Role Flexing: How Community, Religion, and Family Shape the Experiences of Young Black Men Who Have Sex with Men

1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia.
AIDS patient care and STDs (Impact Factor: 3.5). 11/2012; 26(12). DOI: 10.1089/apc.2012.0177
Source: PubMed


Abstract While the disproportionate impact of HIV on young black men who have sex with men (MSM) is well documented, the reasons for this disparity remain less clear. Through in-depth interviews, we explored the role of familial, religious, and community influence on the experiences of young black MSM and identified strategies that these young men use to negotiate and manage their sexual minority status. Between February and April 2008, 16 interviews were conducted among HIV-infected and HIV-uninfected young (19- to 24-year-old) black MSM in the Jackson, Mississippi, area. Results suggest that overall, homosexuality remains highly stigmatized by the men's families, religious community, and the African American community. To manage this stigma, many of the participants engaged in a process of "role flexing," in which individuals modified their behavior in order to adapt to a particular situation. The data also provided evidence of internalized homophobia among a number of the participants. The impact of stigma on risk behavior should be more fully explored, and future intervention efforts need to explicitly address and challenge stigma, both among young men themselves and the communities in which they reside. Attention should also be paid to the role masculinity may play as a driver of the HIV epidemic among young black MSM and how this knowledge can be used to inform prevention efforts.

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Available from: Alexandra M Oster, Oct 05, 2015
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    • "Social vulnerability to HIV among BMSM is exacerbated by mental health problems (e.g., depression, stress, substance abuse, and exposure to violence), which are associated with stigma and social marginalization (Mustanski, Garofalo, Herrick, & Donenberg, 2007; Reisner et al., 2009; Stall et al., 2003). Although research suggests that the family and religious institutions are critical sources of social support and inclusion within Black communities (Haley et al., 1996; McAdoo, 2007; Utsey, Bolden, Lanier, & Williams, 2007), studies have described the homophobia and the HIV-related stigma that BMSM face in religious institutions and the family (Balaji et al., 2012; Hussen et al., 2014; Valera & Taylor, 2011) as sources of HIV vulnerability. BMSM may experience greater psychosocial problems when they internalize multiple forms of social marginalization as racial and sexual minorities, which may be exacerbated in those living in poverty. "
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    ABSTRACT: Black men who have sex with men (BMSM) bear an increasingly disproportionate burden of HIV in the United States. The Centers for Disease Control and Prevention recommends high-impact combination prevention for populations at high risk for HIV infection, such as BMSM. However, few scholars have considered the types of behavioral interventions that combined with biomedical prevention could prove effective for mitigating the epidemic among BMSM. Between June 2013 and May 2014, we conducted three in-depth interviews each with 31 BMSM, interviews with 17 community stakeholders, and participant observation in New York City to understand the sociocultural and structural factors that may affect the acceptance of and adherence to oral preexposure prophylaxis among BMSM and to inform an adherence clinical trial. BMSM and community leaders frequently described condomless sex as a consequence of psychosocial factors and economic circumstances stemming from internalized homophobia resulting from rejection by families and religious groups. BMSM revealed that internalized homophobia and HIV stigma resulted in perceived lack of self- and community efficacy in accepting and adhering to preexposure prophylaxis. Our results indicate that addressing internalized homophobia and fostering emotional social support in peer networks are key elements to improve the effectiveness of combination prevention among BMSM.
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    • "The sources of homonegativity have implications for its potential to affect young MSM. Like Balaji et al. (2012) recently found, young MSM's own families members, churches, and communities perpetrated homonegativity. These entities are those that are both familiar to young MSM and those that young MSM might ordinarily expect to provide them care and support. "
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    ABSTRACT: Unfavourable social environments can negatively affect the health of gay, bisexual, and other men who have sex with men (MSM). We described how experienced homonegativity - negative perceptions and treatment that MSM encounter due to their sexual orientations - can increase HIV vulnerability among young MSM. Participants (n = 44) were young MSM diagnosed with HIV infection during January 2006-June 2009. All participants completed questionnaires that assessed experienced homonegativity and related factors (e.g. internalised homonegativity). We focus this analysis on qualitative interviews in which a subset of participants (n = 28) described factors that they perceived to have placed them at risk for HIV infection. Inductive content analysis identified themes within qualitative interviews, and we determined the prevalence of homonegativity and related factors using questionnaires. In qualitative interviews, participants reported that young MSM commonly experienced homonegativity. They described how homonegativity generated internalised homonegativity, HIV stigma, silence around homosexuality, and forced housing displacement. These factors could promote HIV risk. Homonegative experiences were more common among young Black (vs. non-Black) MSM who completed questionnaires. Results illustrate multiple pathways through which experienced homonegativity may increase HIV vulnerability among young MSM. Interventions that target homonegativity might help to reduce the burden of HIV within this population.
    Global Public Health 08/2015; DOI:10.1080/17441692.2015.1062120 · 0.92 Impact Factor
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