Perspectives of being a Black man among African American MSM/W: Implications for HIV prevention

Background: Male-to-male sexual contact remains the primary transmission category among African Americans. However, many African American MSM also have female partners. While many identify strongly with the African American community and consider ethnicity a primary identity, barriers to HIV prevention may be associated with this relationship. Methods: Seven focus groups with 46 African American non-gay identified men who have sex with men and women (MSM/W) were conducted. Recruitment included fliers and direct outreach throughout Los Angeles County. Interpretative Phenomenological Analysis (IPA), concerned with interpreting personal perceptions, was used to assess responses to two main questions, “What does it mean to be an Black man?” and “Are there cultural and gender expectations for Black men?” The perceived meaning of these experiences was a primary focus. Results: Two opposing themes were identified: (1) the placement of positive values on being a Black man and belonging to the African American community; and (2) the expression of frustration at negative perceptions of African American communities, heightened by gender and sexual discrimination. Stigma of being a Black gay male was a major concern. Conclusions: As a Black man, connection to the African American community provides protection against racism, discrimination and social oppression. Desire to remain healthy and to protect others was a concern. In contrast, negative images of being a Black male diminished the value participants placed on their health and contributed to poor decision-making. Future interventions must consider the socio-cultural context of African American MSM/W if realistic risk-reduction interventions are to be developed.