Our Lives Photovoice: Using digital photography to explore sexual health of non-gay identified African American men who have sex with men

African American men who have sex with men (MSM) and who do not identify as gay (NGI) are at high risk for HIV infection. This paper presents the results of the photovoice component (a participatory action research method) of a two-tiered qualitative study design that explored the perceptions of NGI African American MSM in the San Francisco Bay Area regarding the social, cultural, community, and family influences associated with their HIV risk and their general sexual health. Major themes that emerged from the photographs and discussions fell into three main categories: (1) The importance of a black identity, (2) factors inhibiting HIV prevention, and (3) factors that maintain health or promote health. Through their photographs, the men in this study explored the challenges and difficulties associated with maintaining their sexual health, in addition to describing the health promoting factors that reinforce wise choices in their everyday lives. Because this population has experienced multiple layers of stigmatization, we were not entirely confident at the onset of this study that we would be able to recruit a group of men willing to participate in multiple group sessions aimed at fostering a critical dialogue around black men's sexual health. We were gratified that men were not only willing to come together, but were highly motivated to do so. Seven of the 25 men who were interviewed during the first phase of the study volunteered to participate in photovoice. Along with a presentation of results, advantages of using digital photography are discussed.