Latino immigrant men who have sex with men (MSM) are at risk for HIV and delayed diagnosis. An exploratory study using qualitative interviews that assess the beliefs and attitudes of 54 Latino immigrant MSM in Seattle, Washington, is presented. The goal of this research is to determine whether attitudinal differences exist between participants who had and had not been tested and to use any insight into the development of a media campaign to promote testing. Over one-third of the men have never been tested for HIV. Nontesters are more likely to be men who have sex with men and women, have less knowledge about HIV risks, perceive their sexual behaviors as less risky, and deflect HIV-related stigma. Testers are more likely to be self-identified as being gays. Both groups believe that fear of a positive result is the main barrier to testing. Both groups believe that family members have negative attitudes towards HIV testing and that having Latino staff at HIV testing sites hinders confidentiality. Financial concerns with regard to the cost of testing were also expressed by both groups. Based on these insights, recommended strategies for the development of HIV prevention and testing campaigns are made. 1. Introduction In the United States, Latino are disproportionately affected by HIV infection and have an HIV diagnosis rate that is three times that of non-Latino Whites [1]. An important public health issue among Latinos is that they tend to be diagnosed later in the course of HIV infection than nonLatino Whites [2] and present with lower CD4 counts and more opportunistic infections [3, 4]. In a recent systematic review of delayed HIV/AIDS diagnosis in the United States, Latino males and Latino immigrants were found to have the highest risk for late diagnosis [5]. Late HIV diagnosis has negative implications for individual morbidity and mortality and for public health. The HIV/AIDS epidemic can be lessened substantially by increasing the proportion of HIV positive persons who are aware of their status [6]; 70% of persons who find out that they are HIV positive stop having unsafe sex [7]. Importantly, timely diagnosis and treatment of HIV benefit individuals through a reduction in morbidity and mortality and offer public health benefits through a lowering of the viral load across a population, potentially slowing down new infections [8]. Low levels of acculturation to U.S. culture, defined by limited English proficiency and fewer than 5 years in the U.S [9–11], have been associated with late HIV testing. A previous study also indicates that Latinos who have a
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