ABSTRACT
Hepatitis C (HCV) is a significant public health burden globally. While HIV-positive men who have sex with men (MSM) have traditionally comprised the majority of sexually acquired HCV cases in the USA, recent studies indicate that HIV-negative MSM and MSM who use pre-exposure prophylaxis (PrEP) in particular are at increasing risk for incident HCV. Further, in the USA, African Americans are disproportionately burdened by chronic HCV compared with other ethnic groups. We sought to better understand awareness and knowledge about HCV and the perceived barriers to HCV testing, among young Black MSM (YBMSM) ages 18-24 in an urban southern California setting. This formative work was conducted in the context of a broader study designed to develop a brief, peer-led intervention to increase hepatitis awareness and testing among young men at risk. Our focus group findings suggest that YBMSM are lacking awareness and knowledge about HCV that are important for self-appraisal of their risk and need for testing. Additionally, YBMSM reported low social support for HCV testing; many indicated they do not discuss HCV with peers, community leaders, or family members. Using study participants' recommendations for engaging YBMSM in HCV prevention efforts, our study emphasizes the need for education and screening efforts targeted to YBMSM, and especially YBMSM who are engaging in high-risk sexual activity with HIV-positive and/or older MSM. We offer recommendations for public health strategies that may be helpful for increasing awareness of HCV risks and HCV screening among vulnerable YBMSM groups.
Subject(s)
Black or African American/psychology , Hepatitis C/prevention & control , Hepatitis C/psychology , Homosexuality, Male/psychology , Patient Acceptance of Health Care/psychology , Sexual and Gender Minorities/psychology , Adolescent , Adult , Black or African American/statistics & numerical data , Age Factors , California/epidemiology , California/ethnology , Health Knowledge, Attitudes, Practice , Hepatitis C/epidemiology , Hepatitis C/ethnology , Humans , Incidence , Male , Patient Acceptance of Health Care/statistics & numerical data , Qualitative Research , Sexual and Gender Minorities/statistics & numerical data , Urban Population/statistics & numerical data , Young AdultABSTRACT
The study aims to describe the perceived discriminatory health care treatment experiences and its impact on care among minority urban-dwelling adults. Semistructured qualitative interviews (N = 51) were conducted with patients from community-based health care settings, and systematic, grounded theory approach was used. Three distinct themes emerged: (a) the sources of discriminatory experiences, (b) its impact on health care, and (c) the provider/organization recommendations to address discriminatory practices. The study highlights the relevance of perceived discrimination in avoidance of health care services, nonadherence to treatment, and adverse health-related sequelae by low-income urban-dwelling adults with little access to health care.
