Perceived everyday racism, residential segregation, and HIV testing among patients at a sexually transmitted disease clinic.
OBJECTIVE
More than one quarter of HIV-infected people are undiagnosed and therefore unaware of their HIV-positive status. Blacks are disproportionately infected. Although perceived racism influences their attitudes toward HIV prevention, how racism influences their behaviors is unknown. We sought to determine whether perceiving everyday racism and racial segregation influence Black HIV testing behavior.


METHODS
This was a clinic-based, multilevel study in a North Carolina city. Eligibility was limited to Blacks (N = 373) seeking sexually transmitted disease diagnosis or screening. We collected survey data, block group characteristics, and lab-confirmed HIV testing behavior. We estimated associations using logistic regression with generalized estimating equations.


RESULTS
More than 90% of the sample perceived racism, which was associated with higher odds of HIV testing (odds ratio = 1.64; 95% confidence interval = 1.07, 2.52), after control for residential segregation, and other covariates. Neither patient satisfaction nor mechanisms for coping with stress explained the association.


CONCLUSIONS
Perceiving everyday racism is not inherently detrimental. Perceived racism may improve odds of early detection of HIV infection in this high-risk population. How segregation influences HIV testing behavior warrants further research.
Ford
Chandra L
CL
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. clford@ucla.edu
Daniel
Mark
M
Earp
Jo Anne L
JA
Kaufman
Jay S
JS
Golin
Carol E
CE
Miller
William C
WC
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission; D006801:Humans; D016015:Logistic Models; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D011287:Prejudice; D012111:Residence Characteristics; D018570:Risk Assessment; D012749:Sexually Transmitted Diseases / Q000175:diagnosis; D012938:Social Perception; D011795:Surveys and Questionnaires; D013637:Tape Recording; D055815:Young Adult