HIV coping self-efficacy: a key to understanding stigma and HIV test acceptance among incarcerated men in Jamaica

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Abstract
Although prisons have been noted as important venues for HIV testing, few studies have explored the factors within this context that may influence HIV test acceptance. Moreover, there is a dearth of research related to HIV and incarcerated populations in middle and low-income countries, where both the burden of HIV and the number of people incarcerated is higher compared to high-income countries. This study explores the relationship between HIV coping self-efficacy, HIV-related stigma, and HIV test acceptance in the largest prisons in Jamaica. A random sample of inmates (n=298) recruited from an HIV testing demonstration project were asked to complete a cross-sectional quantitative survey. Participants who reported high HIV coping self-efficacy (adjusted odds ratio (AOR) 1.86: 95% confidence interval CI 1.24–2.78, p-value=0.003), some perceived risk of HIV (AOR 2.51: 95% (CI) 1.57–4.01, p-value=0.000), and low HIV testing stigma (AOR 1.71: 95% CI 1.05–2.79, p-value=0.032) were more likely to test for HIV. Correlates of HIV coping self-efficacy included external and internal HIV stigma (AOR 1.28: 95% CI 1.25–1.32, p-value=0.000 and AOR 1.76: 95% CI 1.34–2.30, p-value=0.000, respectively), social support (AOR 2.09: 95% CI 1.19–3.68, p-value=0.010), and HIV knowledge (AOR 2.33: 95% CI 1.04–5.22, p-value=0.040). Policy and programs should focus on the interrelationships of these constructs to increase participation in HIV testing in prison.

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