Negotiating social and health risks in the pursuit of sexual relationships in physical and virtual spaces: A qualitative study of Black Men who have Sex Men (BMSM) in New York City

 

 

Background: Black Men who have Sex with Men (BMSM) have the highest incidence rates of HIV in the US. Sexual relationships for BMSM entail not only health risks but significant social risks. Physical and virtual spaces influence the way in which BMSM perceive and prioritize different kinds of social and health risks.

Methods: Twenty-six BMSM from NYC completed three 90-minute in-depth interviews. Interviews focused on sexuality, social status and health risks, and perceptions of safety and danger in physical and virtual spaces. Participant-observation was conducted at events, parks, streets, and NGOs. Data were triangulated, coded and analysed at the intersection of three axes: spaces (physical and virtual), health risk (HIV, STIs and drugs), and social risk (reputation and status).

Results: Men sought sexual encounters on hook-up apps, websites, parks, drop-in centers for LGBT youth, supermarkets, bars/cubs and gyms. Cruising spots and parks were perceived as discreet, socially safe spaces, despite the possibility of assault. Drop-in centers were preferred among men who identified as more feminine. The internet was seen as a safe space for the negotiating transactional sex and finding “clean” men (HIV-negative).

 

Conclusion: Pursuit of sexual partners among BMSM in New York takes place in a social landscape rife with hostility which can lead men to take health risks. Public health interventions focused on BMSM could address stigma and discrimination at the community level using (1) social media technology to facilitate early condom-use negotiation (2) partnering with schools and law enforcement to reduce sexuality related verbal or physical violence.