“All We Had Were the Streets”: Lessons Learned From a Recreation-Based Community Health Space for Young Black MSM and Trans Women Across the HIV Prevention and Care Continuum

Abstract

Young Black men who have sex with men (MSM) and transgender people experience disparities in HIV incidence and HIV outcomes. To effectively engage these communities in HIV-related programming, we developed a recreation-based community health space. We sought to examine the challenges and successes in implementing this program. Qualitative data were collected from federal progress reports and by a process evaluator who recorded interviews with staff, stakeholders, and participants. These data were coded for themes related to barriers and successes. We consolidated themes into four key domains: community engagement, service provision, stigma, and violence. Each of these domains was determined to significantly affect programmatic success during the implementation period. Young Black MSM and transgender people experience stigmas that pose challenges to effective engagement in HIV-related programming. These lessons learned offer strategies for community engagement and for addressing violence and stigma to maximize programmatic effectiveness.

Development of a Black Caucus within the HIV Prevention Trials Network (HPTN): Representing the Perspectives of Black Men Who Have Sex with Men (MSM)

“…Cultural responsiveness often had various meanings for HPTN 061 in that it was defined as addressing the socio-cultural contexts of Black MSM culture and implementing a clinical trial within this population as a basis to determine its feasibility. Adapting the model of including culturally responsive staff in clinical trials and prevention research will begin to improve future protocols and ensure acceptability and adaptability within historically-underserved communities [39,41]. These important constituencies will begin to place research in both racial and cultural contexts, provide scientific expertise, and strengthen culturally-relevant theoretical and methodological frameworks.…”

“…Provider bias, past negative experiences with the healthcare system, perceived racist ideologies, and HIV-related conspiracy theories serve as other factors that may impede Black MSM from participating in clinical research studies [12,18,25,28,[36][37][38]. Research has also documented the inadequate incorporation of Black researchers in conducting prevention and clinical studies focused on Black communities [39][40][41]. Moreover, for Black MSM who are willing to participate in clinical research studies, barriers to optimal recruitment and retention are common (e.g., inadequate transportation services, insufficient participant incentives, interferences with work commitments, and insufficient capacity to provide culturally-responsive services on the part of study staff can impede recruitment and retention efforts) [37,42,43].…”

HIV Care Continuum Interventions for Transgender Women: A Topical Review

“…15,16 Structural interventions are needed to create de-stigmatized and inclusive HIV clinical spaces with staff members who are transgender women themselves, health care providers trained in gender-affirming treatments, and services to meet legal, social, and behavioral health needs. 17,18 Although HIV prevention studies with transgender women have been reviewed, 19 to our knowledge, no review of interventions for transgender women with HIV has been conducted. We searched the peer-reviewed literature from the past 10 years for interventions designed to help transgender women diagnosed with HIV progress along the HIV care continuum from linkage to care to viral suppression.…”

Racial and Sexual Minority Scholar Positionality: Advancing Health Status and Life Opportunity Among Sexual Minority Men of Color

“…However, a singular focus on HIV among BLSMM represents a missed opportunity to focus on their overall health status and life opportunity (HSLO). Evidence indicates that BLSMM experience adverse outcomes related to HSLO in a range of domains, including physical and psychosocial health (English et al, 2020; Wade & Harper, 2017), substance use (Carrico et al, 2020), education (Brockenbrough, 2016; McCready, 2004), housing (Adams et al, 2018), and employment (Hill et al, 2020). For BLSMM, adverse outcomes in these domains contribute to inequality affecting long-term HSLO trajectories not unlike their similar age peers (Gamoran & Bruch, 2017; Irons, 2019).…”

“…To date, the dominant trend in health scholarship focusing on BLSMM is to investigate their sexual and behavioral health, with studies often overlooking how improving HSLO may positively influence both outcomes (Auerbach et al, 2011; Hill et al, 2020; Seeley et al, 2012; Wade & Harper, 2017). Although studies identify some strategies for improving HSLO, including improving education (Brockenbrough, 2016), employment (Hill et al, 2020), housing (Adams et al, 2018), and psychosocial outcomes (Felner et al, 2018; Reed et al, 2019), approaches highlighting the influence of racial, ethnic, and sexual minorities in science and public health, are needed. The present article develops a multilevel conceptual model of scholar of color positionality and contends that the perspectives of underrepresented populations, including BLSMM scholars and health service providers are critical, as these perspectives may inform HSLO-related research and public health strategies for improving HSLO among BLSMM.…”