Barriers to HIV Testing in Black Immigrants to the U.S.

BACKGROUND: Late HIV testing is common among immigrants from sub Saharan Africa and the Caribbean. Since 2010, HIV testing is no longer a required component of immigrant screening examinations or mandatory for immigrants seeking long term residence in the US. Thus, barriers to HIV testing must be addressed. METHODS: Five hundred and fifty-five (555) immigrants completed a barriers-to-HIV testing scale. Univariate and multivariate linear regression were performed to examine predictors of barriers. RESULTS: In multivariate analysis, primary language other than English (β=2.9, p=.04), lower education (β=5.8, p=.03), low income [= below $20K/year] (β=4.6, p=.01), no regular provider (β=5.2, p=.002) and recent immigration (β=5.7, p=.0008) were independently associated with greater barriers. Barriers due to health care access, privacy, fatalism, and anticipated stigma were greater for recent versus longer term immigrants. DISCUSSION: Immigrants from sub-Saharan Africa and the Caribbean face significant barriers to HIV testing. Interventions to improve access and timely entry into care are needed.