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There are 4 possible explanations, which are not mutually exclusive: By exploring these possibilities more deeply, we can increase our understanding of the apparent disparity between behavioral risks and outcomes while at the same time improving the design and implementation of prevention programs that address the specific needs of BMSM. Measures, surveys, and instruments may be culturally inappropriate for BMSM; interviewers may not be race- and gender-concordant with or may not be properly trained to interview BMSM; instruments may use language or terminology that does not resonate with BMSM; research settings may not be comfortable environments for open discussion with and responses by BMSM.

Meanwhile, BMSM research participants may 1 be unwilling to use certain sexual orientation labels on surveys for fear of discrimination, 2 distrust or fear researchers, 3 fear that confidential information about their sexual behavior will be disclosed, or 4 report what they think researchers want to hear.

To solve these problems, researchers must conduct more qualitative research with BMSM in environments that provide a more comfortable atmosphere in which to talk openly about sensitive sexual issues. Such research will ultimately guide the development of culturally appropriate assessment techniques.

Employing BMSM as research interviewers may lead to deeper exploration of the unique social situation of being both Black and homosexual through common experiences shared by interviewer and subject.

Likewise, conducting such research away from clubs, bars, parks, and other public or sexually identified venues may yield more honest responses. HIV prevention initiatives based on a more accurate reporting of sexual behavior will more adequately reflect the life experiences of BMSM. Additionally, interventions should be offered in familiar and empowering settings. Thirty-two Black men from various socioeconomic backgrounds were surveyed before and after participating in the CTCA program.

Organizations such as The Balm in Gilead and Interfaith HIV Network hold conferences, provide capacity building to churches and pastors, disseminate HIV educational materials, and create a medium by which issues of sexuality and HIV can now be discussed in the Black faith-based community. Despite condemnation of homosexuality from many pulpits, church and spirituality play a pivotal role in the lives of many BMSM.

However, relationships between the social construct of Black masculinity, sexual identification, and sexual behavior decisionmaking have not been adequately explored. BMSM are more likely to identify as heterosexual or bisexual and less likely to identify as gay than their White counterparts. A deeper description of masculinity and gender roles among BMSM is needed.

This young man abandoned use of a condom, despite his awareness of HIV risk, in pursuing an ideal of Black masculinity in a sexual partner. Further exploration of these dynamics is needed to explain the gap between HIV knowledge and behavior.

BMSM are therefore less able to inform their sexual partners and perhaps more likely to have acute infection or a higher viral load than other MSM. Many participants—already struggling with displacement from both the gay White community for being Black and from the Black community for being homosexual—said that they had experienced additional racism and sexual prejudice with all levels of medical staff in medical settings.

This experience influenced their health care utilization, communication, and medication adherence behaviors. We concluded that access to and quality of health care services received by BMSM can be influenced by both the internalization of their everyday discriminatory experiences and negative interactions with medical staff.

Delays in HIV diagnosis and treatment can lead to more rapid disease progression and increased infectivity, ultimately increasing risk among sexual networks of BMSM. These findings demonstrate the need for a holistic approach to addressing increased HIV infectivity among BMSM that evaluates the complex relationship between possible biological cofactors, such as high STD prevalence and high viremia and social variables, such as racism, sexual prejudices, and poverty, that can influence access to and adherence with medial care.

For example, for HIV-seropositive gay men, traumatic events, such as the death of a partner, or attributions of negative experiences to self can predict faster CD4 decline and progression of disease. While low self-esteem and the internalization of racism and sexual prejudice may influence mental health and selection of specific sexual partners and behaviors, immune system responses to these stressors may also explain increased susceptibility to HIV infection among BMSM.

Twenty-two years into the HIV epidemic, we find ourselves at a watershed. The next steps we take with regard to BMSM will shape the evolution of prevention and intervention programs and policies in the years to come. Robust research on and effective outreach to BMSM requires the identification of diverse recruitment venues to reach and serve a population that is equally diverse in its sexual experiences and identification.

Additionally, it requires methodologies that minimize biased self-reporting of sexual behaviors and research instruments that reflect culturally specific variables influencing this population.

Our assessment of risk behaviors and selection of sexual partners among BMSM needs to take into account distinct meanings of masculinity in relation to race and culture.

Our understanding of infectiousness and susceptibility among BMSM must be informed by considerations of the interactions between the immune system, psychology, culture, and social context, including the health care setting—where racial and sexual prejudice may impair delivery of services, helping to perpetuate rather than ameliorate the HIV epidemic.

Acknowledgments Thanks to Michael Gross, PhD, for his valuable suggestions on revisions to this editorial. Centers for Disease Control and Prevention.

HIV incidence among young men who have sex with men—seven US cities, — Unrecognized HIV infection, risk behaviors, and perceptions of risk among young black men who have sex with men—six US cities, — HIV risk differences between African-American and white men who have sex with men. J Natl Med Assoc. Coming out and AIDS-related high risk sexual behavior. Conceptual and logical issues in theory and research related to black masculinity.

West J Black Stud. Am I a man?: Concurrent infections and HIV pathogenesis. Acute Sexually transmitted infections increase himan immunodeficiency virus type 1 plasma viremia, increase plasma type 2 cytokines, and decrease CD4 cell counts.

J Acquir Immune Defic Syndr. Causal attributions predict rate of immune decline in HIV-seropositive gay men. Immune system changes after the death of a partner in HIV-positive gay men.

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Black Men & White Men on Dating



Black man man sex white

There are 4 possible explanations, which are not mutually exclusive: By exploring these possibilities more deeply, we can increase our understanding of the apparent disparity between behavioral risks and outcomes while at the same time improving the design and implementation of prevention programs that address the specific needs of BMSM.

Measures, surveys, and instruments may be culturally inappropriate for BMSM; interviewers may not be race- and gender-concordant with or may not be properly trained to interview BMSM; instruments may use language or terminology that does not resonate with BMSM; research settings may not be comfortable environments for open discussion with and responses by BMSM. Meanwhile, BMSM research participants may 1 be unwilling to use certain sexual orientation labels on surveys for fear of discrimination, 2 distrust or fear researchers, 3 fear that confidential information about their sexual behavior will be disclosed, or 4 report what they think researchers want to hear.

To solve these problems, researchers must conduct more qualitative research with BMSM in environments that provide a more comfortable atmosphere in which to talk openly about sensitive sexual issues. Such research will ultimately guide the development of culturally appropriate assessment techniques. Employing BMSM as research interviewers may lead to deeper exploration of the unique social situation of being both Black and homosexual through common experiences shared by interviewer and subject.

Likewise, conducting such research away from clubs, bars, parks, and other public or sexually identified venues may yield more honest responses. HIV prevention initiatives based on a more accurate reporting of sexual behavior will more adequately reflect the life experiences of BMSM. Additionally, interventions should be offered in familiar and empowering settings.

Thirty-two Black men from various socioeconomic backgrounds were surveyed before and after participating in the CTCA program. Organizations such as The Balm in Gilead and Interfaith HIV Network hold conferences, provide capacity building to churches and pastors, disseminate HIV educational materials, and create a medium by which issues of sexuality and HIV can now be discussed in the Black faith-based community.

Despite condemnation of homosexuality from many pulpits, church and spirituality play a pivotal role in the lives of many BMSM. However, relationships between the social construct of Black masculinity, sexual identification, and sexual behavior decisionmaking have not been adequately explored.

BMSM are more likely to identify as heterosexual or bisexual and less likely to identify as gay than their White counterparts. A deeper description of masculinity and gender roles among BMSM is needed. This young man abandoned use of a condom, despite his awareness of HIV risk, in pursuing an ideal of Black masculinity in a sexual partner. Further exploration of these dynamics is needed to explain the gap between HIV knowledge and behavior. BMSM are therefore less able to inform their sexual partners and perhaps more likely to have acute infection or a higher viral load than other MSM.

Many participants—already struggling with displacement from both the gay White community for being Black and from the Black community for being homosexual—said that they had experienced additional racism and sexual prejudice with all levels of medical staff in medical settings. This experience influenced their health care utilization, communication, and medication adherence behaviors.

We concluded that access to and quality of health care services received by BMSM can be influenced by both the internalization of their everyday discriminatory experiences and negative interactions with medical staff. Delays in HIV diagnosis and treatment can lead to more rapid disease progression and increased infectivity, ultimately increasing risk among sexual networks of BMSM.

These findings demonstrate the need for a holistic approach to addressing increased HIV infectivity among BMSM that evaluates the complex relationship between possible biological cofactors, such as high STD prevalence and high viremia and social variables, such as racism, sexual prejudices, and poverty, that can influence access to and adherence with medial care.

For example, for HIV-seropositive gay men, traumatic events, such as the death of a partner, or attributions of negative experiences to self can predict faster CD4 decline and progression of disease. While low self-esteem and the internalization of racism and sexual prejudice may influence mental health and selection of specific sexual partners and behaviors, immune system responses to these stressors may also explain increased susceptibility to HIV infection among BMSM.

Twenty-two years into the HIV epidemic, we find ourselves at a watershed. The next steps we take with regard to BMSM will shape the evolution of prevention and intervention programs and policies in the years to come. Robust research on and effective outreach to BMSM requires the identification of diverse recruitment venues to reach and serve a population that is equally diverse in its sexual experiences and identification.

Additionally, it requires methodologies that minimize biased self-reporting of sexual behaviors and research instruments that reflect culturally specific variables influencing this population. Our assessment of risk behaviors and selection of sexual partners among BMSM needs to take into account distinct meanings of masculinity in relation to race and culture.

Our understanding of infectiousness and susceptibility among BMSM must be informed by considerations of the interactions between the immune system, psychology, culture, and social context, including the health care setting—where racial and sexual prejudice may impair delivery of services, helping to perpetuate rather than ameliorate the HIV epidemic. Acknowledgments Thanks to Michael Gross, PhD, for his valuable suggestions on revisions to this editorial.

Centers for Disease Control and Prevention. HIV incidence among young men who have sex with men—seven US cities, — Unrecognized HIV infection, risk behaviors, and perceptions of risk among young black men who have sex with men—six US cities, — HIV risk differences between African-American and white men who have sex with men. J Natl Med Assoc. Coming out and AIDS-related high risk sexual behavior.

Conceptual and logical issues in theory and research related to black masculinity. West J Black Stud. Am I a man?: Concurrent infections and HIV pathogenesis. Acute Sexually transmitted infections increase himan immunodeficiency virus type 1 plasma viremia, increase plasma type 2 cytokines, and decrease CD4 cell counts. J Acquir Immune Defic Syndr. Causal attributions predict rate of immune decline in HIV-seropositive gay men. Immune system changes after the death of a partner in HIV-positive gay men.

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