226443 Migration Experiences of HIV-Positive, English-Speaking, West Indian men who have sex with men in New York City

Tuesday, November 9, 2010 : 1:15 PM - 1:30 PM

Jessica Adams-Skinner, MPH, EdD , Columbia University School of Social Work, HIV Center for Clinical and Behavioral Studies at the NYS Psychiatric Institution and Columbia University, New York, NY
Joanne E. Mantell, PhD, MSPH , HIV Center for Clinical and Behavioral Studies & Mailman School of Public Health, Columbia University, New York, NY
Theo G. M. Sandfort, PhD , HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
Steve Hemraj, BS , Community Healthcare Network, New York, NY
Emily Smith, BA , HIV Center for Clinical and Behavioral Studies, Mailman School of Public Health, New York, NY
Background: West Indian men who have sex with men (WIMSM) often migrate to the US to escape the social injustices (stigma, homonegativity, heterosexism) sustained in their countries of origin. These social injustices often contribute to their inhibited pre-migration sexual experiences, which, in turn, may affect sexual risk behavior in their post-migration gay-friendly, social spaces.

Methods: We conducted in-depth, semi-structured interviews with 20 WIMSM recruited from 5 types of social spaces in NYC to explore their pre- and post-migration experiences. Data were analyzed using a modified grounded theory approach with QSR NVivo 8.

Results: WIMSM reported a heightened sense of stigma and homonegativity in their countries of origin, reinforced by religious beliefs. This led to sexual inhibition (sexual secrecy, masking of sexuality through heterosexual relationships, and periods of sexual abstinence) as a coping mechanism. Most men reported migrating to the US to escape homonegativity and heterosexism, and to achieve greater sexual freedom. Opportunities in the US to frequent gay-friendly social spaces were seen as liberating and conducive to exploring one's sexuality. However, men reported they were less likely to HIV disclose (fear of inciting physical violence) and initiate condom use (sign of being HIV+) in such settings.

Conclusion: We need to better understand the consequences of pre-migration experiences in planning effective interventions for WIMSM migrants. Because these pre-migration experiences often shape post-migration sexual risk behavior, we need to focus on the intersection of pre/post-migration experiences to reduce HIV acquisition and transmission in the US areas to which WIMSM migrate.

Learning Areas:
Assessment of individual and community needs for health education
Diversity and culture
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Discuss the the pre-migration social injustices (stigma, homonegativity, heterosexism)experienced by West Indian men who have sex with men and how these experiences aften contribute to their post-migration sexual behavior in New York City.

Keywords: Immigrants, Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Principal Investigator on this study which was funded by NIMH through Columbia University School of social Work
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.