, being unmarried, and not trusting main and non-main partners. Not trusting partners and the community at large were the most commonly cited reasons that women engaged in concurrent partnerships. Structural factors included economic dependence on partners, partners’ dependence on women for economic support and housing, and incarceration that interrupted partnerships. Behavioral factors including alcohol and cocaine use influenced concurrency. Conclusions Social, structural, and behavioral factors strongly influenced these African American women’s concurrent sexual partnerships. Many evidence-based interventions (EBIs) disseminated by the US Centers for Disease Control and Prevention (CDC) focus largely on behavioral factors and may fail to address the social and structural factors influencing African American women’s sexual networks. Novel HIV prevention interventions that address the social determinants of African American women’s HIV risks in addition to conventional HIV risk- taking behaviors are urgently needed.

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Low Perceived Risk and High HIV Prevalence Among a Predominantly African American Population Participating in Philadelphia's Rapid HIV Testing Program

Cited by 60 publications

References 16 publications

A Multi-Level Approach for Promoting HIV Testing Within African American Church Settings

A Multi-Level Approach for Promoting HIV Testing Within African American Church Settings

Is Self-Perceived HIV Risk Congruent with Reported HIV Risk Among Traditionally Lower HIV Risk and Prevalence Adult Emergency Department Patients? Implications for HIV Testing

Concurrent sexual partnerships among African American women in Philadelphia: results from a qualitative study

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