"I told myself, be bold and go and test": Motivators and barriers to HIV testing among gays, bisexuals, and all other men who sex with men in Ghana - West Africa

Limited evidence from Ghana and SSA shows that despite consistently a disproportionately high burden of HIV, GBMSM infrequently often delay testing until the point of illness. We therefore used qualitative interviews to collect insights of experiences, motivators, and barriers to HIV testing among GBMSM. Two community-based organizations used snowball and convenience sampling to recruit 10 MSM for IDIs and 8 to 12 for FGDs. We transcribed, coded, identified and analyzed the relationship and commonalities between the participants responses. Under experiences with testing, 1) fear of HIV infection created a stressful HIV testing experience; and 2) friendly and supportive healthcare environment facilitated a positive experience in healthcare facilities. Motivators or facilitators of testing include: 1) the perception or belief that HIV testing is a HIV prevention strategy; 2) encouragement from friends and peers; 3) understanding risk associated with certain sexual behaviors such as transactional sex 4) education or information on HIV; 5) access to free testing and incentives; 6) early symptoms and provider recommendation. Barriers to HIV testing include: 1) negative community perceptions of HIV deter; 2) individual-level low risk perception or indifference about HIV infection; 3) location and cost; 4) inadequate testing availability; 5) Stigma at Healthcare facilities. The findings point to the need to address important issues around stigma, education, peer support and healthcare resources through interventions and research to improve HIV testing among GBMSM in the country.