African American patient experiences with a rapid HIV testing program in an urban public clinic.
BACKGROUND
Of 1174 new human immunodeficiency virus (HIV) cases diagnosed in Philadelphia, Pennsylvania, in 2008, a total of 771 (66%) were among African Americans. Philadelphia recently introduced a citywide rapid HIV testing program in public clinics.


METHODS
We conducted a qualitative study among 60 African Americans undergoing rapid HIV testing in one of Philadelphia's public clinics located in a zip code with high HIV incidence. Employing grounded theory, we used semistructured interviews to assess patients' motivations, perceptions, and clinical experiences with rapid HIV testing. Interviews were transcribed and coded; 20% were double coded to enhance reliability.


RESULTS
Primary motivations for undergoing rapid HIV testing included: testing during routine clinical care, presenting for care with symptomatic sexually transmitted infections or opportunistic infections, knowing someone living with HIV/ AIDS, and perceiving oneself at risk for HIV. Most patients reported positive experiences with rapid testing and preferred it to conventional testing because it eliminated the need for return visits and decreased anxiety; however, many expressed concerns about accuracy of rapid HIV testing. Barriers to HIV testing among this population included low self-perceived risk, HIV stigma, and reported homophobia in respondents' communities.


CONCLUSIONS
This rapid testing program was acceptable, convenient, and preferred over conventional HIV testing. Providing educational information about rapid and confirmatory HIV testing may further enhance acceptability of rapid HIV testing in this population. Nationwide expansion of rapid HIV testing in public health centers is an important and acceptable means of achieving President Obama's National AIDS Strategy goals of reducing racial disparities in HIV infection and improving linkage to HIV/AIDS treatment and care services.
Warren Alpert Medical School of Brown University, Division of Infectious Diseases, Providence, Rhode Island 02906, USA. amy_nunn@brown.edu
Amy
A
Nunn
Whitney
W
Eng
Alexandra
A
Cornwall
Curt
C
Beckwith
Samuel
S
Dickman
Timothy
T
Flanigan
Helena
H
Kwakwa
D015492:AIDS Serodiagnosis / Q000379:methods; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000208:ethnology*; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D015143:Philadelphia; D011634:Public Health; D012944:Social Support; D019037:Urban Health Services; D014505:Urban Population