title: Knowing is not enough: a qualitative report on HIV testing among heterosexual African-American men.
abstract: Despite having higher rates of HIV testing than all other racial groups, African-Americans continue to be disproportionately affected by the HIV epidemic in the United States. Knowing one's status is the key step to maintaining behavioral changes that could stop the spread of the virus, yet little is known about the individual- and socio-structural-level barriers associated with HIV testing and communication among heterosexual African-American men. To address this and inform the development of an HIV prevention behavioral intervention for heterosexual African-American men, we conducted computerized, structured interviews with 61 men, focus group interviews with 25 men in 5 different groups, and in-depth qualitative interviews with 30 men living in high HIV prevalence neighborhoods in New York City. Results revealed that HIV testing was frequent among the participants. Even with high rates of testing, the men in the study had low levels of HIV knowledge; perceived little risk of HIV; and misused HIV testing as a prevention method. Factors affecting HIV testing, included stigma, relationship dynamics and communication, and societal influences, suggesting that fear, low perception of risk, and HIV stigma may be the biggest barriers to HIV testing. These results also suggest that interventions directed toward African-American heterosexual men must address the use of "testing as prevention" as well as correct misunderstandings of the window period and the meaning of HIV test results, and interventions should focus on communicating about HIV.
authors.affiliation: a Department of Health and Behaviors Studies , Teachers College Columbia University , New York , NY , USA.
authors.forename: Keosha T
authors.initials: KT
authors.lastname: Bond
authors.forename: Victoria
authors.initials: V
authors.lastname: Frye
authors.forename: Raekiela
authors.initials: R
authors.lastname: Taylor
authors.forename: Kim
authors.initials: K
authors.lastname: Williams
authors.forename: Sebastian
authors.initials: S
authors.lastname: Bonner
authors.forename: Debbie
authors.initials: D
authors.lastname: Lucy
authors.forename: Malik
authors.initials: M
authors.lastname: Cupid
authors.forename: Linda
authors.initials: L
authors.lastname: Weiss
authors.forename: Beryl A
authors.initials: BA
authors.lastname: Koblin
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods; D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D017280:Condoms / Q000706:statistics & numerical data; D017144:Focus Groups; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D020010:Heterosexuality / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D057545:Social Stigma; D011795:Surveys and Questionnaires
keywords: African-American men; HIV testing; heterosexual; sexual communication