HIV Testing Within At-Risk Populations in the United States and the Reasons for Seeking or Avoiding HIV Testing

Kellerman, Scott E.; Lehman, J. Stan; Lansky, Amy; Stevens, Mark R.; Hecht, Frederick; Bindman, Andrew B.; Wortley, Pascale M.

doi:10.1097/00126334-200210010-00011

Cited by 239 publications

(165 citation statements)

References 24 publications

Supporting

Mentioning

148

Contrasting

Unclassified

Order By: Relevance

“…Prevention education needs to address these issues in order to be effective. 46 Moreover, although our study estimated a 13-minute travel time to ASOs and CBOs that offer VCT, accessibility may be an issue for those living in poverty (i.e., those without access to vehicles, etc.). The implementation of mobile HIV prevention units or establishment of physical space in these neighborhoods to serve lower-income residents may be a useful strategy in curtailing the spread of HIV.…”

Section: Discussionmentioning

confidence: 95%

Spatial Clustering of HIV Prevalence in Atlanta, Georgia and Population Characteristics Associated with Case Concentrations

et al. 2011

View full text Add to dashboard Cite

We assessed prevalent HIV cases in Atlanta to examine case distribution trends and population characteristics at the census tract level that may be associated with clustering effects. We calculated cluster characteristics (area and internal HIV prevalence) via Kuldorff's spatial scan method. Subsequent logistic regression analyses were performed to analyze sociodemographics associated with inclusion in a cluster. Organizations offering voluntary HIV testing and counseling services were identified and we assessed average travel time to access these services. One large cluster centralized in downtown Atlanta was identified that contains 60% of prevalent HIV cases. The prevalence rate within the cluster was 1.34% compared to 0.32% outside the cluster. Clustered tracts were associated with higher levels of poverty (OR=1.19), lower density of multi-racial residents (OR=1.85), injection drug use (OR=1.99), men having sex with men (OR=3.01), and men having sex with men and IV drug use (OR=1.6). Forty-two percent (N=11) of identified HIV service providers in Atlanta are located in the cluster with an average travel time of 13 minutes via car to access these services (SD=9.24). The HIV epidemic in Atlanta is concentrated in one large cluster characterized by poverty, men who have sex with men (MSM), and IV drug usage. Prevention efforts targeted to the population living in this area as well as efforts to address the specific needs of these populations may be most beneficial in curtailing the epidemic within the identified cluster.

show abstract

Section: Discussionmentioning

confidence: 95%

Spatial Clustering of HIV Prevalence in Atlanta, Georgia and Population Characteristics Associated with Case Concentrations

et al. 2011

View full text Add to dashboard Cite

show abstract

“…As seen with YMS, differences might be the result of the fact that the HITS participants are recruited from venues that are known to be frequented by persons who are at high risk for HIV and are therefore likely to be the focus of HIV prevention and testing programs by community-based organizations. 22 However, larger proportions of MSM in certain subgroups, Hispanic (47%), aged 18-24 years (62%), residents of the Bronx (50%), and having more than one sex partner (946%), reported having been tested for HIV in the past year. These subgroup findings are more consistent with the HITS-NYC result than is our overall finding of 34%.…”

Section: Discussionmentioning

confidence: 99%

Estimation of HIV Prevalence, Risk Factors, and Testing Frequency among Sexually Active Men Who Have Sex with Men, Aged 18–64 Years—New York City, 2002

et al. 2007

View full text Add to dashboard Cite

Population-based estimates of human immunodeficiency virus (HIV) prevalence and risk behaviors among men who have sex with men (MSM) are valuable for HIV prevention planning but not widely available, especially at the local level. We combined two population-based data sources to estimate prevalence of diagnosed HIV infection, HIV-associated risk-behaviors, and HIV testing patterns among sexually active MSM in New York City (NYC). HIV/AIDS surveillance data were used to determine the number of living males reporting a history of sex with men who had been diagnosed in NYC with HIV infection through 2002 (23% of HIV-infected males did not have HIV transmission risk information available). Sexual behavior data from a cross-sectional telephone survey were used to estimate the number of sexually active MSM in NYC in 2002. Prevalence of diagnosed HIV infection was estimated using the ratio of HIV-infected MSM to sexually active MSM. The estimated base prevalence of diagnosed HIV infection was 8.4% overall (95% confidence interval [CI] = 7.5-9.6). Diagnosed HIV prevalence was highest among MSM who were non-Hispanic black (12.6%, 95% CI = 9.8-17.6), aged 35-44 (12.6%, 95% CI = 10.4-15.9), or 45-54 years (13.1%, 95% CI = 10.2-18.3), and residents of Manhattan (17.7%, 95% CI = 14.5-22.8). Overall, 37% (95% CI = 32-43%) of MSM reported using a condom at last sex, and 34% (95% CI = 28-39%) reported being tested for HIV in the past year. Estimates derived through sensitivity analyses (assigning a range of HIV-infected males with no reported risk information as MSM) yielded higher diagnosed HIV prevalence estimates (11.0-13.2%). Accounting for additional undiagnosed HIV-infected MSM yielded even higher prevalence estimates. The high prevalence of diagnosed HIV among sexually active MSM in NYC is likely due to a combination of high incidence over the course of the epidemic and prolonged survival in the era of highly active antiretroviral therapy. Despite high HIV prevalence in this population, condom use and HIV testing are low. Combining complementary population-based data sources can provide critical HIV-related information to guide prevention efforts. Individual counseling and education interventions should focus on increasing condom use and encouraging safer At the time this work was conducted, Manning and Marx were with the

show abstract

“…Although the fear factor in HIV testing is well documented among gay men generally (e.g., Kellerman et al 2002), those living in small and rural regions may perceive less control over disclosing their status.…”

Section: "It Was Like Fantasy Land": Mobilities and Risk Encountersmentioning

confidence: 99%

Placing HIV beyond the metropolis: Risks, mobilities, and health promotion among gay men in the Halifax, Nova Scotia region

Lewis

2015

Canadian Geographies / Géographies canadiennes

View full text Add to dashboard Cite

Research on HIV/AIDS among gay men in North America has departed from pure disease diffusion models to consider the social and environmental contexts where transmission may take place. Most of this work, however, focuses on large metropolitan areas and operationalizes the concept of place with only some degree of nuance. Large cities-and the bars, bathhouses, and gay villages within them-are often treated as containers of attributes that contribute to and concretize HIV risk. This article therefore seeks to apply a critical, ecological conception of place to understanding HIV risk, education, and prevention among gay men in the small city-region of Halifax, Nova Scotia. Using in-depth interviews with HIV/AIDS-related service providers and self-identified gay men, the study highlights four dynamics of HIV risk potentially affecting gay men in smaller cities and rural areas: (1) institutional ambivalence toward HIV education and messaging, (2) narrow conceptions of risk, (3) migrations into unfamiliar social and sexual environments, and (4) social and structural barriers to health service utilization. Keywords: HIV/AIDS, gay men, Nova Scotia, sexual health, health promotionSituer le VIH au-del a de la m etropole : les risques, les mobilit es, et la promotion de la sant e chez les hommes gais dans la r egion d'Halifax, NouvelleEcosseLes travaux de recherche men es sur le VIH/sida chez les hommes gais en Am erique du Nord ont rompu avec les mod eles limit es a la diffusion de la maladie afin de tenir compte davantage des contextes sociaux et environnementaux de transmissions possibles. Cependant, ce corpus scientifique est consacr e aux grandes r egions m etropolitaines et applique la notion de lieu de faS con peu nuanc ee. Les grandes villes, les bars, les saunas, et les villages gais qu'on y retrouve sont souvent d esign es comme des milieux caract eris es par les attributs qui favorisent et concr etisent le risque de transmission du VIH. S'appuyant sur une conception ecologique critique du lieu, cet article a pour objet de mettre en lumi ere le risque, les programmes d' education et la pr evention en mati ere de VIH chez les hommes gais a Halifax, NouvelleEcosse, une viller egion de petite taille. Au moyen d'entrevues r ealis ees aupr es de fournisseurs de services sp ecialis es dans le VIH/sida et aupr es d'hommes s' etant d eclar es gais, l' etude montre combien les dynamiques sociales et institutionnelles particuli eres ont une influence sur la faS con dont les gais de la r egion conS coivent et se pr eoccupent du risque de transmission du VIH. Leurs r ecits mettent en evidence l'ambivalence institutionnelle envers les programmes d' education et la communication de messages portant sur le VIH, les n egociations individuelles complexes entourant l'identit e sexuelle et l'acte sexuel proprement dit, et les obstacles a l'acc es aux services de sant e sexuelle. Il en ressort un agencement particulier de discours sur le VIH et des risques potentiels que courent les hommes gais dans les petites villes et les autres ...

show abstract

HIV Testing Within At-Risk Populations in the United States and the Reasons for Seeking or Avoiding HIV Testing

Cited by 239 publications

References 24 publications

Spatial Clustering of HIV Prevalence in Atlanta, Georgia and Population Characteristics Associated with Case Concentrations

Spatial Clustering of HIV Prevalence in Atlanta, Georgia and Population Characteristics Associated with Case Concentrations

Estimation of HIV Prevalence, Risk Factors, and Testing Frequency among Sexually Active Men Who Have Sex with Men, Aged 18–64 Years—New York City, 2002

Placing HIV beyond the metropolis: Risks, mobilities, and health promotion among gay men in the Halifax, Nova Scotia region

Contact Info

Product

Resources

About