Community-Based Rapid HIV Testing is an Effective Strategy for High-Risk African Americans

A team of University of Miami champions for health equity recently published study findings showing that the use of community-based health workers along with rapid, home-based HIV testing is an effective strategy for getting more high-risk African American residents tested and connected to health services and treatment.

The study, led by Sonjia Kenya, Ed.D., M.S., M.A., assistant professor of general medicine and Director of Community Health Programs at the Jay Weiss Institute for Health Equity, was conducted in Overtown, one of Miami-Dade County’s most underserved communities, with a disproportionately high HIV rate. Titled “Strategies to Improve HIV Testing in African Americans,” the study findings based on community focus group discussions were published April 11 in the Journal of the Association of Nurses in AIDS Care.

“Only 17 percent of Miami-Dade County residents are African American, yet this population accounts for 59 percent of the county’s HIV-related mortality. We needed an effective intervention to stem these numbers,” said Kenya. Collaborating on the study were Olveen Carrasquillo, M.D., M.P.H., professor of medicine and public health sciences and Chief of the Division of General Internal Medicine, Guillermo “Willy” Prado, Ph.D., M.S., professor of public health sciences, study coordinator Ikenna Okoro, M.S., and research assistant Kierea Wallace.

“Anecdotally, we know that the stigma of HIV plays a major role among the barriers to residents getting tested and treated,” said Kenya. “The aim of our study was to gain a consensus on what methods would help increase testing among this population.”

Funded by the Miami Clinical and Translational Science Institute, the study began in the summer of 2013, with a series of neighborhood focus groups that helped researchers identify knowledge gaps and obtain input on the community’s overall perceptions of HIV, preferred methods of prevention, medical intervention and whether the use of OraQuick (the first FDA-approved home-based HIV rapid test) would be an effective testing strategy.

Four focus group sessions were conducted at a women’s shelter, a recreational center and a youth center. The 27 participants included 8 men and 19 women, 81 percent of whom identified as black.

Most of the participants felt that rapid testing by community health workers could provide the necessary support to complete an HIV test and, if positive, access HIV care. The participants also preferred community health workers who were of a similar cultural background as them.

The focus group research set the basis for a second phase of the study, which sent community health workers into the neighborhood to test residents with OraQuick.

“Dr. Kenya’s study identified critically important information about HIV testing preferences among vulnerable populations,” said Carrasquillo. “Her ability to collect meaningful data from hard-to-reach populations fills important knowledge gaps in health care delivery and has the potential to increase access to cutting edge HIV testing mechanisms among needy populations who are often lost in the formal health care system.”

The study also provided researchers with more insight into the residents’ attitudes toward research and misconceptions of HIV and AIDS.

“This study demonstrates that home-based HIV rapid testing coupled with community health workers may be a promising strategy for increasing HIV testing among African Americans, a population disproportionately impacted by HIV,” said Prado.

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