379. HIV testing, risk practices, and barriers to care in men who have sex with men (MSMs) in rural Central Louisiana
Session: Poster Abstract Session: HIV Epidemiology: Screening and Testing - Outpatient to Inpatient
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • Poster #379 for ID Week 9-24-15.pdf (715.1 kB)
  • Background: Louisiana ranks third for HIV/AIDS case rates, with MSMs and African Americans disproportionally affected. The South has the highest proportion of cases in rural areas. This study identifies risk behaviors, practices, and barriers to HIV testing among rural MSMs.

    Methods: Anonymous surveys were administered to adult MSMs in diverse settings. Clinic surveys were performed at a Ryan White-funded clinic in Central Louisiana. Community surveys were performed online and at two local venues. 

    Results: 71 clinic and 42 community participants were analyzed. Average ages were 42.5 and 39.2, respectively. The clinic population was more racially diverse: 46.5% identified as African American, 52% identified as White compared to 2.4% and 85.7% in the community, respectively. 15.5% of clinic respondents were tested because of routine screening; barriers to testing were: not feeling at risk for HIV and fear of: being HIV positive, being seen getting tested, costs associated with HIV, and community reactions to HIV diagnosis. The majority of the clinic population (61%) had a positive HIV disclosure experience, citing emotional and adherence support as paramount. For community respondents, 43% reported not using condoms with their last sexual encounter, and 39% reported rare/never condom use. Of rare/never condom users, 66.7% reported not feeling at risk for HIV. Seventy-four percent of community respondents reported substance use with sex. Partners were most commonly met online (55%) and “through friends” (45%). Barriers to HIV testing were: fear of HIV diagnosis and fear of stigma associated with HIV. All respondents preferred HIV testing where counselors/specialists were available. A majority of community respondents (62%) had heard of Pre-exposure Prophylaxis (PrEP); 87% of clinic respondents would advise their partners to use it, and 93% of community participants would use it if available.

    Conclusion: Routine HIV testing was uncommon among high-risk patients with the majority reporting not feeling at risk. Testing preference indicated in-person testing with HIV counselors/specialists. Interventions focused on HIV education via routine testing, condoms and PrEP as well as offering of these services will be essential to curb the HIV epidemic among rural MSMs in Louisiana.

    Nicholas Van Sickels, MD1, Paula Seal, MD, MPH2, Alexandra Abrams-Downey, MD3 and Christopher Lacross, MD3, (1)Infectious Diseases Section, Tulane University, New Orleans, LA, (2)Infectious Diseases Section, Louisiana State University Health Sciences Center, New Orleans, LA, (3)Internal Medicine, Tulane University, New Orleans, LA

    Disclosures:

    N. Van Sickels, None

    P. Seal, None

    A. Abrams-Downey, None

    C. Lacross, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.