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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.120865v1 99/S1/S137    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ford, C. L. Articles by Miller, W. C. Search for Related Content PubMed PubMed Citation Articles by Ford, C. L. Articles by Miller, W. C. Related Collections Access to Care HIV/AIDS Prevention African Americans/Blacks Screening Socioeconomic Factors

Chandra L. Ford, PhD, MPH, MLIS, Mark Daniel, PhD, Jo Anne L. Earp, ScD, Jay S. Kaufman, PhD, Carol E. Golin, MD and William C. Miller, MD, PhD, MPH

At the time of this study, Chandra Ford was with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. Mark Daniel was with the Département de Médecine Sociale et Préventive, Université de Montréal, Montreal, Quebec. Jo Anne L. Earp and Carol E. Golin are with the Department of Health Behavior and Health Education, University of North Carolina School of Public Health, Chapel Hill. Jay S. Kaufman and William C. Miller are with the Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill. Carol E. Golin and William C. Miller are also with the School of Medicine, University of North Carolina, Chapel Hill.

Correspondence: Reprint requests should be sent to Chandra Ford, Department of Community Health Sciences, School of Public Health, University of California at Los Angeles, 650 Charles E. Young Dr. S., Los Angeles, CA, 90095 (e-mail: clford{at}ucla.edu).

Objectives. More than one quarter of HIV-infected people are undiagnosed and therefore unaware of their HIV-positive status. Blacks are disproportionately infected. Although perceived racism influences their attitudes toward HIV prevention, how racism influences their behaviors is unknown. We sought to determine whether perceiving everyday racism and racial segregation influence Black HIV testing behavior.

Methods. This was a clinic-based, multilevel study in a North Carolina city. Eligibility was limited to Blacks (N = 373) seeking sexually transmitted disease diagnosis or screening. We collected survey data, block group characteristics, and lab-confirmed HIV testing behavior. We estimated associations using logistic regression with generalized estimating equations.

Results. More than 90% of the sample perceived racism, which was associated with higher odds of HIV testing (odds ratio = 1.64; 95% confidence interval = 1.07, 2.52), after control for residential segregation, and other covariates. Neither patient satisfaction nor mechanisms for coping with stress explained the association.

Conclusions. Perceiving everyday racism is not inherently detrimental. 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.