"Invisible Men" no more: Including all sexually active Black men in community-based sexual health research

Issues: Despite an HIV racial disparity among Black men that transcends sexual behavioral risk categories and an international HIV prevention focus that emphasizes targeting all sexually active men, the United States continues to exclusively sensationalize and target individual behavioral risks among Black men who have sex with men (MSM) and secretly bisexual (“down low”) men. This approach not only stigmatizes homosexual behavior, but essentially ignores how social/structural contexts factor in the lives of all sexually active Black men and their sexual decision-making. Description: Project ADOFO involves an interdisciplinary approach to conducting sexual health and HIV prevention research with Black men living in varied geographical contexts and representing diverse sexual behavioral categories. The project represents a community and organizational-based collaboration that emphasizes exploring the broader social and structural contexts factoring into the HIV risk protective and promoting behavior of all Black men. We conducted 90 one-on-one interviews with men in metropolitan Atlanta, Columbus and Valdosta, Georgia, investigating themes of racism, geography, trauma, mental health, coping strategies, sexual behavior and healthcare utilization practices. Community and organizational involvement was instrumental in the development of research instruments, guidance of recruitment venues and plans for data dissemination. Lessons Learned: A broader approach to sexual health and HIV prevention for Black men was well received by our community and organizational collaborators, advisory board and study participants alike. Involving community stakeholders from the outset in an innovative HIV research project highlighting sexual health among Black men was invaluable to successful acceptance and engagement in the study. Next Steps: Developing community-based sexual health and HIV prevention research efforts that include all Black men is an idea whose time has come, and is essential to ensure the development of culturally competent health initiatives. We should consider addressing the broader social contexts of Black men's lives as a means to improving their sexual health a social justice priority, regardless of sexual behavioral risk category or identification labels.