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Barriers and Facilitators to Engaging African American Men Who Have Sex With Men in the HIV Care Continuum

A Theory-Based Qualitative Study

Jemmott, John B. III, PhD; Zhang, Jingwen, PhD*; Croom, Mikia, MSEd; Icard, Larry D., PhD; Rutledge, Scott E., PhD; O'Leary, Ann, PhD

Journal of the Association of Nurses in AIDS Care: May-June 2019 - Volume 30 - Issue 3 - p 352–361
doi: 10.1097/JNC.0000000000000087
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African American men who have sex with men (MSM) have high rates of HIV, but interventions are needed to address their low rates of engagement in the HIV care continuum. To identify modifiable factors potentially affecting such engagement, we conducted qualitative interviews guided by the Theory of Planned Behavior with 27 African American MSM who had participated in an HIV risk-reduction intervention trial. Qualitative analyses resulted in four overarching themes: stigma, concerns with health care providers (HCPs), social support, and logistical issues. Facilitators of care continuum engagement included reassurance about health, feeling and looking better, receiving treatment, avoiding infecting others, good relations with HCP, and social support. Barriers included HIV stigma, concerns about confidentiality, negative perceptions of HCP, convenience and availability of testing/treatment facilities, cost, and lack of social support. Efforts to improve African American MSM HIV care continuum engagement should focus on individual and health care system changes.

John B. Jemmott, III, PhD, is a Professor, Perelman School of Medicine and Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Jingwen Zhang, PhD, is an Assistant Professor, Department of Communication, University of California, Davis, Davis, California, USA. Mikia Croom, MSEd, is a Senior Research Coordinator, Center for Health Behavior & Communication Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Larry D. Icard, PhD, is a Professor, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA. Scott E. Rutledge, PhD, is an Associate Professor, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA. Ann O'Leary, PhD, is a Senior Behavioral Scientist, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Corresponding author: Jingwen Zhang, e-mail: jwzzhang@ucdavis.edu

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

© 2019 Association of Nurses in AIDS Care
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