Promoting Comprehensive HIV Services for Black and Latino Young Men who Have Sex with Men (YMSM) in the Detroit Metro Area

In the Detroit Metro Area (DMA), Black and Latino YMSM (BLYMSM), ages 13-29, account for 16% of all HIV/AIDS cases, echoing data indicating this population's increasing infection rate across the United States. Seeking to address this alarming trend, we developed an academic-community partnership, United for HIV Integration and Policy (UHIP), with the goal of creating policy recommendations that address structural and community factors increasing BLYMSM vulnerability to HIV/AIDS.

We interviewed 50 key stakeholders based on their intersectoral work with Black and Latino youth, LGBT populations, and/or involvement in HIV service provision. We conducted in-depth interviews focused on stakeholders' professional roles, perspectives on the HIV/AIDS epidemic, and recommendations to reduce BLYMSM's HIV risk. Using thematic analyses, we sought to identify the structural factors limiting BLYMSM's access to care and services in the DMA.

Stakeholders identified homophobia and HIV/AIDS stigma as structural factors limiting BLYMSM's access to tailored, comprehensive services offered through LGBT and HIV/AIDS organizations. Stakeholders also discussed how current HIV funding mechanisms make intersectoral collaboration difficult, do not link HIV/AIDS prevention and care to other public health problems, and compartmentalize service provision to specific populations or health outcomes.

We propose policies that reduce these structural barriers and improve service delivery for BLYMSM in the DMA. These policies include (1) creating funding mechanisms that encourage intersectoral partnerships, (2) developing a service network that facilitates BLYMSM's access to comprehensive care, and (3) requiring training in sexuality and HIV education among providers working in these prevention and care organizational networks.