Perceived HIV Risk, Barriers, and Preferences for HIV Testing in Structurally Vulnerable Communities in St. Louis: A...

Area of Science:

• Public Health
• Epidemiology
• Social Science

Background:

• Persistent gaps in HIV epidemic control in the US necessitate community-specific HIV testing strategies.
• Underserved populations, including Black, queer, and young adults, face unique barriers to HIV testing.
• Understanding these barriers is crucial for developing effective interventions.

Purpose of the Study:

• To investigate barriers and preferences related to HIV testing among underserved populations in St. Louis, Missouri.
• To identify the relative importance of various barriers to HIV testing.
• To explore variations in testing preferences among different demographic groups.

Main Methods:

• A Best-Worst Scaling (BWS) survey was administered to 152 adults (16+ years).
• Participants evaluated 13 potential barriers to HIV testing.
• Hierarchical-Bayes estimation and latent class conditional logit models were used to analyze data.

Main Results:

• Low perceived risk for HIV was the most prominent barrier (MPW: 13.9).
• Black participants cited lack of trust and peer encouragement as significant barriers.
• Queer participants identified stigma, limited access, and fear of positive results as critical barriers.
• Latent class modeling revealed two groups: 'Low-risk perceivers' and 'Stigma avoiders'.

Conclusions:

• Low perceived HIV risk and social stigma are substantial deterrents to HIV testing in the St. Louis region.
• Tailored HIV testing initiatives are essential to address these barriers and improve testing uptake.
• Addressing community-specific needs is vital for ending the HIV epidemic.