HIV Risk Factors and Identity Dynamics Among Black Sexual Minority Men
Summary
In epidemiological terms, Black sexual minority men experience disproportionate incidence and prevalence of HIV, influenced by interrelated individual, interpersonal, community and structural determinants. Elevated prevalence within social and sexual networks, socioeconomic marginalisation, intersectional stigma associated with race, sexuality and HIV, and barriers to culturally competent healthcare converge to heighten vulnerability. Mental health challenges and substance use further compound risk and can undermine engagement with prevention and care services.
Identity dynamics shape risk and resilience. Negotiation of racial and sexual orientation identities may lead to concealment of sexual behaviour, social isolation or retreat into alternative kinship structures. Community networks, exemplified by the House Ball Community, offer affirming spaces that bolster self-efficacy, social support and adherence to preventive behaviours.
Biomedical interventions — including pre-exposure prophylaxis, routine diagnostic testing and prompt antiretroviral therapy — have demonstrated efficacy in reducing transmission. However, uptake remains constrained by mistrust, stigma and limited access. Emerging strategies favour status-neutral, multilevel interventions that integrate structural reforms, mental health support and identity-affirming approaches to holistically address both prevention and care.
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HIV Risk Factors and Identity Dynamics Among Black Sexual Minority Men publication trend
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Technical terms
Pre-exposure prophylaxis (PrEP): Biomedical intervention involving administration of antiretroviral medication to uninfected individuals to prevent HIV acquisition.
Viral suppression: Reduction of HIV viral load in the blood to undetectable levels through consistent antiretroviral therapy.
Intersectional stigma: Concurrent experience of multiple forms of social prejudice based on race, sexual orientation and HIV status that compounds vulnerability.
House Ball Community: Kinship network rooted in performance balls that provides social support, affirmation and cultural identity for many Black sexual minority individuals.
Status-neutral framework: Public health approach that integrates HIV prevention and care services without presuming an individual’s HIV status, aiming to reduce stigma and facilitate engagement.
References
- Leveraging family-based assets for Black men who have sex with men in House Ball Communities: Protocol for a cluster randomized controlled trial. PLOS ONE (2023).
- “The Awesomeness and the Vastness of Who You Really Are:” A Culturally Distinct Framework for Understanding the Link Between Spirituality and Health for Black Sexual Minority Men. Journal of Religion and Health (2021).
- Combining the HYM (Healthy Young Men’s) Cohort Study and the TRUTH (A Trans Youth of Color Study): Protocol for an Expanded Mixed Methods Study Renewal. JMIR Research Protocols (2022).
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