African-Americans who perceive racism — whether subtle or overt — might be more likely to accept readily available HIV testing, according to a study conducted in a county public health STD clinic in North Carolina. Although one might expect awareness of racism to be a barrier, it seemed to have the opposite effect.

“We were investigating the extent to which [study participants] believe that most blacks still experience racism,” said lead study author Chandra Ford, Ph.D. “We wanted to understand whether they thought it was still prevalent, and if so whether this was a barrier to obtaining CDC-recommended HIV testing as has been hypothesized.”

Ford is an assistant professor in the department of community health sciences at the UCLA School of Public Health. The clinic-based, multilevel study included 373 blacks seeking sexually transmitted disease diagnoses or screening. The study appears in the April supplement of the American Journal of Public Health.

Ford said that only about 6 percent of participants did not perceive everyday forms of racism (such as being followed by white clerks or security guards while shopping). Of interest, individuals who perceived racism were more likely to undergo HIV testing, even when controlling for other factors such as perceived risk of HIV infection.

“This study highlights the importance of moving away from a ‘business as usual’ approach to investigating health behaviors and treatment seeking behaviors,” said Craig Demmer, Ed.D. “Health inequalities connected to race and racism are well established, but our constant preoccupation with looking to race as the definitive explanation or cause for a multitude of health behaviors and attitudes, including HIV/AIDS, is shortsighted.”

Demmer, a professor in the department of health sciences at Lehman College at CUNY, said the findings serve as an important reminder “to look at the whole person and not make assumptions as to why a category of people feel and behave the way they do.”

“Awareness of racism in the environment is not inherently a barrier to HIV testing,” Ford said, “so it need not be something to avoid discussing.” In fact, the greatest barrier might be that two-thirds of study participants believed they had a very low or no risk for HIV infection, despite seeking STD testing and despite 40 percent having symptoms.

Demmer noted that the study made no mention of sexual orientation and said that it is also important to look at how racism intersects with homophobia when it comes to attitudes to testing and treatment. “We need to be open to exploring factors associated with race, but also those that may extend beyond race to explain why some people may be more inclined to get tested for HIV than others,” he said.

The American Journal of Public Health is the monthly journal of the American Public Health Association. Visit http://www.apha.org for more information. Complimentary online access to the journal is available to credentialed members of the media. Contact Patricia Warin at APHA, (202) 777-2511 or .(JavaScript must be enabled to view this email address).

Ford CL, et al. Perceived everyday racism, residential segregation, and HIV testing in a sexually transmitted disease–clinic sample. Am J Pub Health 99(S1), 2009.

Source: Health Behavior News Service