Date of Conferral

7-15-2026

Date of Award

July 2026

Degree

Doctor of Public Health (DrPH)

School

Health Sciences

Advisor

Kaye Reynolds

Abstract

Examining factors that affect HIV testing in the Black/African American population is important because socioeconomic hardship, stigma, and restricted access to healthcare all lead to gaps in early diagnosis and prevention treatment to prevent further spread of infection. However, most studies have focused on these factors separately, leaving less understanding of how they work together to influence HIV testing behavior. Guided by the health belief model, this study examined the relationship between sexual orientation, gender identity, healthcare access, and HIV high-risk behaviors. The study examined the relationship between sexual orientation, gender identity, healthcare access, and HIV testing, and the influence of HIV-related risk behaviors on HIV testing. A cross-sectional design was used with secondary data from the 2023 Behavioral Risk Factor Surveillance System. The sample (N = 6,863) consisted of Black/African Americans residing in Georgia, Alabama, Mississippi, Florida, and Texas. The data were analyzed using binary logistic regression, descriptive statistics, and interaction terms to examine moderating effects. Results showed that sexual orientation, healthcare access, and HIV high-risk behaviors were associated with HIV testing. In the final model, sexual orientation remained significant (OR = 0.40, p = .035), healthcare access was not significant (p = .822), and HIV high-risk behaviors were the strongest predictor of testing (OR = 3.12, p = .001). No significant moderation effects were found. These findings support improving culturally responsive HIV prevention and expanding HIV testing access among Black/African Americans in the Southern United States.

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