Barriers to HIV Testing in Black Immigrants to the U.S.

Ojikutu, Bisola; Nnaji, Chioma; Sithole-Berk, Juliet; Bogart, Laura M.; Gona, Philimon

doi:10.1353/hpu.2014.0141

Cited by 41 publications

(33 citation statements)

References 61 publications

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“…Study participants were not likely to get tested at the AHC for various reasons, including trust and privacy concerns. This result echoes a report that Sub-Saharan and Caribbean immigrants, particularly recent immigrants, face significant barriers to HIV testing due to concerns about privacy, stigma and fatalism [17]. …”

Section: Discussionsupporting

confidence: 82%

HIV Stigma, Testing Attitudes and Health Care Access Among African-Born Men Living in the United States

Bova¹,

Nnaji²,

Woyah³

et al. 2014

J Immigrant Minority Health

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The purpose of this study was to describe HIV-testing attitudes, HIV related stigma and health care access in African-born men taking part in the African Health Cup (AHC), a soccer tournament held annually to improve HIV awareness and testing. Venue sampling was used to collect survey and qualitative interview data related to HIV-testing attitudes, stigma and experiences associated with the AHC. The sample included 135 survey respondents and 27 interview participants. AHC participants were successfully accessing health care services. Although the AHC was viewed positively, HIV testing rates remain low due to stigma and privacy concerns. This population continues to have misconceptions about HIV transmission and to use condoms inconsistently. The AHC is a successful intervention to engage African-born men in HIV awareness and education. More work is needed to enhance these AHC aspects and address stigma and privacy concerns related to using onsite health screenings. Continuing to develop novel strategies to educate African-born immigrants about HIV is urgently needed

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Section: Discussionsupporting

confidence: 82%

HIV Stigma, Testing Attitudes and Health Care Access Among African-Born Men Living in the United States

Bova¹,

Nnaji²,

Woyah³

et al. 2014

J Immigrant Minority Health

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“…Many barriers to routine HIV testing stem from medical staff, including discomfort discussing HIV with patients, fears about offering testing due to a perceived lack of knowledge about HIV and lack of awareness of an individual's HIV risk, and often misguided perceptions of patients feeling offended if an HIV test is suggested . Additional challenges include the use of interpreters for non‐English speaking culturally and linguistically diverse populations and HIV‐related stigma …”

Section: Discussionmentioning

confidence: 99%

Missed opportunities for HIV testing persist despite a single educational intervention: how can we close this evidence‐practice gap?

King

Seah

Cheng

et al. 2020

Internal Medicine Journal

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Background In Australia, one‐third of human immunodeficiency virus (HIV) diagnoses occur late, with an estimated 11% of people with HIV unaware of their diagnosis. Undiagnosed and untreated HIV infection increases morbidity in the HIV positive person and allows onward transmission of HIV. Aim To determine the rate of HIV testing in acute general medicine patients with HIV indicator conditions (IC) and evaluate the effectiveness of an educational intervention in improving testing rates. Methods Single‐centre, tertiary hospital, before‐after study of general medicine inpatients with IC for 12 weeks prior and 10 weeks post an educational intervention focusing on recommendations for HIV testing including IC. The REASON Cohort Discovery Tool was used to search for the IC using ICD‐10 codes and laboratory data. The presence of IC was estimated, and HIV testing rates before and after the intervention were compared. Regression analysis was utilised to identify characteristics associated with HIV testing. Results Of 1414 admissions in the baseline period and 946 in the post‐period, 161 (11.4%) and 132 (14.0%) had at least one IC present respectively. There were 18 (11.2%) HIV tests performed for admissions with IC in the pre‐period which increased to 27 (20.5%) (P = 0.028) in the post‐period. Younger patients were more likely to be tested and regression analysis identified the educational intervention (adjusted odds ratio) 2.2 (1.1, 4.4) to be significantly associated with testing. Conclusions Although HIV testing rates for IC doubled following the intervention, they remained unacceptably low. The recently introduced electronic medical record presents opportunities to prompt HIV testing.

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“…We suspect that even prior to entering our healthcare system, unequal barriers to HIV testing due to perceived need, stigma, fear of deportation, and lack of a regular health care provider, may have contributed to the disparity in baseline disease severity (De Jesus, Carrete, Maine, & Nalls, 2015; Hacker et al, 2011; Levy et al, 2007; Ojikutu, Nnaji, Sithole-Berk, Bogart, & Gona, 2014; Ransome et al, 2015). While US Immigration and Customs Enforcement detention facilities house nearly 32,000 immigrants per day, HIV screening is not routine (Martinez-Donate et al, 2015; Venters, McNeely, & Keller, 2009).…”

Section: Discussionmentioning

confidence: 99%

Foreign-born status as a predictor of engagement in HIV care in a large US metropolitan health system

et al. 2016

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We sought to determine linkage to and retention in HIV care after HIV diagnosis in foreign-born compared with US-born individuals. From a clinical data registry, we identified 619 patients aged ≥18 years with a new HIV diagnosis between 2000 and 2012. Timely linkage to care was the proportion of patients with an ICD-9 code for HIV infection (V08 or 042) associated with a primary care or infectious disease physician within 90 days of the index positive HIV test. Retention in HIV care was the presence of an HIV primary care visit in each 6-month period of the 24-month measurement period from the index HIV test. We used Cox regression analysis with adjustment for hypothesized confounders (age, gender, race/ethnicity, substance abuse, year and location of HIV diagnosis). Foreign-born comprised 36% (225/619) of the cohort. Index CD4 count was 225/μl (IQR 67–439/μl) in foreign-born compared with 328/μl (IQR 121–527/μl) in US-born (p<0.001). The proportion linked to care was 87% (196/225) in foreign-born compared with 77% (302/394) in US-born (p=0.002). The adjusted hazard ratio of linkage to HIV care in foreign-born compared with US-born was 1.28 (95% confidence interval [CI], 1.05–1.56). Once linked, there was no difference in retention in care or virologic suppression at 24 months. These results show that despite late presentation to HIV care, foreign-born persons can subsequently engage in HIV care as well as US-born. Interventions that promote HIV screening in foreign-born persons are a promising way to improve outcomes in these populations.

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Barriers to HIV Testing in Black Immigrants to the U.S.

Cited by 41 publications

References 61 publications

HIV Stigma, Testing Attitudes and Health Care Access Among African-Born Men Living in the United States

HIV Stigma, Testing Attitudes and Health Care Access Among African-Born Men Living in the United States

Missed opportunities for HIV testing persist despite a single educational intervention: how can we close this evidence‐practice gap?

Foreign-born status as a predictor of engagement in HIV care in a large US metropolitan health system

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