By the age of 35, Black Men who have Sex with Men (MSM’s) have a one in two chance of HIV infection. Black MSM’s, which represent less than one percent of the US population, is home to nearly a quarter of existing HIV cases, AIDS deaths as well as new HIV diagnosis. As early as 1987 studies were published revealing a paradoxical reality, that although Black MSM’s had no significant difference in risk behavior, there is a much larger HIV Prevalence among this group as nearly one in three Black MSM’s are HIV positive. Consistently and repeatedly, studies have shown Black MSM’s have fewer sexual partners than their White counterparts, and fewer occurrences of unprotected anal intercourse, yet significantly higher rates of HIV Incidence. The theoretical basis for this analysis is the concept Intersectionality, originated by Kimberlé Crenshaw, which states that cohorts comprised of multiple statuses of historic discrimination are qualitatively different from individual cohorts of component status. This qualitative difference requires the analysis of the composite cohort as an independent and unique entity as opposed to only looking at the components that it is made of. Therefore, Black MSM’s are a unique group and cannot be fully understood by looking at Black Men or MSM separately. This is particularly applicable for Black MSM’s because of the: history of oppression as Black Men, history of marginalization as MSM, isolation of Blacks within MSM community, isolation of MSM within the Black community and the history of HIV among Black MSM’s which dates back at least to 1969 (predating the publicly acknowledged epidemic in the White MSM community by 12 years) . This traditional policy analysis evaluated the 2010 National HIV/AIDS Strategy for its effectiveness in addressing HIV/AIDS among Black MSM’s. To accomplish this, a convergence of evidence approach was implemented, utilizing a key document review, qualitative interviews with key stakeholders, as well as quantitative surveys of 300 Black MSM’s. These methods were then applied to each of the four stages of Policy Analysis: agenda setting, formulation, implementation and evaluation. This analysis revealed a landmark policy that has comprehensively improved the Federal response to HIV in the US. Innovations developed and instituted because of this policy included the Community Listening Sessions of the formulation stage, and even more importantly the new metrics that better equip agencies to understand the nature of the epidemic. Further, the results of this study were compared with the August 2014 Kaiser Family Foundation study, which produced a nationally representative survey of Gay and Bisexual men (sampling error ±7%). The findings of this study paralleled and/or magnified those of Kaiser in several key areas. Kaiser found that Men of Color were more likely to know someone with HIV/AIDS and those that do are more likely to say it is a significant personal issue. The results of this study of Black MSM’s expose a sample where 97% knew someone who has/had HIV/AIDS and almost all considered this to be a significant personal issue. Both studies also confirmed the continuing presence of stigma and perceived discrimination by the general public. In both studies, evidence also indicates the opportunity for increasing frequency of HIV testing and the widespread lack of knowledge of PrEP (Pre-Exposure Prophylaxis). Several key recommendations should also be taken from this analysis to improve the policy moving forward. The first is that Black MSM’s should be an independent category for policy targeting. The next is that as Black MSM’s are the only group that is at high risk of infection and also makes up a large portion of the disease, Black MSM’s are a significant hotspot that should be a primary focus of the intervention. Finally, the greatest advances in fighting HIV have come through biomedical progress. Therefore, educating and implementing biomedical innovations such as PrEP should compliment behavioral change as intervention objectives. / 1 / Paul T. Winfield

Black men who have sex with men (MSM) on Historically Black College/University (HBCU) campuses face a unique set of challenges. In addition to being disproportionately affected by HIV, Black MSM are impacted by risk behavior, stigma, and environmental policies and practices that adversely influence their experiences. The purpose of this study was to explore the experiences of Black MSM at a HBCU and how stigma, culture, social practices and the collegiate environment impact HIV risk-taking behavior. Utilizing the ecological framework and qualitative analysis, the behaviors of 13 Black MSM on a HBCU campus were examined. Personal interviews and risk assessment questionnaires were analyzed utilizing the phenomenological inquiry method. Data were inductively coded and combined into themes using a qualitative data analysis computer software package. The findings revealed that these 13 participants perceived that HIV-related risk behavior is occurring. They also noted a stigma within the current culture and expressed feelings of marginalization and a negative campus climate from students in the sexual majority. Implications for improving social change from this research include opportunities to (a) establish a culture of social responsibility and consciousness related to the integration and socialization of Black MSM; (b) dialogue regarding the campus climate; and (c) address conscious, unconscious, individual, and environmental stigmas experienced by Black MSM attending this HBCU.

The incidence rate of HIV among Black males having sex with Black males (BMSM) is high compared to that of other racial groups. Researchers have established the association between inappropriate sexual practices, age, income, and environmental determinants and HIV positive status among BMSM. Guided by resilience theory, the purpose of this study was to examine the relationship between HIV risk behavior and resiliency with the goal of identifying a new intervention to mitigate the HIV infection rate in the BMSM community. The theoretical framework used for this study was the resilience theory. This theory is concern with the phenomenon of why some people thrive after period of catastrophic adversity while others do not. A quantitative research design was used to test for a correlation between psychosocial resilience and HIV risk behavior. Fifty seven respondents were included in the study, 28 who were HIV positive, and 29 who were HIV negative. The Risky Behavior Questionnaire and the Resilience Survey were used to collect study data. The main study finding was a significant correlation between resilience and sex-related HIV risk behaviors, including unprotected sex, a lack of awareness of HIV status, multiple male sexual partners, and alcohol and drug use during sex. According to study findings, BMSM with higher resilience might be less likely to engage in sex-related HIV risk behaviors than those with low resilience. Strategies to mitigate HIV transmission could include resilience training. The benefit to the society would be reduced HIV infections transmission due to reduced risky HIV behaviors. The population social change would be the importance of the resiliency practice among BMSM in an effort to dispel the fear about the disease.

Previous research on HIV stigma and the use of spirituality by people living with HIV/AIDS is scarce. Moreover, the research with older Black men who have sex with men (BMSM) is scant. The focus of this qualitative transcendental phenomenological study was to examine the lived experiences of BMSM living with HIV aged 50 and older with encounters of HIV stigma on the use of spirituality. The research questions were designed to explore the lived experiences of aging, HIV stigma, and spirituality. Conceptually, this study was framed within the minority stress theory and the HIV stigma framework. Data were collected through in-depth individual interviews, which provided detailed descriptions of the participants' experiences and created a basis for analysis. Ten participants from an HIV service organization in the Mid-Atlantic United States were selected for participation. Semi-structured interviews were digitally recorded, and data were coded and thematized using a modified vam Kaam data analysis method, which lead to the disclosure of 8 critical themes that illuminated the participants' lived experiences of living with HIV, aging, stigma, and spirituality. Older BMSM identified stigma as a stressor that reinforced the use of their spirituality. The results of this study may provide social workers, community organizations, and policymakers with data that inform a deeper understanding of the challenges older BMSM face due to HIV stigma. This study contributes to positive social change by providing practical information for social workers to inform intervention strategies that might reduce stigma and increase coping resources.