Healthcare Providers' Perspective on HIV Testing and Hypothetical mHealth-connected Linkage to Care Among Men who have Sex with Men (MSM) in South Carolina

Abstract

BackgroundHIV continues to be an important public health concern in South Carolina (SC). However, an examination of providers' willingness to use mHealth technologies to address ongoing barriers to HIV care and prevention strategies, particularly among men who have sex with men (MSM) is currently lacking in SC. We therefore explored HIV care providers' perceptions of HIV testing and treatment uptake among MSM, and providers' willingness to use mHealth technology to address barriers to HIV testing and treatment in SC.MethodsBetween August and December 2021, we conducted semistructured virtual interviews with 10 HIV care providers recruited purposively based on their experience (2-11 years of service) providing HIV-related services to MSM in peri-urban (n = 7) and rural (n = 3) SC. The interviews were audio recorded, lasted 40-70 min, and were transcribed verbatim. The interview transcripts were analyzed inductively.ResultsFive themes emerged from the analysis: (a) challenges to HIV testing services; (b) concerns about HIV knowledge and status in the MSM community; (c) mixed feelings about HIV self-testing; (d) providers' perception of HIV treatment uptake and retention; and (e) potential of mHealth technology for the delivery of HIV care. Overall, participants reported limited resources, homophobia, medical mistrust, distance, medical costs, and HIV-related stigma as major barriers to HIV testing and treatment uptake in their localities (especially in rural areas). Particularly, they reported that MSM experience significant stigma associated with their sexual orientation and HIV.ConclusionsGiven barriers to care such as stigma and lack of access to care still impede MSM from receiving appropriate HIV services, mHealth-connected approaches could potentially address the barriers to HIV testing and care among MSM and improve their health outcomes. This is key to ending the HIV epidemic in SC and the United States by 2030.

Keywords: HIV testing; MSM; healthcare providers; mHealth; qualitative.