Barriers to HIV Testing in Black Immigrants to the US

Background. Late HIV testing is common among immigrants from sub Saharan Africa and the Caribbean. Since 2010, HIV testing is no longer a required component of immigrant screening examinations or mandatory for immigrants seeking long term residence in the US. Thus, barriers to HIV testing must be addressed. Methods. Five hundred and fifty-five (555) immigrants completed a barriers-to-HIV testing scale. Univariate and multivariate linear regression were performed to examine predictors of barriers. Results. In multivariate analysis, primary language other than English (beta=2.9, p=.04), lower education (beta=5.8, p=.03), low income [= below $20K/year] (beta=4.6, p=.01), no regular provider (beta=5.2, p=.002) and recent immigration (beta=5.7, p=.0008) were independently associated with greater barriers. Barriers due to health care access, privacy, fatalism, and anticipated stigma were greater for recent versus longer term immigrants. Discussion. Immigrants from sub-Saharan Africa and the Caribbean face significant barriers to HIV testing. Interventions to improve access and timely entry into care are needed.