Repeat HIV testing among low-income minority women: A descriptive analysis of factors influencing decisional balance

Objective: This exploratory study quantified potential barriers to repeat HIV testing, as well as perceptions supporting further testing among women previously tested for HIV. The study also determined associations between summative measures of barriers (and supportive factors) and women's intent to be tested for HIV. Design and Setting: One hundred forty-three women (95.4% African-American) who attended an urgent care center, and reported a history of HIV testing, completed a face-to-face interview. Results: Frequently perceived barriers included perceptions that repeat testing was unnecessary, either based on: 1) having only one sex partner since the last test (38.1% of responders); 2) obtaining a negative test result in the past year (36.7%); 3) worry about coping with a positive diagnosis (30.7%); 4) a belief that "guys I have sex with always use condoms" (27.5%); or 5) a belief that treatment may not be affordable (25.2%). Other barriers were endorsed with less frequency. A broad range of supportive factors were endorsed, including: 1) testing is part of self-care (85.8%); 2) knowing to avoid sex if HIV-positive (85.8%); 3) test results are reliable and important (84.7%); 4) early diagnosis can improve odds of staying healthy (83.0%); and 5) coping with a positive test result, and paying for treatment, would be manageable (78.6% and 78.2%, respectively). Conclusions: Findings suggest that barriers and supportive factors played equally important roles in women's intent to be tested for HIV. Intervention efforts designed to promote repeat HIV test acceptance among low-income, African-American women should focus on changing perceptions of barriers, and enhancing supportive factors.