Saturday, 15 January 2005 - 2:00 PM

This presentation is part of: HIV and AIDS

Elaborate Lives: HIV/AIDS and Black Men Who Have Sex With Men

Purpose: In this presentation the authors will present findings from a qualitative study examining behavioral, social and cultural factors impacting HIV/AIDS risk and resilience among Black/African American men who have sex with men (MSM) in New York City. Method: Using semi-structured focus group and individual interview guides, 18- focus groups and 22- individual interviews were conducted. A total of 162 men participated in the focus groups. The investigative team conducted extensive targeted venue-based outreach to reach the respondents. More than 360 men completed brief street interviews and were screened for inclusion in this study. Men meeting inclusion criteria were invited to participate in a focus group or interview.

The focus groups were divided based on the HIV-sero status of the man (positive or negative). Focus group participants responded to questions in four domains: characteristics of the Black/African American MSM population; location and context of sex; social discrimination; and resiliency. Individual interviews were conducted with 12 HIV negative men and 10 HIV positive men. The individual interviews covered content in the following areas: location and context of sex; social discrimination and resiliency; health care utilization; and two explicit sexual narratives in which men described factors impacting choices related to HIV/AIDS risks.

All focus groups and individual interviews were tape recorded and transcribed. The transcripts were reviewed and cleaned to replace or amend any missing or incorrect content. Cleaned transcripts were coded and analyzed using AnSWR software developed by the Centers for Disease Control and Prevention.

Results:

The mean age for the sample of men was 35 years. Ninety-four percent spoke English as their primary language; 2% spoke either Spanish or French. More than 10% of the men identified as heterosexual and 52% of the men identified as bisexual. More than 20% of the men in this study reported having sex with a female partner in the past three months. All men in the sample reported at least one sexual experience with a man in the past twelve months.

Analyses of the data produced a number of significant thematic occurrences. These included: the role of substance use/abuse; suppression of homosexual desire; clandestine nature of sexual engagement; confluence of race and sex and objectification of the self and other in sexual decision making. These themes were compared between the groups of positive and negative men as well as other demographic characteristics.

Implications:

The analyses suggest strong linkages between sexual decision making and socio-cultural and environmental factors such as, perception of masculine role, economics and discrimination. Data from this study are being used to inform the development of a structured survey instrument that will be used in an epidemiological survey with Black and African-American MSM in the fall of 2004. These data point to the need for great attention on socio-cultural and structural factors in the design, development and implementation of HIV/AIDS preventions and interventions targeting this population.

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