Bringing the message: College black men who have sex with men on sex, sexuality and how to spin HIV prevention

Background: In 2005, 1,806 new HIV infections were reported in North Carolina. Although only 21.8% of North Carolinians are Black, this group represented two thirds of new HIV cases reported in the state in 2005. Among men aged 13-24 years, Blacks accounted for over 70% of the cases. Methods: In order to better understand the forces driving the HIV epidemic among young Black MSM in North Carolina, we conducted three focus groups (n= 17) and a club survey (n=40) with college age students. The focus groups sought to capture a realistic perspective on issues faced by young Black male college students regarding STDs/HIV and sexual health. Focus groups were transcribed verbatim and coded for themes using an open coding schema. Results: Participants described early messages about sexuality and how these messages affect Black MSM. The majority agreed that homophobia in the Black community was a deterrent to prevention efforts. Mistrust of white people, the burden of racism, stigma around sexuality, and hyper-sexualized ideas about Black masculinity were mentioned as contributors to the increase of HIV. Conclusions: Our research informs HIV prevention programs specifically targeting Black MSM college students. Recommendations for programs include having Black MSM involved in program design and implementation, increasing confidentiality in HIV testing locations on campus, and incorporating HIV information into college coursework.