142nd APHA Annual Meeting and Exposition

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“It's Crazy Out There. You Gotta Strap Up”: Black Heterosexual Men's Discursive Constructions of Sexual HIV Risk and Condom Use

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 12:45 PM - 1:00 PM

Lisa Bowleg, PhD , Department of Psychology, The George Washington University, Washington, DC
Andrea L. Heckert, Ph.D. , Department of Psychology, The George Washington University, Washington, DC
Tia L. Brown , Department of Psychology, The George Washington University, Washington, DC
Jenne Massie, MS , Department of Psychology, The George Washington University, Washington, DC
Background: Black heterosexual men (BHM) ranked among the populations most-affected by HIV incidence in 2010, underscoring the need for innovative methodological approaches to inform HIV risk reduction efforts for BHM. HIV prevention discourse analysis research has flourished internationally, but interestingly, not in the U.S. Discourse analysis asserts that language is functional in the sense that people use language in a variety of ways to construct versions of the social world. We used discourse analysis to examine: (1) how BHM discursively construct sexual HIV risk and condom use; (2) the action orientation of those discourses; (3) their discursive strategies; and (4) the role of discursive context (individual interview vs. focus group).

Methods:  Informed by Potter and Wetherell’s (1987) guidelines for discourse analysis, we analyzed data from individual interviews (n = 30) and four focus groups (n = 26) conducted with self-identified Black/African American heterosexual men, ages 18 to 44 in Philadelphia, PA.  

Results:  Discursive constructions about sexual HIV risk included: “gotta be safe”; and the public health HIV prevention discourse.  Discursive constructions about condom use were: condom mandate for first time sex; relationship/trust/knowledge construction; condom mandate for strictly casual sex; and women’s blame for STIs/responsibility for safer sex.  Analyses showed that discursive context shaped how participants talked about sexual HIV risk and condom use.

Conclusions: There is an urgent need for U.S. public health HIV prevention discourses that reflect the epidemiological reality of BHM’s HIV risk, and the real-world relationship contexts of ongoing sexual relationships with ex-wives, ex-girlfriends or “baby mamas.”

Learning Areas:

Assessment of individual and community needs for health education
Diversity and culture
Social and behavioral sciences

Learning Objectives:
Describe the central tenets of discourse analysis Demonstrate how Black men’s discursive constructions about sexual HIV risk and condom use can be used to design HIV interventions

Keyword(s): HIV Risk Behavior, Men’s Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI of the NIH/NICHD grant that funded this study.
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.

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