Understanding structural barriers to accessing HIV testing and prevention services among black men who have sex with men (BMSM) in the United States

Matthew E. Levy*, Leo Wilton, Gregory Phillips, Sara Nelson Glick, Irene Kuo, Russell A. Brewer, Ayana Elliott, Christopher Watson, Manya Magnus

*Corresponding author for this work

Research output: Contribution to journalReview article

92 Scopus citations

Abstract

Structural-level factors have contributed to the substantial disproportionate rates of HIV among Black men who have sex with men (BMSM) in the United States. Despite insufficient HIV testing patterns, however, there is a void in research investigating the relationship between structural factors and access to HIV testing and prevention services among BMSM. Building on previous scholarly work and incorporating a dynamic social systems conceptual framework, we conducted a comprehensive review of the literature on structural barriers to HIV testing and prevention services among BMSM across four domains: healthcare, stigma and discrimination, incarceration, and poverty. We found that BMSM experience inadequate access to culturally competent services, stigma and discrimination that impede access to services, a deficiency of services in correctional institutions, and limited services in areas where BMSM live. Structural interventions that eliminate barriers to HIV testing and prevention services and provide BMSM with core skills to navigate complex systems are needed.

Original languageEnglish (US)
Pages (from-to)972-996
Number of pages25
JournalAIDS and behavior
Volume18
Issue number5
DOIs
StatePublished - May 2014

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Keywords

  • Black men who have sex with men
  • HIV
  • HIV testing
  • Healthcare services
  • Incarceration
  • Poverty
  • Prevention
  • Stigma
  • Structural barriers

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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