Ten Strategies to Develop a Culturally Sensitive Prevention Program for Black Men Who Have Sex with Men: A Qualitative Analysis

Abstract

Prevention programs are designed to expose participants to information, activities, and strategies to cultivate certain capacities and outcomes. Programs to prevent the transmission of HIV/AIDS among young Black men who have sex with men (YBMSM) are no different and are particularly important given the disproportionate rates at which the virus affects this population. However, studies show the limited number of culturally sensitive prevention programs specifically designed for YBMSM. The current study reflects a content analysis of 78 in-depth interviews with YBMSM ages 18 to 24 years old who participated in the prevention program, the IAM! Experience. The overwhelming majority of individuals describe the program favorably and provide ideas to make it even better. Ten suggestions emerge that illustrate the importance of cultural sensitivity that takes the form of: exciting, innovative, research-informed program content informed by racial, gender, sexuality, economic, and age-related issues; processes that build intra-group support; and, well-prepared, funded personnel to develop prevention programs that attract and retain YBMSM. The featured results document the importance of developing culturally sensitive preventions to combat HIV/AIDS among YBMSM as well as incorporating the suggestions and practices of participants during program development, implementation, and maintenance.

Keywords

HIV prevention program planning Black men who have sex with men cultural sensitivity

Get full access to this article

View all access options for this article.

References

Abreu

Townsend

Mitchell

Ward

Audette

Gonzalez

(2022). LGBTQ qualitative and mixed methods research in counseling psychology: A content analysis. The Counseling Psychologist, 50(5), 708–737. https://doi.org/10.1177/00110000221092481

Arnold

E. A.

Rebchook

G. M.

Kegeles

S. M.

(2014). “Triply cursed”: Racism, homophobia, and HIV-related stigma are barriers to regular HIV testing, treatment adherence, and disclosure among young Black gay men. Culture, Health & Sexuality, 16(6), 710–722. https://doi.org/10.1080/13691058.2014.905706

Arscott

Humphreys

Merwin

Michael

(2020). That guy is gay and Black. That’s a red flag. How HIV stigma and racism affect perception of risk among young Black men who have sex with men. AIDS and Behavior, 24(1), 173–184. https://doi.org/10.1007/s10461-019-02607-4

Barnes

S. L.

(2020). Applying the structure versus agency discourse to the challenges of Black men who have sex with men. Sexuality & Culture, 25(2), 430–454. https://doi.org/10.1007/s12119-020-09777-7

Barnes

S. L.

Collins

(2019). I feel blacker: Applying a Black feminist paradigm to an intervention program for Black men who have sex with men in Tennessee. Sexuality & Culture, 23(3), 862–881. https://doi.org/10.1007/s12119-019-09598-3

Barnes

S. L.

Hollingsworth

(2018). Spirituality and social media: The search for support among Black men who have sex with men in Tennessee. Journal of Homosexuality, 67(28), 1–25. https://doi.org/10.1080/00918369.2018.1525945

Barnes

S. L.

Streaty-Wimberly

(2016). Empowering Black youth of promise: Education and socialization in the village-minded Black Church. Routledge Press.

Benoit

Pass

Randolph

Murray

Downing

M. J.

(2012). Reaching and engaging non-gay identified, non-disclosing Black men who have sex with both men and women. Culture, Health & Sexuality, 14(9), 975–990. https://doi.org/10.1080/13691058.2012.709640

Binkley

(2020, May 3). Unimpressed by online classes, college students seek refunds. AP. https://apnews.com/f18a0a48925a19586e4d810f6e88eff3

10.

Black AIDS Institute. (2020). We the people: A Black plan to end HIV. https://blackaids.org/report/we-the-people/

11.

Braun

Clark

(2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise & Health, 11(4), 589–597.

12.

Brewer

Hood

Moore

Spieldenner

Daunis

Mukherjee

Smith-Davis

Brown

Bowen

Schneider

(2020). An exploratory study of resilience, HIV-related stigma, and HIV care outcomes among men who have sex with men (MSM) living with HIV in Louisiana. AIDS and Behavior, 24(7), 2119–2129. https://doi.org/10.1007/s10461-020-02778-5

13.

Centers for Disease Control and Prevention (CDC). (2018). Gay, bisexual, and other men who have sex with men. https://www.cdc.gov/hiv/library/reports/hiv-surveillance/vol-31/content/msm.html#race

14.

Centers for Disease Control and Prevention (CDC). (2020a, May). Diagnoses of HIV infection in the United States and dependent areas. HIV Surveillance Report 2020 (31). https://www.cdc.gov/hiv/library/reports/hiv-surveillance/vol-31/index.html

15.

Centers for Disease Control and Prevention (CDC). (2020b). Compendium of evidence-based interventions and best practices for HIV prevention. https://www.cdc.gov/hiv/research/interventionresearch/compendium/index.html

16.

Collins

L. V.

(2015). Examining intragroup racism and racial battle fatigue in historically Black colleges and universities. In Fasching-Varner

K. J.

Albert

K. A.

Mitchell

R. W.

Allen

(Eds.), Racial battle fatigue in higher education (pp. 92–102). Rowman & Littlefield.

17.

Dacus

Devasri

Voisin

D. R.

Barker

(2018). Proud I am negative’: Maintaining HIV-seronegativity among Black MSM in New York City. Men and Masculinities, 21(2), 276–290. https://doi.org/10.1177/1097184x17696174

18.

Dangerfield

D. T.

Williams

J. E.

Bass

A. S.

Wynter

Blumenthal

R. N.

(2019). Exploring religiosity and spirituality in the sexual decision-making of Black gay and bisexual men. Journal of Religion and Health, 58(5), 1792–1802. https://doi.org/10.1007/s10943-019-00845-3

19.

Denson

Gelaude

Schoua-Glusberg

. (2022). We in this fight together: HIV treatment and prevention among couples of HIV-discordant Black and Latino men who have sex with men. Journal of Preventive Health Promotion, 1(10), 1–22. https://doi.org/10.1177/26320770221074979

20.

Dimock

(2019, January 17). Defining generations: Where Millennials end and Generation Z begins. Pew Research Center. https://www.pewresearch.org/fact-tank/2019/01/17/where-millennials-end-and-generation-z-begins/

21.

English

Hickson

D. M. A.

Callander

Goodman

M. S.

Duncan

D. T.

(2020). Racial discrimination, sexual partner race/ethnicity, and depressive symptoms among Black sexual minority men. Archives of Sexual Behavior, 49(5), 1799–1809. https://doi.org/10.1007/s10508-020-01647-5

22.

Ferguson

(2004). Aberrations in Black: Toward a queer of color critique. University of Minnesota Press.

23.

Fields

E. L.

Bogart

L. M.

Smith

K. C.

Malebranche

D. J.

Ellen

Schuster

M. A.

(2015). I always felt I had to prove my manhood: Homosexuality, masculinity, gender role strain, and HIV risk among young Black men who have sex with men. American Journal of Public Health, 105(1), 122–131. https://doi.org/10.2105/ajph.2013.301866

24.

Fields

E. L.

Hussen

Malebranche

(2020). Mind the gap: HIV prevention among young Black men who have sex with men. Current HIV/AIDS Report, 17(6), 632–642. https://doi.org/10.1007/s11904-020-00532-z

25.

Firestone

(1993). Alternative arguments for generalizability from data as applied to qualitative research. Educational Researcher, 22(4), 17–23. https://doi.org/10.3102/0013189X022004016

26.

Garcia

Parker

R. G.

Wilson

P. A.

Philbin

Hirsch

J. S.

(2015). You’re really gonna kick us all out? Sustaining safe spaces for community-based HIV prevention and control among Black men who have sex with men. PLoS One, 10(10), 1–17. https://doi.org/10.1371/journal.pone.0141326

27.

Garcia

Parker

R. G.

Wilson

P. A.

Philbin

Hirsch

J. S.

(2016). Psychosocial implications of homophobia and HIV stigma in social support networks: Insights for HIV combination prevention among Black men who have sex with men. Health Education & Behavior, 43(2), 217–225. https://doi.org/10.1177/1090198115599398

28.

Hardee

(2024). The interconnectedness of the classroom to the health of Black men who have sex with men. Immigration and Human Rights Law Review, 5(1), 1–28. https://scholarship.law.uc.edu/ihrlr/vol5/iss1/5

29.

Henny

K. D.

Nanin

Gaul

Murray

Sutton

M. Y.

(2018). Gay identity and HIV risk for Black and Latino men who have sex with men. Sexuality & Culture, 22(1), 258–270. https://doi.org/10.1007/s12119-017-9465-3

30.

Jeffries

Flores

Rooks-Peck

Gelaude

Belcher

Ricks

Millet

. (2021). Experienced homophobia and HIV infection risk among U.S. gay, bisexual, and other men who have sex with men: A meta-analysis. LGBT Health, 8(1), 1–10. https://doi.org/10.1089/lgbt.2020.0274

31.

Jones

Smith

J. C.

Moore

Newman

Camacho-Gonzalez

Harper

G. W.

Del Rio

Hussen

S. A.

(2022). Passion, commitment, and burnout: Experiences of Black gay men working in HIV/AIDS treatment and prevention in Atlanta, GA. PLoS One, 17(8), e0264680. https://doi.org/10.1371/journal.pone.0264680

32.

Krueger

Holloway

Lightfoot

Lin

Hammack

Meyer

. (2020). Psychological distress, felt stigma, and HIV prevention in a national probability sample of sexual minority men. LGBT Health, 7(4), 190–197. https://doi.org/10.1089/lgbt.2019.0280

33.

Lee-Foon

Logie

Siddiqi

Grace

(2020). I just trust what Google says, it’s the bible: Exploring young, Black gay and other men who have sex with men’s evaluation of sexual health information sources in Toronto, Canada. Canadian Journal of Human Sexuality, 29(3), 275–288. https://doi.org/10.3138/cjhs.2020-0026

34.

Lenning

(2017). Unapologetically queer in unapologetically Black spaces: Creating an inclusive HBCU campus. Humboldt Journal of Social Relations, 1(39), 283–293. https://doi.org/10.55671/0160-4341.1019

35.

Levitt

Bamberg

Creswell

Frost

Josselson

Suarez-Orozco

(2018). Journal article reporting standards for qualitative primary, qualitative meta-analytic, and mixed methods research in psychology: The APA publications and communications board task force report. American Psychologist, 73(1), 26–46. https://doi.org/10.1037/amp0000151

36.

Malebranche

D. J.

Fields

E. L.

Bryant

L. O.

Harper

S. R.

(2007). Masculine socialization and sexual risk behaviors among Black men who have sex with men: A qualitative exploration. Men and Masculinities, 12(1), 90–112. https://doi.org/10.1177/1097184X07309504

37.

Mayring

(2021). Qualitative content analysis: A step-by-step guide. Sage.

38.

Mays

Cochran

S. D.

Zamudio

(2004). HIV prevention research: Are we meeting the needs of African American men who have sex with men? Journal of Black Psychology, 30(1), 78–105. https://doi.org/10.1177/0095798403260265

39.

McQueen

Barnes

(2017). Social support and suggestions among Black men who have sex with men in Tennessee. Journal of Positive Sexuality, 3(2), 22–26.

40.

Mehra

Jaber

(2023). Don’t’ say gay in Alabama: A taxonomic framework of LGBTQ+ information support services in public libraries—An exploratory website content analysis of critical resistance. Journal of the Association for Information Science and Technology, 74(8), 954–970.

41.

Miller

Wagner

Serner

(2005). Sexual diversity among Black men who have sex with men in an inner-city community. Journal of Urban Health, 82(Suppl 1), i26–i34. https://doi.org/10.1093/jurban/jti021

42.

Moore

Jones

Smith

J. C.

Hood

Harper

G. W.

Camacho-Gonzalez

del Rio

Hussen

S. A.

(2019). Homonegativity experienced over the life course by young Black gay, bisexual and other men who have sex with men (YB-GBMSM) living with HIV in Atlanta, Georgia. AIDS and Behavior, 23(S3), S266–S275. https://doi.org/10.1007/s10461-019-02658-7

43.

Nelson

L. R. E.

Walker

J. J.

DuBois

S. N.

Giwa

(2014). Your blues ain’t like mine: Considering integrative antiracism in HIV prevention research with Black men who have sex with men in Canada and the United States. Nursing Inquiry, 21(4), 270–282. https://doi.org/10.1111/nin.12055

44.

Neuendorf

K. A.

(2016). The content analysis guidebook. Sage.

45.

Patton

L. D.

(2011). Perspectives on identity, disclosure, and the campus environment among African American gay and bisexual men at one historically Black college. Journal of College Student Development, 52(1), 77–100. https://doi.org/10.1353/csd.2011.0001

46.

Phillips

(2005). Deconstructing down low discourse: The politics of sexuality, gender, race, AIDS, and anxiety. Journal of African American Studies, 9(2), 3–15. https://doi.org/10.1007/s12111-005-1018-4

47.

Polit

Beck

. (2010). Generalization in quantitative and qualitative research: Myths and strategies. International Journal of Nursing Studies, 47(11), 1451–1458.

48.

Quinn

Dickson-Gomez

Zarwell

Pearson

Lewis

(2019). A Gay man and a doctor are just like, a recipe for destruction: How racism and homonegativity in healthcare settings influence PrEP uptake among young Black MSM. AIDS and Behavior, 23(7), 1951–1963. https://doi.org/10.1007/s10461-018-2375-z

49.

Smallwood

S. W.

Spencer

S. M.

Ingram

L. A.

Thrasher

J. F.

Thompson-Robinson

M. V.

(2015). Examining the relationships between religiosity, spirituality, internalized homonegativity, and condom use among African American men who have sex with men in the deep south. American Journal of Men’s Health, 11(2), 196–207. https://doi.org/10.1177/1557988315590835

50.

Stake

R. E.

Trumbull

. (1982). Naturalistic generalizations. Review Journal of Philosophy and Social Science, 7(1), 1–12.

51.

Stokes

J. P.

Vanable

P. A.

McKirnan

D. J.

(1996). Ethnic differences in sexual behavior, condom use, and psychosocial variables among Black and White men who have sex with men. Journal of Sex Research, 33(4), 373–381. https://doi.org/10.1080/00224499609551855

52.

Strayhorn

T. L.

(2013). And their own received them not: Black gay male undergraduates’ experiences with White racism, Black homophobia. Counterpoints, 383, 105–119. https://www.jstor.org/stable/42981251

53.

Strayhorn

T. L.

Tillman-Kelly

D. L.

(2013). Queering masculinity: Manhood and Black gay men in college. Spectrum: A Journal on Black Men, 1(2), 83. https://doi.org/10.2979/spectrum.1.2.83

54.

Watkins

D. C.

Green

B. L.

Goodson

Guidry

J. J.

Stanley

C. A.

(2007). Using focus groups to explore the stressful life events of Black college men. Journal of College Student Development, 48(1), 105–118. https://doi.org/10.1353/csd.2007.0009

55.

Watkins

T. L.

Simpson

Cofield

S. S.

Davies

Kohler

Usdan

(2016). The relationship of religiosity, spirituality, substance abuse, and depression among Black men who have sex with men (MSM). Journal of Religion and Health, 55(1), 255–268. https://doi.org/10.1007/s10943-015-0101-y

56.

Watson

R. J.

Fish

J. N.

Allen

Eaton

(2018). Sexual identity disclosure and awareness of HIV prevention methods among Black men who have sex with men. The Journal of Sex Research, 55(8), 975–983. https://doi.org/10.1080/00224499.2017.1375452