title: The Experience of Screening for HIV/AIDS Medical Studies among African-American/Black and Latino/Hispanic Persons Living with HIV/AIDS: A Mixed-Methods Exploration.
abstract: OBJECTIVE
  African-American/Black and Latino/Hispanic persons living with HIV/AIDS (i.e., "PLHA of color") are under-represented in HIV/AIDS medical studies (HAMS). A crucial entry point into HAMS is screening, but PLHA of color face serious barriers to screening compared to Whites. Recently we evaluated a social/behavioral intervention that substantially increased rates of HAMS screening among PLHA of color. Yet very little is known about the actual screening experience for these under-represented subgroups. Thus, the objectives of the present study were to explore participants' motivations for and experiences of HAMS screening.
  
  
  METHODS
  A total of 186 participants in the larger study's intervention arm were screened for HAMS, 35 of whom also participated in qualitative interviews. Participants engaged in a structured interview about the screening experience at 4- and 12- months post-baseline (14 items, Cronbach's α=0.72). Further, from a qualitative data set we purposively selected a set of three case studies to contextualize and enrich quantitative findings on screening experiences.
  
  
  RESULTS
  The screening experience was overwhelmingly positive. Almost all participants reported being treated with dignity and respect, did not feel they were being treated like a "guinea pig," and experienced a high level of trust in the setting and the screener, with no gender or racial/ethnic differences, and no differences based on whether participants were found eligible for HAMS during screening. A number of areas where screening could be improved were also identified.
  
  
  CONCLUSIONS
  Despite the complex barriers PLHA of color experience to screening for HAMS, the experience of screening was positive. Moreover, HAMS screening experiences were positive regardless of gender, race/ethnicity, or HAMS eligibility. HAMS screening can therefore be a productive learning experience that may reduce patient concerns about participating in HAMS. As such, fostering screening among PLHA of color can be an important component of reducing racial/ethnic disparities in HAMS.
authors.affiliation: Karolinska University Hospital, Solna, SE-17176 Stockholm, Sweden.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Engel
authors.affiliation: New York University College of Nursing, New York, NY, USA.
authors.forename: Marya Viorst
authors.initials: MV
authors.lastname: Gwadz
authors.affiliation: New York University College of Nursing, New York, NY, USA.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Cleland
keywords: African American; Clinical trials; HIV/AIDS medical studies; Latino; Racial/ethnic disparities; Screening