Learning from "The Forgotten Group": Lessons from HIV prevention research and programs with Black heterosexually active men

Issues: Ten years ago, Exner et al. called heterosexual men “The Forgotten Group” in HIV prevention interventions. Little has changed since then, particularly with HIV research and interventions for Black heterosexually active men (BHM). Although HIV/AIDS cases due to “high risk heterosexual contact” (HRHC) are highest among Black men; HIV is more efficiently transmitted from men to women; and HRHC accounts for 73% and 66% of HIV/AIDS cases respectively among Black women, research on the specific HIV prevention issues and needs of BHM remains virtually nonexistent.

Description: This presentation focuses on lessons learned from the qualitative phase of NIH/NICHD-funded study of BHM's risk behaviors in Philadelphia. Participants include a predominantly low-income sample of 56 BHM between the ages of 18 to 44. The goal of the 3-year mixed methods study is to examine the effects of gender role norms, sexual scripts, structural factors and psychological factors (e.g., trauma, resilience) on condom use.

Lessons Learned: These include: (1) findings that structural factors such as poverty, unemployment, racism, and incarceration appear to impose considerable stress and psychological distress that pose barriers to condom use; (2) the importance of cultural competence logistics such as transcriptionists, issues of representation, and a community advisory board; and (3) simply asking BHM about their lives and experiences may serve a therapeutic function for BHM in ways that have implications for HIV interventions and programs.

Recommendations: More research and interventions focused on the psychosocial and structural factors that increase and decrease HIV risk in BHM are desperately needed.