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Black Men Who Have Sex with Men and Lifetime HIV Testing: Characterizing the Reasons and Consequences of Having Never Tested for HIV

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Abstract

HIV testing remains a critical point of entry to HIV treatment services and now biomedical prevention as well. Yet despite the high HIV prevalence among Black men who have sex with men (MSM), insufficient attention has been given to factors associated with those Black MSM in the United States who have never received an HIV test in their lifetime. Promoting Our Worth, Equality, & Resilience (POWER) is a cross-sectional observational study that recruited Black MSM at Black Pride events across six cities in the United States from 2014 to 2017. Participants completed an anonymous questionnaire and were offered free, confidential HIV testing. Of the 4174 Black MSM without a prior HIV diagnosis, 404 (9.68%) had never tested for HIV (mean age = 31.03 years). Lower education and greater internalized homophobia were associated with never having tested for HIV. Higher age (AOR = 1.05, 95%, 1.02–1.07) and assumption of HIV-positivity (AOR = 3.24, 95% CI 1.53–6.84) were both associated with increased odds of an HIV-positive test result (n = 119; 36%). To compare, HIV prevalence among Black MSM who had received at least one HIV test before study participation was 23%. While a minority of Black MSM had never received an HIV test, this group had a significantly higher likelihood of HIV infection. Alternative HIV testing strategies are needed to facilitate HIV testing initiation among Black MSM for whom conventional HIV testing modalities are insufficient.

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Acknowledgements

We express our appreciation to the thousands of participants who donated their time in our research, and to the Center for Black Equity for welcoming our research team into the community of Black Prides across the country. We extend a special thanks to the dozens of service organizations who provided HIV testing services for our study participants.

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Authors and Affiliations

  1. Department of Health Behavior, The University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA

    Derrick D. Matthews

  2. Center for LGBT Health Research, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA

    Jordan M. Sang, Leigh A. Bukowski, M. Reuel Friedman & Ron D. Stall

  3. Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA

    Jordan M. Sang, Leigh A. Bukowski & Ron D. Stall

  4. Department of Epidemiology, Emory University Rollins School of Public Health, Druid Hills, GA, USA

    Cristian J. Chandler

  5. Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA

    M. Reuel Friedman

  6. Department of Human Development and Family Studies, University of Connecticut, Mansfield, CT, USA

    Lisa A. Eaton

Authors
  1. Derrick D. Matthews
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  2. Jordan M. Sang
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  3. Cristian J. Chandler
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  4. Leigh A. Bukowski
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  5. M. Reuel Friedman
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  6. Lisa A. Eaton
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  7. Ron D. Stall
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Corresponding author

Correspondence to Derrick D. Matthews.

Ethics declarations

This study was approved by the University of Pittsburgh’s IRB. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. This research was supported by the National Institute of Nursing Research (grant R01NR013865), the National Institute of Allergy and Infectious Diseases (grant R21AI120777), and the National Institute of Mental Health (grant T32MH094174).

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The authors declare that they have no conflict of interest.

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Matthews, D.D., Sang, J.M., Chandler, C.J. et al. Black Men Who Have Sex with Men and Lifetime HIV Testing: Characterizing the Reasons and Consequences of Having Never Tested for HIV. Prev Sci 20, 1098–1102 (2019). https://doi.org/10.1007/s11121-019-01022-4

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  • DOI: https://doi.org/10.1007/s11121-019-01022-4

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