Drugs, Sex, Condoms: Cultural Messages Influencing HIV+ Black Gay/Bisexual Male Youth

Background:

Young Black gay/bisexual men (YBGM) have been disproportionately affected by HIV/AIDS in the U.S., thus it's important to develop secondary prevention interventions for HIV+ YGBM.

Methods:

Qualitative interviews were conducted with 36 HIV+ YBGM ages17-24, recruited from four geographically/demographically diverse clinics. Questions explored ethnic/cultural messages HIV+ YBGM receive that either promote or discourage substance use, condom use, and sexual activity.

Results:

Data revealed that cultural messages emanate from multiple sources: family, peers, sexual partners, community/neighborhood, and broader society. Regarding substance use, most messages promoted use: marijuana viewed as natural/not a drug, common community images of use, easy accessibility, and media images of Black men using; with only one message discouraging use: negative images of family substance abuse. Messages promoting non-use of condoms included: increased pleasure with non-use, penis too big, dealing with consequences later, and only used for pregnancy prevention; whereas those promoting condom use included: BGM featured in porn using condoms; high rates of HIV/STIs among BGM, Black-specific television messages promoting use. Messages regarding sexual activity were all risk promoting: pressure to be dominant, inactivity as a sign of weakness, silence due to religion, promotion of irresponsibility, overexposure of sexuality in media, insatiability, objectification (by partners), monogamy viewed as only for White gay men.

Conclusions:

These data demonstrate the wide range of cultural messages related to risk behaviors that may influence HIV+ YBGM. Future secondary prevention programs for this population should assist with developing a critical consciousness regarding these messages in order to promote health enhancing behaviors.