Perceived HIV Risk Among Black MSM Who Maintain HIV-Negativity in New York City
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ORIGINAL PAPER
Perceived HIV Risk Among Black MSM Who Maintain HIV‑Negativity in New York City Jagadisa‑devasri Dacus1,2 · Theo G. M. Sandfort1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Black men who have sex with men (MSM) are disproportionately burdened by the HIV epidemic. Although there has been an increased focus on reducing HIV prevalence in Black MSM, little attention has been given to how and why Black MSM are able to remain HIV-negative, beyond believing that they are lucky. The purpose of this qualitative study was to explore how Black MSM try to stay HIV-negative. Guided by constructivist grounded theory and a strengths-based approach, we conducted in-depth interviews to explicate how Black MSM demonstrate resilience by staying seronegative amidst high seroprevalence. Results from this study suggest that it is their perceptions of HIV risk that translate into protective strategies that enable them to prevent infection. Our study offers insight into their reasoning processes that guide their efforts to stay HIV-negative. Keywords Black MSM · HIV-negative · Perceptions of risk · Strengths-based · Qualitative Resumen Los hombres Afro-Americanos que tienen sexo con hombres (HAASH) son desaproporcionalmente afectados por la epidemia del VIH. Aunque ha habido un mayor enfoque en la reducción del VIH en HAASH, no se ha prestado tanta atención a los que son VIH negativos. Muchos HAASH son seronegativos y es importante identificar como siguen siéndolos a pesar de que HAASH crean que es por suerte. El propósito de este estudio cualitativo fue explorar como HAASH tratan de mantenerse VIH negativos. Guiados por “constructivist grounded theory” y un enfoque en las fortalezas, llevamos a cabo entrevistas individuales para explicar como pueden mantenerse seronegativos a pesar de una alta seroprevalencia. Los resultados de este estudio sugieren que sus percepciones del riesgo son los que se convierten en estrategias de protección que les permite prevenir la infección. Nuestro estudio ofrece información sobre sus procesos de razonamiento que guían sus esfuerzos para mantenerse VIH negativos.
Introduction HIV surveillance data continue to indicate that Black gay, bisexual, same gender loving, and other men who have sex with men (MSM) carry the greatest HIV burden in the US [1]. When Black MSM are examined by age groups, the epidemic is most burdensome among those aged 13–29 * Jagadisa‑devasri Dacus [email protected] 1
HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, USA
New York State Psychiatric Institute, 1051 Riverside Drive, Unit 15, New York, NY 10032, USA
2
[2–4]. The primary mode of HIV transmission for Black MSM continues to be condomless anal sex (CAS) [1, 2]. Even though HIV seroprevalence is high in Black MSM, research has shown that Black MSM engage in less high risky sex-related behaviors than their non-Black MSM counterparts [5–7]. For instance, they are more likely to report
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