African-American men who have sex with men (MSM) and have never been tested for human immunodeficiency virus (HIV) are a small group, but they have a significant impact on the HIV epidemic. New research from a faculty member at the University of North Carolina Gillings School of Global Public Health shows that efforts to end this epidemic must address the different needs of men who have been historically underserved by HIV prevention and treatment efforts.
Dr. Derrick Matthews, assistant professor in the Department of Health Behavior, is lead author of “Black Men Who Have Sex with Men and Lifetime HIV Testing: Characterizing the Reasons and Consequences of Having Never Tested for HIV,” published online in Prevention Science.
Matthews and his team used data from Promoting Our Worth, Equality and Resilience (POWER), a cross-sectional observational study that recruited African-American MSM at Black Pride events the United States from 2014 to 2017. Participants completed an anonymous questionnaire and were offered free, confidential HIV testing.
Of the 4,174 participants without a prior HIV diagnosis, nearly one in 10 had never been tested for HIV. Results showed these men had multiple factors associated with never having been tested, including lower education, greater internalized homophobia, fear of results, lack of health coverage and depressive symptoms. Of the participants who received their first HIV test through the POWER study, about one-third ended up having an HIV-positive test result.
“Though it is a minority of Black MSM who have never been tested for HIV, this group can have a disproportionately large influence on the epidemic if they do become HIV-positive,” said Matthews. “This is due to both their unaddressed individual health needs and their capacity to unknowingly infect others.”Friday Letter Submission, Publish on July 26