Black Gay Men Research Articles

Psychometric Validation of the Patient Anal Cancer Knowledge Scale (PACKS) in a Cohort of Black and Hispanic/Latino Sexual and Gender Diverse Young Adults.

Lack of anal cancer information in priority populations is a major barrier to the uptake and utilization of prevention services. A validated measure of anal cancer knowledge is needed to inform patient education and shared clinical decision-making for anal cancer prevention. The purpose of this study was to validate the Patient Anal Cancer Knowledge Scale (PACKS) in a sample of GBM, namely Black and Hispanic gay, bisexual, and other men who have sex with men (GBM) and gender expansive young adults (aged 18-30 years) living in the USA (N=188). Anal cancer knowledge was hypothesized as a 3-factor scale representing (1) risk and primary prevention (9 items), (2) symptoms (5 items), and (3) screening (3 items). Confirmatory factor analysis, internal consistency, and criterion validity were assessed. The 3-factor model demonstrated adequate fit (RMSEA=0.02; CFI=0.99). All items loaded on their respective factors (p<0.01). Scale scores indicated low to moderate anal cancer knowledge and acceptable reliability: factor 1 (M=3.5; SD=2.3; range: 0-9; α=.71), factor 2 (M=2.9; SD=1.9; range: 0-5; α=.85), and factor 3 (M=2.0; SD=1.2; range: 0-3; α=.79). History of HPV vaccination (51.3%) was positively correlated with factors 1 and 2. The PACKS demonstrated good construct validity related to knowledge of anal cancer risk, prevention, symptoms, and screening. Limited anal cancer knowledge among Black and Hispanic GBM is a potential barrier to the uptake and utilization of prevention recommendations.

"When my Brother Fell, I Picked Up His Weapons": Collective Remembrance as Community Mobilization among Black Gay, Bisexual, and Queer Men.

The Counter Narrative Project (CNP) was founded to shift narratives and shatter stereotypes about Black gay, bisexual, and queer men to advance social justice. This paper describes three programs CNP implemented that were organized around collective memory as a strategy to respond to collective trauma experienced by this community.

Reducing Stigma and HIV-related Disparities through a Peer-led Support Network for Black Gay Men Who are Living with HIV.

Undetectables Atlanta (UA), a peer support network for Black gay men living with HIV, conducted an exploratory evaluation to begin identifying outcomes of UA membership. Th is initial evaluation suggested decreased HIV stigma and increased comfort with disclosure, treatment adherence, and other areas of well-being that warrant prospective evaluation.

Feasibility and acceptability of a peer influencer delivered social media based intervention to promote mental health awareness for young Black and Latinx gay and bisexual men and transgender women

Background Young Black and Latinx Gay and Bisexual Men and Transgender Women (YBLGBMTW) face high levels of mental health related concerns. While online interventions show promise for addressing mental health conditions, few models focus on this population. Methods We used a pre-post design to assess the feasibility and acceptability of a peer delivered mental health awareness intervention for YBLGBMTW. This study was nested as the control arm from a larger study investigating if Peer Influencers (PIs) can improve HIV prevention. PIs helped develop an online outreach campaign to raise awareness of pertinent mental health topics as chosen by the PIs. PIs recruited YBLGBMTW participants from online social networks, posted contents over a six-week period, and participants completed baseline and post-intervention surveys. Results PIs successfully recruited 71 participants of whom 92% completed the six-week post-intervention survey. Participants had on average 6.7 engagements with posted contents and 82% of participants indicated being very satisfied with the intervention. Conclusion Using an intervention informed and delivered by PIs, participants were presented with information to address relevant mental health concerns. We found that such novel means of engaging this sample to raise mental health awareness is feasible, acceptable, and merits further development.

The Discursive Work of “Bottom-Shaming”: Sexual Positioning Discourse in the Construction of Black Masculinity

This article uses ethnographic data and interviews with young Black gay cisgender men to illustrate how masculinity is interactionally created and policed within gay communities. Here, I specifically highlight the ways Black masculinity is constructed against Latino and white men’s masculinity, discursively situating this masculinity within a racial hierarchy celebrating hypermasculinity among Black men. Black masculinity is further policed within Black gay communities through what I term sexual positioning discourse. Through the use of sexual positions within gay relationships (e.g., “top,” “bottom,” “versatile”), peers shame the act of bottoming to interactionally shore up their own masculinity through a ritualistic emasculation of other men, which simultaneously denigrates the social position of women and femininity. Building on prior empirical and theoretical work examining the use of homophobic discourse among straight men as playing a critical role in their constructions of masculinity, I show similarities and differences through an examination of gender and sexual discourse mobilized within gay communities and by Black gay cis men. Sexual positioning discourse is integral to masculinity boundary work among gay men, yet when employed by heterosexual men, this discourse calls their sexuality into question. Specifically, when Black gay men mobilize sexual positioning discourse, it serves to assert their claims to Black masculinity relative to one another; whereas when straight men use the same discourse it serves to cast doubt on their claims to “straight” sexual identities.

Effects of internalised racism and internalised homophobia on sexual behaviours among black gay and bisexual men in the USA: a systematic review protocol

IntroductionBlack gay and bisexual men are overburdened by HIV in the USA. While the socioecological model has been applied to understand potential mechanisms of HIV acquisition among black gay and...

Speaking Out: Intersectional Denunciations of Sexual Assault and Police Responses in Michaela Coel’s I May Destroy You and Édouard Louis’ Histoire de la violence

Increasingly diverse Western European societies have developed their own conversations around intersectionality that focus on local issues. Two artists and public intellectuals that demonstrate this increasing level of engagement with intersectionality in Western Europe are writer and actress Michaela Coel and writer Édouard Louis, from England and France, respectively. In the 2020 TV series I May Destroy You, Coel presents the story of a working-class English black writer named Arabella who has been sexually assaulted. She also gives the spotlight to Arabella’s best friend, Kwame, a black gay man who has also been assaulted but whose experience differs greatly from Arabella due to his gender and sexual orientation. I May Destroy You introduces its viewers to intersectionality by insisting on how Arabella and Kwame’s specific identities lead to different outcomes. Likewise, French writer Édouard Louis’s 2018 novel Histoire de la violence revolves around the author’s rape by a man of North African descent in order to examine the treatment of queer people and ethnic minorities by the police and French society at large. Both creators have succeeded in making their audiences aware of how intersectionality is a necessary tool to comprehend systemic inequality in their respective countries.

“They’re not feeling the love they need to feel”: HIV stigma and other intersecting stigmas among Black gay and bisexual men and transgender women in house and ball communities

Introduction: Stigma negatively influences engagement in HIV prevention and care. This study explores how young Black gay and bisexual men and transgender women (GBT) in the House and Ball Community (HBC) experience HIV and other intersecting stigmas. Method: We conducted phenomenological analysis of interviews with 60 young Black GBT HBC members and 30 older leaders of the HBC. Result: Participants described experiences of enacted, perceived, and internalized HIV stigma and intersecting stigmas related to race, ethnicity, sexuality, gender identity, gender expression, and body size, as well as their responses to HIV stigma. Intersecting stigmas shaped and reinforced one another, leading to isolation and increased HIV vulnerability. Conclusion: Interventions to ameliorate intersectional stigma and its effects are needed to improve primary and secondary HIV prevention in the HBC.

Intersectional Person Perception: A Scoping Review of Studies Investigating the Roles of Category Relationships and Cognitive Processes

This review considered experimental studies that used an intersectional framework in order to examine (1) how perceived relationship between the categories in a given intersection impacts the perception of its members and (2) how intersectional person perception has been studied through different cognitive processes. A systematic search in databases identified 5,393 records, and a screening processes resulted in 43 articles reporting 110 studies. The way intersectional targets were cognitively processed depended on contextual factors as well as on the perceived relationship between intersected identities (e.g., perceived [in-]congruence between identities). Less prototypical intersectional targets (e.g., Black gay men) sometimes experienced intersectional invisibility, facing both relative advantages (e.g., being less associated with certain negative stereotypes), and disadvantages (e.g., being overlooked, less recognized) compared to more prototypical members of their constituent ingroups (e.g., Black people, gay men). Future work should incorporate observed exceptions to these patterns and expand the cultural context of analysis.

Ending the HIV epidemic PrEP equity recommendations from a rapid ethnographic assessment of multilevel PrEP use determinants among young Black gay and bisexual men in Atlanta, GA.

Efforts to mitigate HIV transmission among gay and bisexual men have not been sufficient to level persistent racial inequities which now extend to the use of daily oral pre-exposure prophylaxis (PrEP) for HIV prevention. Community-involved ethnographic research is crucial to galvanizing collaboration between patients, researchers, and policymakers to identify the social determinants of emerging PrEP inequities. In partnership with community key informants, we conducted a Rapid Ethnographic Assessment (REA) of multilevel PrEP use determinants among young Black gay and bisexual (YBGBM) men in the metropolitan Atlanta area to inform the development and coordination of local HIV programs. In the assessment, we drew upon the perspectives of local clinicians, community-based organization leaders, health educators, and PrEP clients to identify barriers and facilitators to PrEP use among YBGBM through interviews (N = 23). Data were collected from September 2020 -to January 2021 and were analyzed through a staged deductive-inductive thematic analysis. The themes were later summarized and presented to community stakeholder participants to facilitate member-checking. Our analyses revealed structural, cultural, relationship, and developmental factors which shaped PrEP use. The most prominent being "ease of access to PrEP" (structural level), "provider support" (interpersonal), and "life-stage traits" (individual). Our results also contribute novel information concerning the axes of intersectional stigma (spatial, racial, sexual identity, and HIV) among YBGBM in Atlanta and its divergent effects on PrEP use. Increased PrEP use among YBGBM, particularly among those living in the south, is essential to ending the domestic HIV epidemic. Altogether, our results emphasize the need for PrEP program modifications, which increase flexibility in methods and modes of access and are culturally adapted to the needs of YBGBM. There is also a need for resources that holistically focus on mental health, trauma, and racism as critical components of support.

A Principal Investigator as a PrEP-Using Peer Change Agent for HIV Prevention among Black Gay and Bisexual Men: An Autoethnography.

HIV pre-exposure prophylaxis (PrEP) use remains suboptimal among Black gay and bisexual men (GBM). Multilevel factors such as medication costs, intersectional stigma, patient-clinician communication, medical mistrust, side effect concerns, and low perceived HIV risk (PHR) are well-established PrEP initiation barriers for this group. Peer change agents (PCAs) are culturally congruent interventionists who can circumvent multilevel PrEP barriers among Black GBM. I led an intervention as a PrEP-using PCA to improve PHR and PrEP willingness among 69 Black GBM from 2019-2022 and conducted an autoethnography to better understand multilevel barriers and identify the personal/professional challenges of being an in-group HIV interventionist serving Black SMM. Findings provide novel perspectives regarding PrEP barriers, the role of cultural homophily in behavior change interventions, and how interpersonal dynamics can impact staff fatigue, protocol fidelity, and research participation. Recommendations to prepare and support culturally congruent research staff are also provided.

Disparities in access to primary care, a key site for HIV prevention services, among gay and bisexual men in the United States

ABSTRACT U.S. HIV diagnoses disproportionately affect Non-Hispanic Black (NHB) and Hispanic gay and bisexual men. Using data from the National Health Interview Survey (2013-2018), we examined race and ethnicity and primary care access, an HIV prevention resource, among gay and bisexual men. The explanatory variable was NHB, Hispanic or Non-Hispanic White (NHW). Outcomes were primary care-specific usual place of care (potential access) and saw general doctor <12 months (realized access). We used multivariable logistic regression, adjusting for individual sociodemographic characteristics, health status, and care barriers. In sensitivity analysis, we examined general access (any place/doctor) and subgroups (1) NHB (2) has usual place of care. The sample included 1,858 adult, gay and bisexual men (unweighted). Nearly one-third self-identified as NHB or Hispanic. Compared to NHW men, NHB and Hispanic men were younger, with lower household income, and more care barriers (p < 0.05). NHB and Hispanic men had lower realized access (aOR 0.7058, p = 0.030) than NHW men. Potential access was lower for NHB only (versus NHW) and, among those with any usual place of care, NHB and Hispanic men versus NHW men. Lower primary care access for NHB or Hispanic, rather than NHW, gay and bisexual men, may reduce HIV prevention access.

Examining HIV organizational structures and their influence on engagement with young Black gay, bisexual, and other men who have sex with men in Atlanta, Georgia

Young Black gay, bisexual, and other men who have sex with men (YB-GBMSM) are disproportionately impacted by HIV. Structural influences on these disparities, including characteristics of the various organizations that serve YB-GBMSM living with HIV, remain understudied. We drew on Weick’s model of organizing to conduct and analyze qualitative interviews with 28 HIV service providers representing healthcare and community-based organizations in Atlanta, Georgia. Enactment of HIV service provision was described as following simplified and standardized responses-defined as “rules”, and/or more dynamic exchanges to formulate responses -otherwise known as “communication behavior cycles” (CBCs). Rules, including patient quotas and limited hours of operation, were viewed as rigid, out-of-touch, and inhibiting engagement with YB-GBMSM. CBCs, such as patient feedback loops and rejection of traditional hierarchies, fostered creative insights to combating the epidemic and increased levels of cultural awareness and community buy-in. Organizations should strive to enact CBCs, to foster culturally congruent approaches to service delivery for YB-GBMSM.

Racial differences in the association of undetectable HIV viral load and transportation to an HIV provider among men who have sex with men in Atlanta, Georgia: a health equity perspective

ABSTRACT There are inequities in HIV outcomes among Black gay, bisexual, and other sexual minority men who have sex with men (GBMSM) compared to GBMSM overall, including access to transportation to HIV care. It is unclear if the relationship between transportation and clinical outcomes extends to viral load. We assessed the relationship between transportation dependence to an HIV provider and undetectable viral load among Black and White GBMSM in Atlanta. We collected transportation and viral load information from GBMSM with HIV from 2016–2017 (n = 345). More Black than White GBMSM had a detectable viral load (25% vs. 15%) and took dependent (e.g. public) transportation (37% vs. 18%). Independent (e.g. car) transportation was associated with undetectable viral load for White GBMSM (cOR 3.61, 95% CI 1.45, 8.97) but was attenuated by income (aOR. 2.29, 95% CI 0.78, 6.71), and not associated for Black GBMSM (cOR 1.18, 95% CI 0.58, 2.24). One possible explanation for no association for Black GBMSM is that there are more competing barriers to HIV care for Black GBMSM than White GBMSM. Further investigation is needed to confirm whether 1) transportation is unimportant for Black GBMSM or 2) transportation interacts with additional factors not considered in this analysis.

Blackness preferred, queerness deferred: navigating sense of belonging in Black male initiative and men of color mentorship programs

This research focused on Black gay, bisexual, and queer men (BGBQM) and addressed the nuanced ways BGBQM experienced a sense of belonging within mentorship program settings, given their intersecting identities. Utilizing a novel research design that blended aspects of phenomenology and arts-based research, this study explored the following research questions: (1) How do BGBQM experience a sense of belonging in Black Male Initiatives (BMI) and Men of Color (MoC) mentorship programs? (2) What formative experiences do BGBQM develop in belonging to these mentorship program environments? Findings revealed approaches to how BGBQM experienced Blackness and queerness within mentorship programs in higher education settings. Being immersed in traditionally heteronormative enclaves, these men found solace in racial belonging yet experienced isolation due to their sexuality. This work provides key insight into addressing the pervasive ways mentorship programs need to dismantle heteronormativity and hypermasculine norms and ideals.

A quare theory analysis of black gay men college students at predominantly white institutions

Because there is a lack of research related to Black gay men college students, this study presents experiences of five participants who attend predominately White institutions (PWI). Framed by quare theory, in-depth semi-structured interviews were conducted for each participant. The thematic analysis demonstrates strong correlation to what it means to be a Black man in America who happens to be gay. To that end, it is with hope that this article informs researchers of the complexities and intersectionality of Black gay men college students and how they navigate collegial White spaces.

Homophobia in higher education: Untold stories from Black gay men in Jamaican universities.

Homophobia in higher education: Untold stories from Black gay men in Jamaican universities.

Unspoiling Identity: An Intersectional Expansion of Stigma Response Strategies

Sociological research has documented the various strategies employed by members of stigmatized populations to mitigate the negative social effects of these identities in everyday life. Furthermore, social and political campaigns have called for efforts toward destigmatizing identities. However, we know much less about how these groups come to aim for destigmatization and how individuals navigate multiple stigmas simultaneously or intersectional stigmas. Drawing on four years of ethnographic data, I use the case of Black gay men to articulate a form of stigma response that prioritizes the “stigmatized” rather than attending to the smoothness of interactions with a potential stigmatizer. I illustrate how the confines of multiple forms of stigma can make existing stigma response techniques, like passing and covering, untenable. I offer the term, “unspoiling” to account for the ways that some members of stigmatized populations reject the Goffmanian notion that these identities would be perpetual marks of inferiority. In so doing, I articulate an intersectional understanding of (de)stigmatization processes by attending to groups that are overlooked in mainstream efforts to focus solely on either race or sexuality. These findings add to the growing literature of stigma management response techniques and challenge the conversation of larger group destigmatization processes. This work reveals the contested process of stigma negotiation as young Black gay men debate the appropriate strategies to combat stigma in their local communities. Ultimately, unspoiling is a strategy borne out of tense discussions about the (un)acceptability of passing or covering one’s sexual identity.

Improvisation and Social Aesthetics

Improvisation and Social Aesthetics

Temporalities and racialization of young black gay men: between memories and images of future

Resumo Este artigo tem o objetivo de problematizar as singularidades presentes nas narrativas de jovens gays negros acerca das suas memórias e o que imaginam para o futuro. No contexto brasileiro, as suas experiências são atravessadas pelo racismo, homofobia e desigualdades sociais que se perpetuam ao longo das gerações ocasionando altas taxas de violência, exclusão e morte. Para compor essa discussão apresentamos reflexões, desde uma perspectiva dos estudos raciais e de gênero, de conversas realizadas com dois jovens negros e gays com o intuito de abordar as suas vivências e o que imaginam para o futuro. No diálogo construído com nossos interlocutores se revelam as singularidades presentes no modo de narrar as conexões e vínculos construídos em suas histórias de vida e como se relacionam com as narrativas de futuro, onde imaginam espaços de cuidado de si, lançando luz às resistências e possibilidades de existência encontradas pelos jovens.