"Meet people where they are": a qualitative study of community barriers and facilitators to HIV testing and HIV self-testing among African Americans in urban and rural areas in North Carolina

被引：53

作者：

Mathews, Allison ^{[1
,2
]}

Farley, Samantha ^{[3
]}

Conserve, Donaldson F. ^{[4
]}

Knight, Kimberly ^{[2
]}

Le'Marus, Alston ^{[5
]}

Blumberg, Meredith ^{[3
]}

Rennie, Stuart ^{[1
]}

Tucker, Joseph ^{[2
,6
]}

机构：

[1] Univ North Carolina Chapel Hill, Sch Med, Dept Social Med, 333 South Columbia St,MacNider Hall,Room 348 CB, Chapel Hill, NC 27599 USA

[2] Univ North Carolina Chapel Hill, Sch Med, Inst Global Hlth & Infect Dis, 333 South Columbia St,MacNider Hall,Room 348 CB, Chapel Hill, NC 27599 USA

[3] Univ North Carolina Chapel Hill, Gillings Sch Global Publ Hlth, Dept Hlth Policy & Management, Chapel Hill, NC USA

[4] Univ South Carolina, Arnold Sch Publ Hlth, Dept Hlth Promot Educ & Behav, Columbia, SC 29208 USA

[5] Fielding Grad Univ, Dept Clin Psychol, Santa Barbara, CA USA

[6] London Sch Hyg & Trop Med, London, England

来源：

BMC PUBLIC HEALTH | 2020年 / 20卷 / 01期

关键词：

African Americans; HIV; HIV self-testing; Community engagement; UNITED-STATES; EMERGENCY-DEPARTMENT; HIGH-RISK; HEALTH; YOUNG; CARE; LINKAGE; KIOSKS; STIGMA; MODEL;

D O I：

10.1186/s12889-020-08582-z

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

BackgroundHIV testing programs in the United States aim to reach ethnic minority populations who experience high incidence of HIV, yet 40% of African Americans have never been tested for HIV. The objective of this study is to identify community-based strategies to increase testing among African Americans in both urban and rural areas.MethodsThis study conducted focus group discussions (FGDs) informed by community-based participatory research principles to examine African American's concerns and ideas around HIV testing and HIV self-testing. Participants included highly affected (i.e., PLWH, MSM, PWID, low-income, teens and young adults) populations from African American communities in North Carolina, aged 15 years and older. We digitally transcribed and analyzed qualitative data using MAXQDA and axial coding to identify emergent themes.ResultsFifty-two men and women between 15 to 60 years old living in urban (n=41) and rural (n=11) areas of North Carolina participated in focus group discussions. HIV testing barriers differed by HIV testing setting: facility-based, community-based, and HIV self-testing. In community-based settings, barriers included confidentiality concerns. In facility-based settings (e.g., clinics), barriers included negative treatment by healthcare workers. With HIV self-testing, barriers included improper use of self-testing kits and lack of post-test support. HIV testing facilitators included partnering with community leaders, decentralizing testing beyond facility-based sites, and protecting confidentiality.ConclusionsFindings suggest that HIV testing concerns among African Americans vary by HIV testing setting. African Americans may be willing to test for HIV at community events in public locations if client confidentiality is preserved and use HIV self-testing kits in private if post-test social support and services are provided. These community-identified facilitators may improve African American testing rates and uptake of HIV self-testing kits.

引用

页数：10

共 31 条

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