A Qualitative Descriptive Approach Exploring the Perceptions, Attitudes and Experiences of HIV Testing Uptake Among Sub-Saharan African Born Immigrants in the United States

Human immunodeficiency virus (HIV) testing is essential when implementing HIV prevention and treatment services because it can lead to positive behavioral change and increased access to HIV care services. The high incidence of HIV rates among sub-Saharan African born immigrants (SSAIs) living in the United States (US) mirrors the rate of infection burden in the sub-Saharan Africa region. SSAIs data is often aggregated among the data of Blacks or African Americans masking the important distinctions between these populations. There is a paucity of knowledge about HIV testing perceptions, attitudes, and experiences of SSAIs, many of whom have emigrated to the US from high HIV prevalence countries in sub-Saharan Africa. The purpose of this study was to describe the perceptions, attitudes, and experiences of HIV testing uptake among SSAIs living in the US. Identifying barriers and facilitating factors for HIV testing encountered by this specific subgroup within the US black community, who are vulnerable to HIV infection, was paramount. The framework that guided this study was the Health Belief Model (HBM). Purposive and snowball sampling was used to recruit participants. The researcher conducted virtual face-to-face semi-structured in-depth interviews via Zoom with eight sub-Saharan African born immigrant men and women and used an inductive and deductive thematic qualitative analysis to analyze the data. Domains were selected apriori to respond to each research question and, the categories and subcategories were identified through immersion and crystallization of thematic units. Four overarching domains describe perceptions, attitudes, and experiences of SSAIs living in the US towards HIV testing uptake: 1) Barriers to HIV testing among SSAIs; 2) Facilitators to HIV testing among SSAIs; 3) SSAIs cultural influences on HIV testing decisions; and, 4) SSAIs self-confidence to take or adhere to HIV testing. Understanding the HIV testing perceptions, attitudes, and experiences of SSAIs will help healthcare professionals better understand the facilitators and the barriers that SSAIs face regarding HIV testing. This study adds to the science by supporting previous findings that create facilitators and barriers to HIV testing for SSAIs in the US and new knowledge of the significance of cultural barriers. These findings will inform the design of future research, practice, and policy in the US aimed at integrating the unique needs of SSAIs to increase HIV testing uptake