Psychological threat avoidance as a barrier to HIV testing in gay/bisexual men

J Behav Med. 2019 Jun;42(3):534-544. doi: 10.1007/s10865-018-0003-z. Epub 2019 Jan 1.


The present study examined how three psychosocial barriers-anticipated HIV stigma, HIV infectiousness-reduction beliefs, and optimism about available HIV treatments-related to HIV testing history and acceptance of an at-home HIV test among men who have sex with men. We also examined the mediating role of a variable that affects medical screening for other health conditions but has not yet been investigated in HIV contexts: the tendency to avoid psychologically threatening information. Volunteers completed a paper and pencil survey and were offered a free at-home HIV test during the 2015 Atlanta Pride Festival in Atlanta, GA. Anticipated HIV stigma, infectiousness beliefs, and treatment optimism were inconsistently related to HIV testing history and acceptance of an at-home HIV test, but all had direct effects on the desire to avoid HIV information. In a mediation model, each of these psychosocial barriers had indirect effects on both HIV testing outcomes via information avoidance. These findings suggest that information avoidance is an important proximal HIV testing barrier, thus providing a novel target for interventions and information campaigns.

Keywords: Decision making; HIV testing; MSM; Medical testing; Psychosocial barriers.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • HIV Infections / psychology
  • HIV Seropositivity / diagnosis
  • HIV Seropositivity / psychology*
  • Homosexuality, Male / psychology*
  • Humans
  • Male
  • Mass Screening / psychology*
  • Middle Aged
  • Sexual Behavior / statistics & numerical data
  • Sexual and Gender Minorities / psychology*
  • Social Stigma*
  • Surveys and Questionnaires