Suboptimal Recent and Regular HIV Testing Among Black Men Who Have Sex With Men in the United States: Implications From a Meta-Analysis

Liu, Yu; Silenzio, Vincent; Nash, Robertson; Luther, Patrick; Bauermeister, José A.; Vermund, Sten H.; Zhang, Chen

doi:10.1097/qai.0000000000002013

Cited by 23 publications

(19 citation statements)

References 54 publications

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“…Another unconventional finding in our study is that young adults who reported lower household incomes were more likely to get tested for HIV than individuals who lived in households with higher incomes. Scholars who examine social vulnerabilities rank lower income, together with racial minority status as factors associated with lower engagement with care [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]. Studies about HIV have found that lower income factors impede access to HIV services, including HIV testing [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…Scholars who examine social vulnerabilities rank lower income, together with racial minority status as factors associated with lower engagement with care [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]. Studies about HIV have found that lower income factors impede access to HIV services, including HIV testing [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]. Similar to our findings on racial disparities in HIV testing, HIV communication may explain why young adults with lower income in our sample were positively correlated with HIV testing compared to higher incomes.…”

Section: Discussionmentioning

confidence: 99%

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Assessing Different Types of HIV Communication and Sociocultural Factors on Perceived HIV Stigma and Testing among a National Sample of Youth and Young Adults

Abubakari

Smith

Boyd

et al. 2022

IJERPH

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In the United States, racial/ethnic and sexual youth and young adults (YYA) of color are disproportionately affected by HIV. Subsequently, YYA experience HIV stigma and engage in increased risk behaviors and reduced HIV testing. HIV communication has been identified as a potential buffer to HIV stigma, resulting in health-seeking behaviors, such as HIV testing. In this study, we respond to a meaningful gap in the literature by examining different types of HIV communication and their impact on HIV stigma and HIV testing in a diverse sample of YYA. We analyzed secondary data from the Kaiser Family Foundation National Survey of Teens and Young Adults on HIV/AIDS. A 40-question, web-based survey was conducted with 1437 youth (ages 15–24). Recruitment included a dual sampling method from households with: (1) listed phone numbers, (2) unlisted phone numbers, (3) telephones, (4) no telephone, and (5) only cell phone access. The purpose of the survey was to establish participants’ HIV knowledge, communication, experiences, and testing behaviors. Findings suggested an association between intimate-partner HIV communication, increased HIV testing, and reduced HIV stigma. We also identified differentials in HIV testing and stigma based on gender, income, age, and sexual minority status, explained by HIV communication. Further research is needed that examines ways to use intimate-partner HIV communication to reduce stigma and increase HIV testing among YYA of different sociodemographic characteristics and sexual orientations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessing Different Types of HIV Communication and Sociocultural Factors on Perceived HIV Stigma and Testing among a National Sample of Youth and Young Adults

Abubakari

Smith

Boyd

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…A high percentage of MSM in the United States have had an HIV test at some point in their lives, but only a much smaller proportion of persons—even among those at highest risk—test on a regular and frequent basis. 19,20 Most persons diagnosed with HIV infection had a negative result on their last test, and over one-third of HIV infections contracted in the United States represent transmissions from individuals who are unaware that they are HIV-positive. 21…”

Section: Too Few People At High Risk Test Regularly Enoughmentioning

confidence: 99%

Ten Things We Need to Do to Achieve the Goals of the End the HIV Epidemic Plan for America

Kelly

2019

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Problem: DHHS announced a plan for Ending the HIV Epidemic (EtHE) by reducing new HIV infections in the United States by 75 percent within five years and 90 percent within ten years through early diagnosis of all individuals with HIV, immediate treatment to achieve viral suppression, protection of high-risk but uninfected individuals including with pre-exposure prophylaxis (PrEP), and quickly responding to emerging HIV clusters. Approach: Ten steps are outlined that will help the field achieve EtHE Plan goals. Findings: Steps needed to reach EtHE goals are: (1) better reaching, understanding, and meeting the HIV prevention and care needs of Black men who have sex with men (MSM); (2) deployment of interventions that address social, cultural, behavioral, and structural determinants of HIV disparities; (3) improving uptake in biomedical HIV prevention strategies in mid-sized cities across the country’s center; (4) addressing with long-term commitment the urgent HIV prevention needs in the US Southeast; (5) encouraging more frequent and regular HIV testing; (6) developing better strategies to not only encourage initiation but also the long-term and sustained use of PrEP by persons at high risk for contracting HIV infection; (7) improving the comfort and capacity of primary care providers to prescribe PrEP; (8) increasing HIV medical care retention and care re-engagement, especially among persons with competing life stressors; (9) developing sustainable implementation efforts; and (10) addressing policies that can facilitate or impede success in eliminating the HIV epidemic in the United States. Conclusion: EtHE goals are achievable but will require concerted, sustained effort. Summary We are at a point of unprecedented opportunity to end the HIV epidemic in the United States, and the EtHE plan provides sharpness in focus, resources, and levels of coordination needed to achieve high impact in reducing HIV incidence. The analogy is often made that PrEP for high-risk uninfected persons—and ART treatment to produce viral suppression among all persons living with HIV infection—are our most powerful new tools for ending the epidemic. They are. However, having tools does not equate with knowing how best to use them. How we implement new biobehavioral HIV prevention modalities to optimize scale-up and how we tailor them to meet the needs of communities that remain at greatest risk is the field’s most critical current challenge. Behavioral and social science is essential for guiding successful HIV prevention implementation, maximizing the coverage of new prevention modalities, and achieving high impact in ending HIV transmissions in the United States.

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“…8 Besides, a signi cant discrepancy was observed from lifetime HIV testing (i.e., 88.2%) to frequent HIV testing (i.e., 42.2%). 9 Furthermore, little data are available to assess the PrEP linkage and uptake rates initiated from HIV testing programs. 10 Although an upward trend in PrEP use has been observed among MSM across years, inadequate PrEP knowledge, limited awareness, and low uptake have been observed continuously.…”

Section: Introductionmentioning

confidence: 99%

“…11 Unique barriers to the HIV prevention continuum have been identi ed among MSM, such as poverty, mental health status, access to healthcare, and insurance coverage. 9,11 HIV or PrEP related stigma also plays a crucial role in preventing MSM from seeking HIV care. 2,7,12,13 Even for individuals who are actively seeking HIV prevention services (e.g., HIV testing, linkage to PrEP), the internalized (e.g., self-perceived stigmatization) and vicarious stigma (e.g., stigmatized attitudes from health providers or signi cant others) that embedded within their life contexts impeding them from HIV prevention care, such as PrEP.…”

Section: Introductionmentioning

confidence: 99%

Understanding the Association Between PrEP Stigma and PrEP Cascade Moderated by the Intensity of HIV Testing

Zhang

Liu

2022

Preprint

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Background In the United States, men who have sex with men (MSM) account for the majority of new HIV infections. On the other hand, pre-exposure prophylaxis (PrEP) is an effective strategy to curb HIV transmission, but it is widely underutilized. It is unknown how stigma affects PrEP care in the context of other HIV prevention strategies (e.g., HIV testing).17 In the current study, we explored how PrEP and HIV-related stigma affect the PrEP care cascade (i.e., awareness, willingness, and uptake) and how the intensity of HIV testing services moderates the association. Methods We recruited a group of MSM from two cities in the U.S. With informed consent being collected, we included a total of 318 MSM in the current analysis. We employed bivariate and multivariable analyses to assess the association between PrEP stigma and PrEP cascade while controlling for potential confounders on each specific pathway. We further used a series of moderation analyses based upon the intensity of HIV testing within different timeframes to assess the association between PrEP stigma and PrEP cascade. In addition, we conducted the trend-analyses to assess the pattern of PrEP cascade across different time points of HIV testing. Results Compared with MSM who used PrEP, those who never used PrEP reported higher internalized (0.59 vs. 2.99) and vicarious PrEP stigma (3.66 vs. 5.56). Internalized PrEP stigma has significantly reduced the likelihood of PrEP willingness and PrEP uptake among this group. With the increased frequency of HIV testing, stigma became stronger to negatively impact the likelihood of PrEP willingness and PrEP uptake in MSM. The Jonckheere–Terpstra test with Monte Carlo permutations showed significant trend patterns across different frequencies of HIV testing. The same patterns have been identified under other timeframes (i.e., in the past 12m, 6m, and 3m). Conclusions Findings indicated that HIV prevention services might discourage MSM from PrEP use under the influence of stigma. A structural-level reform is urgently needed to turn the HIV service encounters into opportunities to facilitate and optimize the PrEP cascade among this group who may benefit from PrEP use.

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Suboptimal Recent and Regular HIV Testing Among Black Men Who Have Sex With Men in the United States: Implications From a Meta-Analysis

Cited by 23 publications

References 54 publications

Assessing Different Types of HIV Communication and Sociocultural Factors on Perceived HIV Stigma and Testing among a National Sample of Youth and Young Adults

Assessing Different Types of HIV Communication and Sociocultural Factors on Perceived HIV Stigma and Testing among a National Sample of Youth and Young Adults

Ten Things We Need to Do to Achieve the Goals of the End the HIV Epidemic Plan for America

Understanding the Association Between PrEP Stigma and PrEP Cascade Moderated by the Intensity of HIV Testing

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