Year of Publication



Public Health

Date Available


Degree Name

Dr. of Public Health (Dr.P.H.)

Committee Chair

Richard Crosby, PhD

Committee Member

Corrine Williams, ScD, MS

Committee Member

Katherine Eddens, PhD


Background: The study investigated whether experiencing difficulty obtaining heath care due to different forms of discrimination impacts Black and White men being tested for HIV. It is important to discover if discrimination as a structural factor inhibits progression through the HIV Care Continuum among Black men. Structural factors may better explain the origin of HIV prevalence disparities and how the social factors affect Black men being tested for HIV.

Methods: Data utilized was collected through the 2006-2008 Sexual Acquisition and Transmission of HIV Cooperative Agreement Program implemented in 6 U.S. cities and one Russian city: Los Angeles, CA; Chicago, IL; Raleigh-Durham, North Carolina; and St. Petersburg, Russia. Study Participants enrolled in the SATHCAP were Black and White non-Hispanic males. All the men in the study were self-identified as men who have sex with men (MSM), men who have sex with men and women (MSMW), and men who have sex with women (MSW). Chi-square tests and logistic regression were used to analyze the data.

Results: Of the 2,541 participants, 484 (19.1) were White non-Hispanic men and 2057 (80.9) were Black non-Hispanic Black men. Of those men, 80 (16.5) White men had not been tested, although 354 (17.2) Black men had not been tested. More than a quarter of the men in the study experienced difficulty getting health care due to any form of discrimination. Most of the men in this study reported only being sexually involved with women (63.7%), more than 10% reported being sexually involved with only men and more than 20% reported being sexually involved with both men and women (26.2%). I found race and sexual behavior were significant predictors of HIV testing. Black men experienced racial discrimination at higher percentages than White men while trying to get health care. When controlling for correlates, difficulty getting health care due to any form of discrimination was not related to HIV testing among Black and White men.

Conclusion: This study discovered there are complexities in the effects health care based discrimination has on Black and White men and being tested for HIV. Public health efforts must consider how the interplay between health care discrimination and other barriers affect HIV testing among Black men. This study suggests there are multiplicity of structural-related factors need to be considered when addressing participation in HIV testing among Black men.

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