Fixation on the Risk and Erasure of Resilience in HIV Prevention with Young Men Who Use the Internet to Seek Sex with Other Men

Background & Purpose: YMISM (i.e., young men who use Internet to seek sex with men) has emerged as a population in need of HIV prevention, primarily because research finds lower rates of HIV and STI testing among this group compared to their adult counterparts. For YMISM, the Internet has been instrumental in providing venues for sexual health education and connections to the gay community, especially during the process of sexual identity formation. However, online spaces have also been portrayed as inherently dangerous in making young men prone to a wide range of sexual health risks. Moreover, proliferating neoliberal discourses that emphasize personal responsibility to manage HIV risk, coupled with the primacy of behavioral approach, may result in social workers’ inability to address social and structural determinants of the HIV epidemic among this population. The purpose of this paper is to elucidate the limited scope of research on this population and propose critical implications for social work practice.

Method: Using a critical discourse analysis, this study aims to identify the dominant ideologies, which underlie health and social science research on HIV prevention with YMISM. The search of research literature published between 2000 to 2014 produced 21 articles. Through a systematic coding process, common themes emerged from the texts and were analyzed with reference to current social service models.

Results: The findings of this analysis suggest that a neoliberal ideology has obscured the social and structural mechanisms including racism, socio-economic factors, homophobia, and sexual stigma that may be predisposing YMISM to a higher risk of contracting HIV. Furthermore, the current body of scholarship has homogenized YMISM by narrowly referring to behavioral aspects of sexuality. As a result, policy recommendations provided by these studies are largely in tune with the neoliberal ideologies in which YMISM are expected to reduce their number of sexual partners, minimize risky sexual activities, and avoid substance use in sexual situations. Many studies even reinforce medicalization and the stigmatization of deviance among YMISM, positioning them as reckless risk-takers, while dismissing the resilience of these young men. 

Conclusions and Implications: In order to counteract neoliberal ideologies and behavioral bias while promoting resilience discourses on YMISM, we argue for the importance of rethinking the dominant behavioral assumptions behind this group. Furthermore, we urge social work researchers and policy-makers to pay greater attention to the socio-structural conditions that systematically engender the risk of HIV and STIs. Finally, recommendations are provided on sexual rights, sexual health education and further research on sexuality concerning YMISM.