Engagement of African Americans with Rapid HIV Testing and HIV Care.

Introduction/background: African Americans and Blacks experience the greatest human immunodeficiency virus (HIV) burden of any racial group in the US and globally. A number of challenges contribute to the higher rates of HIV infection among African Americans, including a lack of awareness of HIV status. African Americans account for nearly 50% of the newly estimated HIV/acquired immunodeficiency syndrome (AIDS) diagnoses, with the majority being tested only after developing symptoms of AIDS. Moreover, African Americans are more likely to postpone medical care after finding out that they are HIV positive.

Purpose: The aim of this study was to describe African Americans' likelihood of using salivary rapid testing (SRT) methods and entry into healthcare if HIV positive.

Methods/design: Focus groups were conducted among 38 African Americans. The purpose of this study was to (1) describe personal factors, social resources, socio-demographic factors, cognitive appraisal, and health and coping behaviors which predict or influence the likelihood of African Americans' participation in SRT and, if positive, subsequent entry into healthcare and (2) to evaluate HIV Testing Survey items and modify them to be culturally and linguistically appropriate. A modified Comprehensive Health Seeking and Coping Paradigm guided the study (CHSCP).

Results: Of the 38 African American adults who participated in the study, 16 were female between the ages of 18-49 and the mean age was 23 years and there were 22 males, aged between 18-49 and the mean age was 29.5 years. Eight themes emerged from the data: familiarity, stigma, fear, access, immediacy, ease, degree of responsibility, and trust. Gender specific themes were health maintenance (women) and illness management (men). Sub-themes within gender-specific themes were stoicism (women) and anger (men).

Implications: Identifying the factors that influence the likelihood of HIV testing uptake can provide information on which to base development of interventions to facilitate HIV testing and earlier linkage to healthcare.