Newer HIV testing options underused in Black MSM and transgender women
Barriers to and facilitators of HIV testing include knowledge of and access to HIV testing sites and test methods, fear of a reactive HIV test result, and HIV stigma.
Increasing awareness of and access to newer HIV testing options such as free or reduced price on home and self-tests and couples HIV testing and counseling (CHTC) can facilitate increased levels of consistent testing among young, Black men who have sex with men (MSM) and transgender women, according to a study published in PLoS One.
Victoria Frye, MPH, DrPH, from the Department of Community Health and Social Medicine, Sophie Davis School of Biomedical Education, at the CUNY School of Medicine in New York City, and colleagues conducted 30 qualitative, semi-structured, in-depth interviews with young, Black, gay, bisexual, or MSM and transgender women in the New York City metropolitan area to identify preferences for specific HIV tests and aspects of HIV testing options. Participants were recruited between February and May 2014 through online and mobile apps.
Eligibility criteria included: being male at birth; self-identifying as Black, African American, Caribbean Black, African Black, or multiethnic Black; being able to read and respond in English; aged 16 to 29 years; not known to be HIV-infected; reporting insertive or receptive anal intercourse with a man or transgender woman in the last 12 months; residing in the NYC metropolitan area; and providing informed consent or assent for the study. A total of 396 individuals (MSM, N = 378; transgender women, N = 18) completed the online screener, and 78 (20%) were eligible.
The in-depth interview was semi-structured and included personal background, experience of and connection to communities, thoughts and feelings about HIV testing and most recent testing experience, experiences with and perceived facilitators of and barriers to newer testing methods (ie, couples testing, also known as “Testing Together”), venues (ie, mobile units), and operators (ie, self-testing), and use of and thoughts about web- and smart phone app-based technologies for health and testing purposes.
Several factors continue to act as barriers to and facilitators of HIV testing in this population, including: knowledge of and access to HIV testing sites and test methods, fear of a reactive HIV test result, HIV stigma, and concerns about confidentiality and privacy. In terms of access to newer testing methods, a majority of participants were unaware of the CHTC option, although they were open to and enthusiastic about CHTC.
“The numerous HIV testing options that are now available provide more choices to individuals at higher risk for HIV infection, for whom consistent HIV testing is recommended,” the authors stated. “However, there is limited understanding of how newer testing options are perceived, including what aspects of the new options are preferred, and how these preferences could increase the likelihood of testing and/or consistent testing.”
- Frye V, Wilton L, Hirshfield S, et al. Preferences for HIV test characteristics among young, Black men who have sex with men (MSM) and transgender women: Implications for consistent HIV testing. PLoS One. 2018 Feb 20;13(2):e0192936. doi: 10.1371/journal.pone.0192936