Samantha D. Martin

Black communities in the United States (U.S.) have faced stark inequalities in COVID-19 outcomes. The underrepresentation of Black participants in COVID-19 testing research is detrimental to the understanding of the burden of the disease as well as the impact of risk factors for disease acquisition among Black Americans. Prior scholarship notes that the reluctance to engage in medical research among Black people is, in part, due to the exploitation and abuse this community has seen from the medical field and other social institutions. To better understand the barriers and motivations for COVID-19 testing among Black Americans, this study utilized intersectionality as methodological and theoretical frameworks to examine and investigate the barriers and motivations influencing participation in COVID-19 serosurveys (blood test and interview) among the metro-Atlanta Black communities. From May to October 2021, we took a community-based participatory research approach and conducted 52 semi-structured interviews to uncover different Black communities’ feelings and opinions towards COVID-19 testing. Key reasons participants agreed to the blood test include (1) curiosity; (2) health upkeep; (3) family/community/social responsibility; and (4) importance of research. Participants’ reasons for rejecting the blood test were (1) unnecessary/no benefit; (2) fear (of the known and unknown); (3) fear of needles and/or blood; and (4) discomfort with test setting/procedure. Our findings show that perspectives on willingness to engagement in testing or to not participate varied across gender and age for Black individuals.

Black Americans and the Southern United States are disproportionately represented in the HIV epidemic. Historically Black Colleges and Universities (HBCUs) and Predominantly Black Institutions (PBIs), often located in communities that have been historically underserved, are uniquely positioned to implement HIV prevention interventions focused on Black young adults. The purpose of the current study was to conduct a qualitative study, using the Consolidated Framework for Implementation Research (CFIR) model as a guide, to identify the barriers and facilitators to implementing an HIV intervention pre- and post-implementation. Pre-implementation key informant interviews with administrators, faculty, and staff, alongside focus groups with students, highlighted several themes as potential influencers on intervention rollout. These included perceived need, campus health resources, cost, personnel availability, student priorities, HIV-related stigma, and institutional culture. Post-implementation interviews with campus liaisons further revealed themes including institutional culture, external partnerships, internal communication, student health resource accessibility, and peer educator recruitment and retention. These findings underscore the complexities of implementing public health interventions in academic settings and may guide future efforts at HBCUs and PBIs to effectively address HIV prevention.