{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T22:50:56Z","timestamp":1789685456632,"version":"4.0.1"},"reference-count":35,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Care Research Applied Research Collaboration"},{"DOI":"10.13039\/501100000883","name":"University of Bristol","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000883","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000724","name":"Health Foundation","doi-asserted-by":"publisher","award":["FR-000002776"],"award-info":[{"award-number":["FR-000002776"]}],"id":[{"id":"10.13039\/501100000724","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100018336","name":"NIHR Health Protection Research Unit","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100018336","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100022244","name":"National Institute for Health Research Applied Research Collaboration West","doi-asserted-by":"publisher","award":["NIHR200181"],"award-info":[{"award-number":["NIHR200181"]}],"id":[{"id":"10.13039\/501100022244","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,4,22]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>African and Caribbean heritage (ACH) communities in the UK face disproportionately high rates of HIV and often experience delayed diagnoses, worsening health inequities. Increasing HIV testing in these communities is essential to address these disparities and support the UK\u2019s HIV reduction targets. This study examines barriers and facilitators to HIV testing among Bristol\u2019s ACH community, a high-prevalence area with significant rates of late diagnoses, filling a critical gap in context-specific data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a mixed-methods approach, this study combined 29 in-depth interviews and 41 online surveys, capturing ACH community members\u2019 views on HIV stigma, healthcare trust and testing experiences. Data were thematically analysed and mapped to the Social Ecological Model (SEM) framework, with community researchers conducting data collection and analysis to enhance participants\u2019 engagement and trust and contribute to a deeper contextual analytical understanding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Findings highlight significant barriers across SEM levels: individual-level knowledge gaps and stigma, interpersonal confidentiality concerns within tight knit communities, community-level taboos and distrust and organisational barriers, such as discriminatory healthcare experiences. Effective facilitators included culturally specific services, flexible testing options, community-driven outreach and increased healthcare representation, all of which fostered greater trust and engagement in testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study underscores the importance of culturally aligned interventions, including representation within and training in cultural competence for healthcare providers and community co-production in service design. Implementing such strategies could reduce late diagnoses and support the normalisation of routine HIV testing in ACH communities, ultimately contributing to health equity. Future research should explore gender and age-specific barriers, while assessing the long-term impact of community-led interventions to inform national HIV policy and public health strategies for marginalised communities in the UK.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056491","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T13:05:24Z","timestamp":1747314324000},"page":"3-10","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Barriers and facilitators to HIV testing among African and Caribbean heritage communities: a mixed methods study"],"prefix":"10.1136","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6752-1304","authenticated-orcid":false,"given":"Temilola","family":"Adeniyi","sequence":"first","affiliation":[{"name":"Population Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Horwood","sequence":"additional","affiliation":[{"name":"University of Bristol Centre for Academic Primary Care, Bristol, UK"},{"name":"NIHR Applied Research Collaboration West, Bristol, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marsha","family":"Doran","sequence":"additional","affiliation":[{"name":"Brigstowe Charity, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khabo","family":"Piggott","sequence":"additional","affiliation":[{"name":"Population Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisha-Monic","family":"Namurach","sequence":"additional","affiliation":[{"name":"Brigstowe Charity, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Harryman","sequence":"additional","affiliation":[{"name":"University Hospitals NHS Foundation Trust, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmy","family":"Oldenbourg","sequence":"additional","affiliation":[{"name":"University Hospitals NHS Foundation Trust, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miryam","family":"Kiflu","sequence":"additional","affiliation":[{"name":"University Hospitals NHS Foundation Trust, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Speare","sequence":"additional","affiliation":[{"name":"University Hospitals NHS Foundation Trust, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Griffin","sequence":"additional","affiliation":[{"name":"University Hospitals NHS Foundation Trust, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Wilson","sequence":"additional","affiliation":[{"name":"Brook, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Febrache","sequence":"additional","affiliation":[{"name":"Terrence Higgins Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Allbless","sequence":"additional","affiliation":[{"name":"Bristol Health Partners, Academic Health Science Centre, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Dravie-John","sequence":"additional","affiliation":[{"name":"African Voices Forum Ltd, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Copping","sequence":"additional","affiliation":[{"name":"Bristol City Council, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"De Vocht","sequence":"additional","affiliation":[{"name":"Population Health Sciences, University of Bristol, Bristol, UK"},{"name":"NIHR Applied Research Collaboration West, Bristol, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Walter","sequence":"additional","affiliation":[{"name":"NIHR Applied Research Collaboration West, Bristol, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7313-8105","authenticated-orcid":false,"given":"Fiona","family":"Fox","sequence":"additional","affiliation":[{"name":"NIHR Applied Research Collaboration West, Bristol, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"2026081704400968000_102.1.3.1","unstructured":"WHO European Region . 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