title: Receipt of HIV prevention interventions is more common in community-based clinics than in primary care or acute care settings for Black men who have sex with men in the District of Columbia.
abstract: Characterization of structural barriers that impede the receipt of HIV prevention and care services is critical to addressing the HIV epidemic among Black men who have sex with men (BMSM). This study investigated the utilization of HIV prevention and general care services among a non-clinic-based sample of BMSM who reported at least one structural barrier to engagement in care. Proportions of participants who had received HIV prevention services and general care services in different settings were compared using Fisher's exact test and correlates of service receipt were assessed using logistic regression. Among 75 BMSM, 60% had accessed a community-based clinic, 21% had accessed a primary care setting, and 36% had accessed an acute care setting in the last 6 months. Greater proportions of participants who had accessed community-based clinics received HIV prevention services during these visits (90%) compared to those who had accessed primary care (53%) and acute care (44%) settings (p = .005). Opportunities for BMSM to receive HIV prevention interventions differed by care setting. Having access to health care did not necessarily facilitate the uptake of HIV prevention interventions. Further investigation of the structurally rooted reasons why BMSM are often unable to access HIV prevention services is warranted.
authors.affiliation: a Department of Epidemiology and Biostatistics , Milken Institute School of Public Health, The George Washington University , Washington , DC , USA.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Levy
authors.affiliation: a Department of Epidemiology and Biostatistics , Milken Institute School of Public Health, The George Washington University , Washington , DC , USA.
authors.forename: Christopher Chauncey
authors.initials: CC
authors.lastname: Watson
authors.affiliation: a Department of Epidemiology and Biostatistics , Milken Institute School of Public Health, The George Washington University , Washington , DC , USA.
authors.forename: Sara Nelson
authors.initials: SN
authors.lastname: Glick
authors.affiliation: a Department of Epidemiology and Biostatistics , Milken Institute School of Public Health, The George Washington University , Washington , DC , USA.
authors.forename: Irene
authors.initials: I
authors.lastname: Kuo
authors.affiliation: b Department of Human Development , Binghamton University , Binghamton , NY , USA.|c Faculty of Humanities , University of Johannesburg , Johannesburg , South Africa.
authors.forename: Leo
authors.initials: L
authors.lastname: Wilton
authors.affiliation: d Louisiana Public Health Institute , New Orleans , LA , USA.
authors.forename: Russell A
authors.initials: RA
authors.lastname: Brewer
authors.affiliation: e Mervyn M. Dymally School of Nursing , Charles R. Drew University of Medicine and Science , Los Angeles , CA , USA.
authors.forename: Sheldon D
authors.initials: SD
authors.lastname: Fields
authors.affiliation: a Department of Epidemiology and Biostatistics , Milken Institute School of Public Health, The George Washington University , Washington , DC , USA.
authors.forename: Vittoria
authors.initials: V
authors.lastname: Criss
authors.affiliation: a Department of Epidemiology and Biostatistics , Milken Institute School of Public Health, The George Washington University , Washington , DC , USA.
authors.forename: Manya
authors.initials: M
authors.lastname: Magnus
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D003153:Community Health Services; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D004219:District of Columbia; D015658:HIV Infections / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012044:Regression Analysis; D055815:Young Adult
keywords: Black men who have sex with men; HIV; health care; prevention; structural barriers