August 28, 2014
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Black MSM liable to underreport knowledge of HIV status

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In studies of black men who have sex with men, the exclusive use of self-reported data is likely to overestimate the true lack of awareness of HIV status in this population, according to recent study results published in Open Forum Infectious Diseases.

The findings suggest that these men may feel uncomfortable revealing their knowledge of their HIV status, the researchers wrote.

In the study, researchers evaluated data from the InvolveMENt study, a prospective cohort study that sought to determine the variables that contribute to race-based disparities in HIV and sexually transmitted infections. The current study population included black (n=192) and white (n=45) MSM in Atlanta.

Participants were screened for HIV, and prior to receiving the results of the HIV tests, they completed a computer-facilitated self-interview. Men who tested positive for HIV underwent HIV viral load testing, and these results were returned to them.

The researchers utilized several different measures of HIV awareness. The “self-reported” definition of awareness pertained to participants’ responses to questions about past and recent HIV testing experiences. Moreover, patients who claimed prior awareness of their HIV status during the post-test results discussion were considered to be “self-reported aware.”

For patients who did not meet the measures of self-reported awareness, various other methods were used to determine awareness. One measure utilized laboratory testing, including low viral load and detectable antiretroviral drugs. Additionally, the researchers used a public health surveillance measure of awareness, which involved the prior existence of an HIV case surveillance report at the Georgia Department of Public Health. The researchers limited the definition of prior HIV case surveillance to those who had been diagnosed at least 21 days before the current study diagnosis. This was to ensure that the patients had sufficient time to review their test results.

The researchers found that based solely on self-report, 32% of black MSM and 16% of white MSM were unaware of their HIV-positive status (P=.03). Based on self-report and low viral load, 25% of black MSM and 16% of white MSM were unaware of their status (P=.18). When taking into account self-report and antiretroviral drugs, 26% of black MSM and 16% of white MSM were unaware (P=.14). When considering self-report and surveillance report, the researchers found that 15% of black MSM and 13% of white MSM did not know their HIV status (P=.83).

According to the researchers, these findings suggest that HIV status awareness may be significantly underreported in interviews of black MSM.

“These interviews underscore that some part of the research process is creating an environment in which black MSM do not feel inclined to disclose knowledge of their HIV status to researchers,” the researchers wrote. “This may be due to HIV-related stigma or distrust in HIV research, both of which have been reported among black MSM.”

Disclosure: The researchers report no relevant financial disclosures.