Psychological threat avoidance as a barrier to HIV testing in gay/bisexual men
- 24 Downloads
The present study examined how three psychosocial barriers—anticipated HIV stigma, HIV infectiousness-reduction beliefs, and optimism about available HIV treatments—related to HIV testing history and acceptance of an at-home HIV test among men who have sex with men. We also examined the mediating role of a variable that affects medical screening for other health conditions but has not yet been investigated in HIV contexts: the tendency to avoid psychologically threatening information. Volunteers completed a paper and pencil survey and were offered a free at-home HIV test during the 2015 Atlanta Pride Festival in Atlanta, GA. Anticipated HIV stigma, infectiousness beliefs, and treatment optimism were inconsistently related to HIV testing history and acceptance of an at-home HIV test, but all had direct effects on the desire to avoid HIV information. In a mediation model, each of these psychosocial barriers had indirect effects on both HIV testing outcomes via information avoidance. These findings suggest that information avoidance is an important proximal HIV testing barrier, thus providing a novel target for interventions and information campaigns.
KeywordsHIV testing Decision making Psychosocial barriers Medical testing MSM
We thank Seth Kalichman for his unwavering support of this project. Without the generous amount of resources he provided, this study would not have been feasible.
This study was funded by the NIMH T-32 HIV training Grant (5629880).
Compliance with ethical standards
Conflict of interest
Devon M. Price, Jennifer L. Howell, Amanda N. Gesselman, Stephanie Finneran, Diane M. Quinn and Lisa A. Eaton declare that they have no conflict of interest.
Human and animal rights and informed consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
- Centers for Disease Control and Prevention. (2014a). HIV risk, prevention, and testing behaviors: National HIV Behavioral Surveillance System: Men who have sex with men, 20 US Cities, 2011. HIV Surveillance Special Report, 8, 1–40.Google Scholar
- Centers for Disease Control and Prevention. (2014b). Understanding the HIV care continuum. Retrieved June 2016 from http://www.cdc.gov/hiv/pdf/dhap_continuum.pdf.
- Centers for Disease Control and Prevention. (2015a). Georgia 2015 state health profile. Retrieved from http://www.cdc.gov/nchhstp/stateprofiles/pdf/Georgia_profile.pdf.
- Centers for Disease Control and Prevention. (2015b). State HIV prevention progress report, 2010–2013. Retrieved from http://www.cdc.gov/hiv/pdf/policies/progressreports/cdc-hiv-stateprogressreport.pdf.
- Centers for Disease Control and Prevention. (2016a). CDC FY 2017 budget request summary domestic HIV prevention. Retrieved from https://www.cdc.gov/hiv/pdf/policies/cdc-hiv-budget-summary.pdf.
- Centers for Disease Control and Prevention. (2016b). Prevalence of diagnosed and undiagnosed HIV infection—United States, 2008–2012 (MMWR No. 64) (pp. 657–662).Google Scholar
- Nunnally, J. C. (1967). Psychometric theory. New York, NY: McGraw-Hill.Google Scholar
- Price, D. M., Gesselman, A. N., & Garcia, J. (under review). Bisexual men’s and women’s perceptions of acceptance in the LGBTQ community: Evidence from a 2016 National U.S. Sample.Google Scholar
- Shepperd, J. A., & Howell, J. L. (2015). Responding to psychological threats with deliberate ignorance: Causes and remedies. In P. J. Carroll, R. M. Arkin, & A. Wichman (Eds.), Handbook of personal security. New York, NY: Taylor & Francis.Google Scholar
- Steele, C. M. (1988). The psychology of self-affirmation: Sustaining the integrity of the self. Advances in Experimental Social Psychology, 21, 261–302.Google Scholar