“My Sexuality…It Creates a Stress”: HIV-Related Communication Among Bisexual Black and Latino Men, New York City
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Men who have sex with men and women (including bisexual men) comprise 35% of all men who have sex with men (MSM) in the U.S. It is estimated that 121,800 men who have been bisexually active within the past year are living with HIV in the U.S. Communication about HIV may result in risk-reduction behaviors. However, little is known about the nature or context for HIV prevention communication among bisexual men, particularly for blacks and Hispanic/Latinos who are disproportionately at greater HIV risk. Therefore, we explored patterns and contexts of HIV-related communications occurring within personal social networks among bisexual black and Hispanic/Latino men. Using respondent-driven sampling methods, we conducted semi-structured interviews from 2011 to 2012 among 36 participants living in New York City. We examined interview responses from participants for main themes using computer-assisted thematic analyses. The three main themes identified were: (1) communication strategies (e.g., “You can tell a lot from how a person responds just by the tone of their voice”), (2) barriers (e.g., “My sexuality…it creates a stress”), and (3) motivations for these communications (e.g., “I know that’s a(n) issue in the black community…if I could help another brother, I will do it”). Our findings can inform HIV prevention efforts such as social messaging campaigns and other risk-reduction interventions designed for bisexual men.
KeywordsHIV Prevention communication Black/African-American Hispanic/Latino Bisexual men
We thank the men who participated, the Center for HIV Educational Studies and Training, and the Gay Men of African Descent for their participation in and support of this study.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.
This study was supported with CDC’s Minority HIV/AIDS Research Initiative award # U01PS000677
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Bingham, T., Harawa, N., & Williams, J. (2013). Gender role conflict among African American men who have sex with men and women: Associations with mental health and sexual risk and disclosure behaviors. American Journal of Public Health, 103, 127–133. https://doi.org/10.2105/AJPH.2012.300855.CrossRefPubMedPubMedCentralGoogle Scholar
- Campbell, C., Gomez, A., Dworkin, S., Wilson, P., Grisham, K., McReynolds, J., … Hoff, C. (2014). Health, trust, or “just understood”: Explicit and implicit condom decision-making processes among black, white, and interracial same-sex male couples. Archives of Sexual Behavior, 43, 697–706. https://doi.org/10.1007/s10508-013-0146-5.CrossRefPubMedGoogle Scholar
- Centers for Disease Control and Prevention. (2016). HIV infection risk, prevention and testing behaviors among men who have sex with men-National HIV Behavioral Surveillance, 20 U.S. cities. HIV Surveillance Special Report 15. Retrieved June 29, 2018, from http://www.cdc.gov/hiv/library/reports/surveillance/#panel2.
- Centers for Disease Control and Prevention. (2017). HIV Surveillance Report, 2016. Retrieved June 29, 2018, from http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html.
- Dodge, B., Jeffries, W., IV, & Sandfort, T. (2008). Beyond the down low: Sexual risk, protection, and disclosure among at-risk black men who have sex with both men and women (MSMW). Archives of Sexual Behavior, 37, 683–696. https://doi.org/10.1007/s10508-008-9356-7.CrossRefPubMedPubMedCentralGoogle Scholar
- Friedman, M., Wei, C., Klem, M., Silvestre, A., Markovic, N., & Stall, R. (2014b). HIV infection and sexual risk among men who have sex with men and women (MSMW): A systemic review and meta-analysis. PLoS ONE, 9, e87139. https://doi.org/10.1371/journal.pone.0087139.CrossRefPubMedPubMedCentralGoogle Scholar
- Gates, G. (2011). How many people are lesbian, gay, bisexual, and transgender? Retrieved from http://williamsinstitute.law.ucla.edu/wp-content/uploads/Gates-How-Many-People-LGBT-Apr-2011.pdf.
- Grey, J., Bernstein, K., Sullivan, P., Purcell, D., Chesson, H., Gift, T., & Rosenberg, E. (2016). Estimating the population sizes of men who have sex with men in US states and counties using data from the American Community Survey. JMIR Public Health and Surveillance, 2, e14. https://doi.org/10.2196/publichealth.5365.CrossRefPubMedPubMedCentralGoogle Scholar
- Guest, G., MacQueen, K., & Namey, E. (2011). Applied thematic analysis. Los Angeles, CA: Sage.Google Scholar
- Hickson, D., Mena, L., Wilton, L., Tieu, H., Koblin, B., Cummings, V., … Mayer, K. (2017). Sexual networks, dyadic characteristics, and HIV acquisition and transmission behaviors among black men who have sex with men in 6 cities. American Journal of Epidemiology, 185, 786–800. https://doi.org/10.1093/aje/kww144.CrossRefPubMedPubMedCentralGoogle Scholar
- Mavhandu-Mudzusi, A., & Sandy, P. (2015). Religion-related stigma and discrimination experienced by lesbian, gay, bisexual and transgender students at a South African rural-based university. Culture, Health & Sexuality, 17, 1049–1056. https://doi.org/10.1080/13691058.2015.1015614.CrossRefGoogle Scholar
- McCree, D., Oster, A., Jeffries, W., IV, Denson, D., Lima, A., Whitman, H., … Henny, K. (2017). HIV acquisition and transmission among men who have sex with men and women: What we know and how to prevent it. Preventive Medicine, 100, 132–134. https://doi.org/10.1016/j.ypmed.2017.04.024.CrossRefPubMedGoogle Scholar
- Nanin, J. (2013). Testing intent and other demographic, psychosocial, and behavioral predictors of HIV testing among black MSM in New York City. Paper presented at the American Public Health Association Annual Meeting and Exposition, Boston.Google Scholar
- Nanin, J., Osubu, T., Walker, J., Powell, B., Powell, D., & Parsons, J. (2009). “HIV is still real”: Perceptions of HIV testing and HIV prevention among black men who have sex with men in New York City. American Journal of Men’s Health, 3, 150–164. https://doi.org/10.1177/1557988308315154.CrossRefPubMedGoogle Scholar
- New York City Department of Health and Mental Hygiene. (2017). HIV Surveillance Annual Report, 2015. Retrieved June 29, 2018, from https://www.health.ny.gov/diseases/aids/general/statistics/annual/2015/2015_annual_surveillance_report.pdf.
- Purcell, D., Johnson, C., Lansky, A., Prejean, J., Stein, R., Denning, P., … Crepaz, N. (2012). Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. The Open AIDS Journal, 6(Suppl. 1: M6), 98–107. https://doi.org/10.2174/1874613601206010098.CrossRefPubMedPubMedCentralGoogle Scholar
- Serovich, J., Laschober, T., Brown, M., & Kimberly, J. (2017). Longitudinal findings on changes in and the link between HIV-related communication, risky sexual behavior, and relationship status in men who have sex with men living with HIV. Sexually Transmitted Diseases, 44, 732–738. https://doi.org/10.1097/OLQ.0000000000000680.CrossRefPubMedPubMedCentralGoogle Scholar
- Shadaker, S., Magee, M., Paz-Bailey, G., & Hoots, B. (2017). Characteristics and risk behaviors of men who have sex with men and women compared with men who have sex with men—20 US cities, 2011 and 2014. Journal of Acquired Immune Deficiency Syndromes, 75, S281–S287. https://doi.org/10.1097/QAI.0000000000001403.CrossRefPubMedGoogle Scholar
- Tobin, K., Yang, C., Sun, C., Spikes, P., & Latkin, C. (2014). Discrepancies between HIV prevention communication attitudes and actual conversations about HIV testing within social and sexual networks of African American men who have sex with men. Sexually Transmitted Diseases, 41, 221–226. https://doi.org/10.1097/OLQ.0000000000000112.CrossRefPubMedPubMedCentralGoogle Scholar
- Williams, C., Mackesy-Amiti, M., McKirnan, D., & Ouellet, L. (2009). Differences in sexual identity, risk practices, and sex partners between bisexual men and other men among a low-income drug-using sample. Journal of Urban Health, 86, 93–106. https://doi.org/10.1007/s11524-009-9367-2.CrossRefPubMedPubMedCentralGoogle Scholar
- Winter, A., Sullivan, P., Khosropour, C., & Rosenberg, E. (2012). Discussion of HIV status by serostatus and partnership sexual risk among internet-using MSM in the United States. Journal of Acquired Immune Deficiency Syndromes, 60, 525–529. https://doi.org/10.1097/QAI.0b013e318257d0ac.CrossRefPubMedGoogle Scholar
- Wohl, A., Galvin, F., Carlos, J., Myers, H., Garland, W., Witt, M., … George, S. (2013). A comparison of MSM stigma, HIV stigma and depression in HIV-positive Latino and African American men who have sex with men (MSM). AIDS and Behavior, 17, 1454–1464. https://doi.org/10.1007/s10461-012-0385-9.CrossRefPubMedGoogle Scholar