Perceived Everyday Racism, Residential Segregation, and HIV Testing Among Patients at a U.S. STD Clinic

"More than one-quarter of HIV-infected people are undiagnosed and therefore unaware of their HIV-positive status. Blacks are disproportionately infected," the study authors explained. While perceived racism influences African Americans' attitudes toward HIV prevention, how racism influences their behavior is not known. Thus, the researchers sought to determine whether perceiving everyday racism and racial segregation influence black HIV testing behavior.

The clinic-based, multilevel study was conducted in a city in North Carolina. Eligibility was limited to African Americans (N=373) seeking STD diagnosis or screening. Survey data, block group characteristics, and lab-confirmed HIV testing behavior were collected. Associations were estimated using logistic regression with generalized estimating equations.

More than 90 percent of participants perceived racism, which was linked with higher odds of HIV testing (odds ratio=1.64; 95 percent confidence interval=1.07, 2.52), after controlling for residential segregation and other covariates. The association could not be explained by either patient satisfaction or mechanisms for coping with stress.

"Perceiving everyday racism is not inherently detrimental," the researchers concluded. "Perceived racism may improve odds of early detection of HIV infection in this high-risk population. How segregation influences HIV testing behavior warrants further research."

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