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Abstract
INTRODUCTION: In 2010, the rate of new HIV infection was seven times higher in Black men than White men in the United States. Black men account for 74% of persons living with HIV/AIDS in Georgia. Twenty percent of persons with HIV are unaware of their infection due to not receiving an HIV test. PURPOSE: To determine what factors influence Black mens decision to obtain an HIV test in Fulton and DeKalb Counties of Georgia. METHODS: This mixed method study was comprised of three phases. Phase I was an ecological study that examined geographic access to publicly funded free HIV test sites by poverty and census tracts. Phase II was a cross-sectional design that used primary data collection methods to determine whether transit distance (miles) between participants home address and the nearest publicly funded free HIV test site was associated with HIV testing in the past 12 months. Phase III was a qualitative study that used interviews to identify factors that affect Black mens decisions to seek HIV testing. RESULTS: In Phase I, census tracts with high proportions of Black men living below the poverty level had less transit distance to the nearest publicly funded free HIV test site than census tracts with Black men living at and above poverty (p < .01 ). In Phase II, of the 513 Black men, 285 (56%) had received an HIV test in the past 12 months. In a multivariate analysis, for every 1 mile increase in transit distance between a participants home address and the nearest publicly funded free HIV test site, Black men were 1% more likely to have an HIV test in the past 12 months (PR: 1.01, p < .05). Phase III revealed that 57% (n=15) of Black men reported that an HIV clinic was the most uncomfortable place to receive an HIV test. CONCLUSION: The most common barriers Black men faced when obtaining an HIV test were (a) judgment, and (b) privacy of test results. This study found that Black men were not utilizing publicly funded free HIV test sites due to the stigma of HIV clinics.