HIV & STD testing among heterosexual African American men

Rucker, Regine R.

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Description

Title

HIV & STD testing among heterosexual African American men

Author(s)

Rucker, Regine R.

Issue Date

2010-05-14T20:44:17Z

Director of Research (if dissertation) or Advisor (if thesis)

Brashers, Dale E.

Doctoral Committee Chair(s)

Alston, Reginald J.

Committee Member(s)

• Brashers, Dale E.
• Farner, Susan M.
• Notaro, Stephen J.

Department of Study

Kinesiology & Community Health

Discipline

Community Health

Degree Granting Institution

University of Illinois at Urbana-Champaign

Degree Name

Ph.D.

Degree Level

Dissertation

Keyword(s)

• Human Immunodeficiency Virus (HIV)
• HIV/STDs
• HIV/STD Testing
• Male Sexual Health
• Minority Men's Health
• Sexual Behaviors
• National Survey of Family Growth (NSFG)
• Secondary Data Analysis
• Male Sexual Behaviors
• Routine HIV Testing
• Mixed-Methods Design

Abstract

African Americans are disproportionately affected by HIV and other STDs. Given the state of HIV/AIDS and other STDs in the African American population, heterosexual African American men have been inadequately studied. High-risk heterosexual contact as a mode of transmission for HIV and other STDs continues to be the most common mode of infection for African American women and a growing mode of infection for African American men. HIV and STD screenings are important to prevent and reduce the risk of disease transmission. Regular testing also provides an opportunity for early diagnosis of infection and links those who are diagnosed with an infection to the appropriate medical care and services. The Centers for Disease Control and Prevention’s (CDC) recommendations for routine HIV testing provide an opportunity to increase HIV & STD testing among persons who may not perceive themselves to be at risk. Little is known about HIV and STD testing behaviors among men, particularly heterosexual African American men. To understand this phenomenon, it is important to examine the characteristics of heterosexual African American men who do get tested for HIV and other STDs. The author employed a mixed methods design to (a) identify the predictors for the use of HIV and STD testing services among heterosexual African American men, 18 - 44 years of age, (b) determine the views of heterosexual African American men on routine HIV testing recommended by the CDC in 2006, and (c) obtain suggestions of how to increase the use of HIV and STD testing services among heterosexual African American men. The analysis of data from the 2002 National Survey of Family Growth (NSFG) revealed that lifetime HIV testing was reported by 74% of the men; and 31% had received HIV testing, as well as STD testing, in the last year. The author hypothesized that men with improved social determinants of health, health care access, and responsible sexual behaviors would be more likely to reporting HIV and STD testing in the last year. Despite high rates of lifetime testing, regular HIV and STD testing were less common and very few improved states of the variables predicted HIV and STD testing in the last year. Having a physical exam in the last year emerged as an independent predictor for both HIV and STD testing. Binomial multivariate logistic regression analysis revealed profiles of the men most likely to test for HIV and other STDs. Men who were (a) 25 – 34 years old, (b) widowed or divorced, (c) lived alone, (d) had moderately high incomes, and (e) received an annual physical exam were most likely to report HIV testing in the last year, χ² (9, N = 717) = 138.451, p < .001. Men who (a) were unemployed, (b) lived in a metropolitan area (but not the central city), (c) received an annual physical exam, (d) had unprotected anal sex with a female, (e) had sex with an female intravenous drug user were more likely to report STD testing in the last year, χ² (7, N = 753) = 129.019, p < .001. Parallel with the analysis of the NSFG data, the author used the Health Belief Model as a conceptual framework to determine views about routine HIV testing among heterosexual African American men, 18 – 44 years old in Champaign, Illinois (n = 30) and obtain suggestions of how to increase the use of HIV and STD testing among heterosexual African American men. The quantitative analysis provided a continuum of risk based on having had a routine physical exam to categorize the risk levels for the underutilization of such services among the men who volunteered for interviews. Most of the men who participated in the interviews occupied a high position on the continuum for HIV and STD testing use. HBM constructs may assist in the explanation of HIV and STD testing use among this sample of heterosexual African American men 18 – 44 years old in Champaign, IL. The responses of the participants provided information related to each construct. The interviews called attention to several important factors: (a) there is a concern and fear for HIV and STD infection, but there is a disconnect between the expressed beliefs and actions employed to prevent infection; (b) the maintenance of their sexual health, particular sexual functioning and reproduction, was viewed as the sole benefit of HIV and STD testing; (c) relationship status and a lack of physical symptoms emerged as barriers to regular HIV and STD testing; and (d) a desire to know one’s status of infection, knowledge of possible exposure, and incarceration were the most common cues to use HIV and STD testing services. The men were also willing to accept HIV testing as a part of routine care, although they were unaware of the routine HIV testing recommendations. This suggests that (a) routine HIV testing policies may not be implemented in some health care facilities, (b) reluctance exist to practice routine testing among heterosexual African American men, and (c) the uptake of routine testing by health care organizations, as well as the dissemination of information, has not reached heterosexual African American men. A variety of strategies is needed to increase regular HIV and STD testing among heterosexual African American; however, messages need to focus on sexual health as a component of overall health. Routine HIV testing may increase opportunities and access to both HIV and STD testing services for heterosexual African American men in Champaign, Illinois who do not have access to routine health care or those who do have access, but do not use HIV testing services.

Graduation Semester

2010-5

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Copyright 2010 Regine R. Rucker

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