HIV/AIDS Disparity between African-American and Caucasian Men Who Have Sex with Men: Intervention Strategies for the Black Church

Abstract

This manuscript examines the HIV/AIDS health disparity among African-American (AA) men who have sex with men (MSM) as compared to non-Hispanic White (NHW) MSM, and proposes faith-based intervention strategies as a means of reducing the disparity. Effective faith-based HIV/AIDS intervention programs to encompass AA MSM must include community-based participatory research; engage the faith community through data sharing; specifically target and equip church leaders in addition to laity; involve effective collaboration and compromise between public health practitioners and faith leaders; emphasize spirituality and compassion; utilize popular opinion leaders; and be intergenerational.

Reframing and Understanding the HIV Epidemic in MSM: Masculinity, Racism, and Homophobia

“…MSM reactions to the pressure to conform lead to the cultural phenomenon of being on the ''down-low,'' in which Black men engage in casual but secret sexual relationships with other men, while at the same time maintaining separate, often ''heterosexual'' lives and identities (Hill & McNeely, 2013). Hiding sexual orientation leads to less discussion between sexual partners regarding sexual history and safe sex practices, thus leading to increased rates of HIV transmission.…”

“…This stereotype can cause other races to avoid partnerships with Black MSM. Because HIV rates are high in Black male communities compared to other MSM communities, HIV transmission is consequently higher within this sexual network (Hill & McNeely, 2013).…”

“…When internalized, prevalent homophobic messages in mainstream society can lead to social isolation, nondisclosure of sexual orientation, and decreased access to HIV prevention and resources (Herrick et al, 2011). Individuals with internalized homophobia are more likely to feel disconnected from others of their same sexual orientation and have impaired decision-making (Hill & McNeely, 2013). Internalized homophobia leads to lower HIV status awareness and decreased utilization of preventative services (Hill & McNeely, 2013); an MSM with a damaged self-concept is much less likely to care about getting infected or infecting someone else.…”

“…Individuals with internalized homophobia are more likely to feel disconnected from others of their same sexual orientation and have impaired decision-making (Hill & McNeely, 2013). Internalized homophobia leads to lower HIV status awareness and decreased utilization of preventative services (Hill & McNeely, 2013); an MSM with a damaged self-concept is much less likely to care about getting infected or infecting someone else. By not disclosing their sexual orientation, MSM cannot benefit from support groups and outreach in the gay community.…”

“…MSM who internalize homophobia have been shown to have a lower awareness and utilization of HIV prevention services (Hill & McNeely, 2013). Negative encounters with medical personnel are associated with nondiscussion and mistrust of health care providers and the health care system in general.…”