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Attitudes Toward HIV Voluntary Counseling and Testing (VCT) Among African American Men Who Have Sex With Men: Concerns Underlying Reluctance to Test. AIDS Educ Prev 2015 Jun;27(3):195-211



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Scopus ID

2-s2.0-84939152126   24 Citations


Contemporary antiretroviral therapy (ART) can produce viral suppression of HIV, maintain health, and prevent onward HIV transmission from infected persons to their sexual partners, giving rise to the concept of treatment as prevention. Successful implementation of test-and-treat strategies rests on the early detection of HIV infection through voluntary counseling and testing (VCT) followed by entry and retention in care, ART initiation and adherence, and subsequent viral suppression. In the United States, African American men who have sex with men (MSM) bear a disproportionate burden of HIV and have high rates of undetected and untreated HIV infection. However, little research has examined racial minority MSM's views about HIV testing. In this study, in-depth interviews were conducted with 96 key informants knowledgeable about racial minority MSM as well as 100 African American MSM community members in Milwaukee, Cleveland, and Miami. Most men in the sample were aware of the availability of testing and knew testing locations, but many voiced great personal ambivalence about being tested, feared knowing their HIV status, expressed concern about stigma and loss of confidentiality, and held beliefs indicative of medical mistrust. Participants did not spontaneously cite benefits of being tested, risk reduction behavior changes made as a consequence of testing, nor the benefits of testing to get early medical care for HIV infection. There is a gap between the public health field's perception of testing benefits and the beliefs about testing held by racial minority MSM in this sample. To increase the desired outcomes from VCT for minority MSM, VCT promotion should address the concerns of African American MSM and underscore the benefits of early entry into medical care.

Author List

St Lawrence JS, Kelly JA, Dickson-Gomez J, Owczarzak J, Amirkhanian YA, Sitzler C


Yuri A. Amirkhanian PhD Professor in the Psychiatry department at Medical College of Wisconsin
Julia Dickson-Gomez PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Jeffrey A. Kelly PhD Professor in the Psychiatry department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

HIV Infections
Health Knowledge, Attitudes, Practice
Homosexuality, Male
Interviews as Topic
Mass Screening
Patient Acceptance of Health Care
Population Surveillance
Qualitative Research
Social Stigma
Surveys and Questionnaires
Voluntary Programs
Young Adult