It’s official. African Americans are not getting testing for HIV and the majority of African American doctors are not urging them to do so. Resistance and hesitancy on both parties stem from social stigma. The news comes from a study commissioned jointly by Janssen Products, LP, and the National Medical Association (NMA).
African American account for almost half of the new HIV cases in the United States when compared with other races and ethnic groups. Over 93 percent of the physician surveyed agree that HIV is either very serious or at a crisis stage in the African American community, but only one-third of these physician’s patients were tested in the past year. Since September 2006, the Centers for Disease Control and Prevention (CDC) has recommended that diagnostic HIV testing and optional HIV screening be a part of routine clinical care in all healthcare settings.
“The survey findings tell us that despite HIV education efforts, the stigma surrounding the disease is still very strong and is a significant barrier to routine testing among African-American doctors,” said Wilbert C. Jordan, MD, MPH, Medical Director of the OASIS Clinic of King/Drew Medical Center and member of the NMA. “With African Americans more likely to contract HIV than any other ethnic group, this is particularly concerning as the study uncovered that most patients decide to get tested based on their physician’s recommendation. It’s crucial that we educate doctors and patients by providing the resources they need to make HIV testing a routine practice.”
Physicians are concerned that patients may interpret a recommendation to get tested as an accusation of risky behavior or even being judgmental (57 percent). Additionally, physicians are concerned that patients would worry about being identified as HIV positive if people found out (43 percent). A larger number of doctors (45 percent) cite “competing priorities” and “a lack of time” with patients as the reasons why they do not routinely test their patients.
The physicians surveyed estimate that of the 70 percent of patients tested in the last year, were done at the physician’s recommendation. Still, this was only after taking a risk-based approach to recommending. This included patients who disclosed having multiple sex partners (89 percent), injection drug use (85 percent), engaging in commercial sex work (77 percent), homosexuality (77 percent), and previous incarceration (70 percent).
Increase patient-focused communication tools were high on the list of physician recommendations toward getting both parties beyond this impasse. In-office brochures and increased media attention (51 percent), more training on testing (44 percent), in-office pre-packaged HIV testing kits (42 percent).
