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J Natl Med Assoc. 2017 Summer;109(2):115-125. doi: 10.1016/j.jnma.2016.11.005. Epub 2017 Feb 13.

Communication Between Middle SES Black Women and Healthcare Providers About HIV Testing.

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University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Clinical Oncology Research Program, 101 East Weaver Street, CB# 7294, Carrboro, NC 27510, United States. Electronic address:
Department of African, African American, and Diaspora Studies, University of North Carolina at Chapel Hill, CB #3395, 208 Battle Hall, Chapel Hill, NC 27599, United States.



This article explores the impact of patient and healthcare provider communication (PPC) on the HIV testing behaviors of middle socioeconomic status (SES) Black women in North Carolina. We explore how PPC about STIs and HIV (or the lack thereof) affects the provision of STI/HIV testing by either confirming the need for middle SES Black women to test routinely or potentially deterring women from feeling they need to be tested.


After conducting 15 qualitative interviews with middle SES Black women between 25 and 45 years of age, we uncovered the role of patient self-advocacy in promoting HIV testing among middle SES Black women when they communicate with their healthcare providers.


We discuss the importance of healthcare providers engaging their middle SES Black female patients in routine discussions about sexual health and sexual risk reduction, regardless of providers' perceptions of their potential STI/HIV risk. We recommend including SES as a variable in data collection and research in order to better understand how social class, race, and gender affect sexual health behavior and the provision of STI and HIV/AIDS prevention to diverse populations.


Black women; HIV testing; Middle SES; Patient provider communication; Sexual health

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