1
|
Hussen SA, Drumhiller K, Emerenini S, Moore SJ, Jones MD, Camacho-González A, Ransome Y, Elopre L, Del Río C, Harper GW. Understanding social capital among young black gay and bisexual men living with HIV: a qualitative exploration. CULTURE, HEALTH & SEXUALITY 2022; 24:1498-1513. [PMID: 34506268 DOI: 10.1080/13691058.2021.1974561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/26/2021] [Indexed: 06/13/2023]
Abstract
Social capital, defined as the sum of an individual's resource-containing, reciprocal and trustworthy social network connections, has been associated with improved engagement in care among people living with HIV globally. We conducted a qualitative interview study of social capital among 28 young Black gay, bisexual and other men who have sex with men ages 18-29 living with HIV in Atlanta, Georgia. We asked participants about bonding capital (relationships between individuals with similar demographic characteristics), bridging capital (relationships with individuals of different backgrounds), collective efficacy (involvement with community organisations) and satisfaction with their social networks. We found that participants described bonding capital from friends and family in depth, while more gaps were noted in bridging capital and collective efficacy. Bonding capital derived from families was especially critical to participants' satisfaction with their social capital. Findings suggest that interventions targeting young Black gay, bisexual and other men who have sex with men should build upon strong bonds with family and friends, and/or fill gaps in bridging capital and collective efficacy by connecting young men to mentors and organisations.
Collapse
Affiliation(s)
- Sophia A Hussen
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA, USA
| | | | - Sabina Emerenini
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Shamia J Moore
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Marxavian D Jones
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Andrés Camacho-González
- Department of Pediatrics, Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA, USA
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, School of Public Health, Yale University, New Haven, CT, USA
| | - Latesha Elopre
- Department of Medicine, Division of Infectious Diseases, University of Alabama, Birmingham, AL, USA
| | - Carlos Del Río
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Infectious Diseases, School of Medicine, Emory University, Atlanta, GA, USA
| | - Gary W Harper
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
2
|
Lacombe-Duncan A, Olawale R. Context, Types, and Consequences of Violence Across the Life Course: A Qualitative Study of the Lived Experiences of Transgender Women Living With HIV. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:2242-2266. [PMID: 32639854 DOI: 10.1177/0886260520935093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Violence is a known driver of HIV vulnerability among transgender (trans) women, who are disproportionately impacted by HIV globally. Violence is also a barrier to accessing HIV prevention, treatment, and support. Yet, little is known about the everyday experiences of violence faced by trans women living with HIV, who live at the intersection of a marginalized gender identity and physical health condition. To address this gap, this study draws on semi-structured, individual interviews conducted 2017-2018 with a purposive sample (selected based on diverse identities) of trans women living with HIV (n = 11) participating in a large, community-based cohort study in three Canadian provinces. Framework analysis was used to identify key themes, patterns within themes between participants, and patterns across themes among participants. Findings showed that trans women living with HIV experience specific contexts of violence shaped at the intersection of stigma based on gender identity, gender expression, and HIV status, among other identities/experiences. Violence experienced in childhood (e.g., familial rejection, bullying) increased trans women's likelihood of being exposed to a violent social context in young adulthood (e.g., state violence perpetuated by the police, interpersonal violence perpetuated by sexual partners, and community violence perpetuated by society-at-large/the general public), which increased trans women's HIV vulnerability; once living with HIV trans women were subjected to discursive violence from healthcare providers. These multiple forms of violence have serious consequences for trans women living with HIV's ongoing social, mental, and physical well-being. The findings suggest that interventions are urgently needed to reduce violence against trans women in childhood and young adulthood, in addition to reducing violence against trans women living with HIV perpetuated by healthcare providers in adulthood, to both proactively and responsively promote their safety, health, and well-being.
Collapse
|
3
|
Sherman ADF, Allgood S, Alexander KA, Klepper M, Balthazar MS, Hill M, Cannon CM, Dunn D, Poteat T, Campbell J. Transgender and Gender Diverse Community Connection, Help-Seeking, and Mental Health Among Black Transgender Women Who Have Survived Violence: A Mixed-Methods Analysis. Violence Against Women 2022; 28:890-921. [PMID: 34167394 PMCID: PMC9171078 DOI: 10.1177/10778012211013892] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Black transgender women are disproportionately affected by violence and poor care-delivery, contributing to poor mental health. Little is known regarding the effect of transgender and gender diverse (TGD) community connection (TCC) on health. This analysis (a) explores relationships between TCC, polyvictimization, and mental health and (b) analyzes how TCC influenced help-seeking following violent experiences among Black transgender women. Mixed-methods data from 19 Black transgender women were analyzed using correlational and thematic content analyses. Findings suggest that TCC is associated with improved help-seeking and mental health among Black transgender women, highlighting a need for longitudinal research to identify approaches for leveraging TCC.
Collapse
Affiliation(s)
| | - Sarah Allgood
- Johns Hopkins University School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Kamila A. Alexander
- Johns Hopkins University School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Meredith Klepper
- Johns Hopkins University School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Monique S. Balthazar
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA,Monique S. Balthazar, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, 140 Decatur St SE, Atlanta, GA 30303, USA.
| | - Miranda Hill
- University of California San Francisco, San Francisco, CA, USA
| | | | | | - Tonia Poteat
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Jacquelyn Campbell
- Johns Hopkins University School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
4
|
White JJ, Dangerfield DT, Donovan E, Miller D, Grieb SM. Exploring the role of LGBT-affirming churches in health promotion for Black sexual minority men. CULTURE, HEALTH & SEXUALITY 2020; 22:1191-1206. [PMID: 31594476 PMCID: PMC7141971 DOI: 10.1080/13691058.2019.1666429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 09/08/2019] [Indexed: 06/01/2023]
Abstract
In the USA, Black sexual minority men (BSMM) remain disproportionately impacted upon by HIV and other sexual health issues. Individuals who attend church have lower rates of morbidity and mortality than those that do not; however, church attendance presents a paradox of being protective for some health outcomes and a risk for others among this population. Lesbian, gay, bisexual, and transgender (LGBT) affirming churches may offer support, but little is known about the role of LGBT-affirming churches in the lives of BSMM and how they may impact HIV and other health outcomes. This study explored the role of LGBT-affirming churches in the lives of BSMM. Nine focus groups (N = 52) were conducted in Baltimore City, Maryland between December 2017 and April 2018. Thematic analysis evaluated domains related to how men perceived, experienced, and engaged with LGBT-affirming churches. Three primary themes identified: (1) preferring traditional church environments over LGBT-affirming churches; (2) experiencing the LGBT-affirming church as a space of acceptance, emotional healing, and modelling loving same-sex relationships; and (3) perceiving LGBT-affirming churches as opportunities to engage community members to promote the well-being of BSMM. A secondary theme identified involvement in the house and ballroom community as an LGBT-affirming religious experience.
Collapse
Affiliation(s)
- Jordan J White
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Suzanne M Grieb
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| |
Collapse
|
5
|
Zarwell M, Ransome Y, Barak N, Gruber D, Robinson WT. PrEP indicators, social capital and social group memberships among gay, bisexual and other men who have sex with men. CULTURE, HEALTH & SEXUALITY 2019; 21:1349-1366. [PMID: 30724712 PMCID: PMC6684860 DOI: 10.1080/13691058.2018.1563912] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/23/2018] [Indexed: 05/25/2023]
Abstract
Efforts to reduce HIV among gay, bisexual and other men who have sex with men include increasing awareness and uptake of pre-exposure prophylaxis (PrEP). Social capital may facilitate engagement in HIV prevention. Membership of social groups including chosen families (i.e. friends as family relationships) - one potential indicator of social capital - may be protective against HIV risk and infection. In this cross-sectional quantitative study, we examined social capital items and social group membership in association with PrEP outcomes. In 2014, the New Orleans arm of the National HIV Behavioral Surveillance recruited 353 HIV-negative men, of whom 46% identified as Black, Latino or Other Race and 54% as Non-Hispanic White, using venue-based sampling to complete a structured survey. Multivariable logistic regression models tested the relations between social group membership and social capital with PrEP indicators. Men who reported community group participation were more likely to be aware of PrEP compared to those who did not. Men in chosen families associated with a family name were least likely to be aware of and willing to take PrEP compared to those not in any other social groups. Social group membership is a potential social capital indicator for assessing HIV prevention among men.
Collapse
Affiliation(s)
- Meagan Zarwell
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Narquis Barak
- NO/AIDS Task Force d.b.a CrescentCare Health, New Orleans, LA, USA
| | - DeAnn Gruber
- Department of Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- STD/HIV Program, Louisiana Office of Public Health, New Orleans, LA, USA
| | - William T. Robinson
- Department of Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- STD/HIV Program, Louisiana Office of Public Health, New Orleans, LA, USA
| |
Collapse
|
6
|
Zarwell M, Robinson WT. Network Properties Among Gay, Bisexual and Other Men Who Have Sex with Men Vary by Race. AIDS Behav 2019; 23:1315-1325. [PMID: 30725398 DOI: 10.1007/s/10461-019-02416-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The HIV burden among gay, bisexual, and other men who have sex with men (GBM) may be related to variations in network characteristics of the individual's social and sexual network. This study investigates variations in network properties among 188 Black and 295 White GBM recruited in New Orleans during the National HIV Behavioral Surveillance in 2014. Participants described up to five people who provided social support and five sex partners in the past 3 months. Network properties and network dissimilarity indicators were aggregated to the participant level as means or proportions and examined using PROC GLM. White participants reported larger networks (p = 0.0027), had known network members longer (p = 0.0033), and reported more substance use (p < 0.0001) within networks. Black participants reported networks with fewer men (p = 0.0056) and younger members (p = 0.0110) than those of White GBM. Network properties among GBM differ by race in New Orleans which may inform prevention interventions.
Collapse
Affiliation(s)
- Meagan Zarwell
- Center for AIDS Intervention Research, Medical College of Wisconsin, 2071 N Summit Ave, Milwaukee, WI, 53202, USA.
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
| | - William T Robinson
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Louisiana Office of Public Health STD/HIV Program, New Orleans, LA, USA
| |
Collapse
|
7
|
Abstract
The HIV burden among gay, bisexual, and other men who have sex with men (GBM) may be related to variations in network characteristics of the individual's social and sexual network. This study investigates variations in network properties among 188 Black and 295 White GBM recruited in New Orleans during the National HIV Behavioral Surveillance in 2014. Participants described up to five people who provided social support and five sex partners in the past 3 months. Network properties and network dissimilarity indicators were aggregated to the participant level as means or proportions and examined using PROC GLM. White participants reported larger networks (p = 0.0027), had known network members longer (p = 0.0033), and reported more substance use (p < 0.0001) within networks. Black participants reported networks with fewer men (p = 0.0056) and younger members (p = 0.0110) than those of White GBM. Network properties among GBM differ by race in New Orleans which may inform prevention interventions.
Collapse
|
8
|
Zarwell M, Robinson WT. Development of a social capital scale for constructed families of gay, bisexual, and other men who have sex with men. PLoS One 2018; 13:e0208781. [PMID: 30543653 PMCID: PMC6292593 DOI: 10.1371/journal.pone.0208781] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 11/26/2018] [Indexed: 11/18/2022] Open
Abstract
Despite previous empirical studies which have linked social capital to a number of health outcomes, few studies have investigated sub-group specific social capital among populations at increased risk for HIV infection such as gay, bisexual and other men who have sex with men (GBM). Many GBM of color belong to constructed families in which friends refer to each other with kinship terms such as parents and children. No studies have measured social capital provisions within constructed family networks. This study developed a preliminary instrument for assessing social capital among constructed families. The network level social capital scale incorporated the following theoretical domains hypothesized to define social capital derived from network membership: social influence, multiplex ties, heterogeneity, social cohesion, trust, quality of support, and compositional quality. A cross-sectional survey administered an eight-item scale to 131 GBM who belonged to constructed families. The factor structure and confirmatory factor analysis were assessed. Reliability was evaluated using Cronbach's alpha to measure internal consistency. A final single factor solution was obtained which was comprised of six items with high factor loadings. The resulting measures were highly correlated with an alpha of 0.84 and each factor loading was well above 0.3. This study assessed the psychometric properties of a preliminary network level social capital instrument among GBM in constructed families. Future studies may utilize or adopt this scale to measure network-level social capital within other populations.
Collapse
Affiliation(s)
- Meagan Zarwell
- LSU Health Sciences Center, School of Public Health, Behavioral and Community Health Sciences, New Orleans, Louisiana, United States of America
- NO/AIDS Task Force, d.b.a CrescentCare, New Orleans, Louisiana, United States of America
- Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
| | - William T. Robinson
- NO/AIDS Task Force, d.b.a CrescentCare, New Orleans, Louisiana, United States of America
- Louisiana Office of Public Health, STD/HIV Program, New Orleans, Louisiana, United States of America
| |
Collapse
|
9
|
Soler JH, Caldwell CH, Córdova D, Harper G, Bauermeister JA. Who counts as family? Family typologies, family support, and family undermining among young adult gay and bisexual men. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2018; 15:123-138. [PMID: 29713394 PMCID: PMC5922785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Gay and bisexual men may form chosen families in addition to or in place of families of origin. However, the characteristics of these diverse families remain largely unexamined in the quantitative literature. The purpose of this study was to develop a family typology based on responses from a racially and ethnically diverse sample of young adult gay and bisexual men (YGBM) recruited from the Detroit Metropolitan Area (N=350; 18-29 years old). To explore the role of family, we then examined family social support and social undermining in relation to YGBM psychological distress within different family types. A series of multivariate regressions were used to examine associations between family social support and social undermining with depression and anxiety outcomes. The majority (88%) of YGBM included family of origin in their definitions of family and 63% indicated having chosen families. Associations between family social processes and psychological outcomes varied by type of family, suggesting that family composition shapes how perceptions of support and undermining relate to experiencing symptoms of depression and anxiety. Chosen families play a prominent role in the lives of YGBM and should not be overlooked in family research. Findings also highlight the importance of examining co-occurring family social support and social stress processes to further address psychological distress symptoms among YGBM.
Collapse
|
10
|
The Influence of Constructed Family Membership on HIV Risk Behaviors among Gay, Bisexual, and Other Men Who Have Sex with Men in New Orleans. J Urban Health 2018; 95:179-187. [PMID: 29047021 PMCID: PMC5906379 DOI: 10.1007/s11524-017-0203-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Gay, bisexual, and other men who have sex with men (MSM) represent more new HIV infections than all other at-risk populations. Many young black MSM belong to constructed families (i.e., the house ball community, gay families, and pageant families) which are often organized in a family structure with members referred to as parents and children. Many constructed families are associated with a family surname which is informally adopted by members. In some cases, however, constructed families do not identify with a collective family name. In 2014, 553 MSM were recruited through venue-based time-space sampling during the National HIV Behavioral Surveillance (NHBS) in New Orleans to complete a structured survey and HIV test. Black, Latino, and other race MSM were more likely to belong to constructed families in comparison to white MSM. In addition, participants who belonged to constructed families with a family name were more likely to engage in protective behaviors including wearing condoms at last sexual intercourse. Overall, younger, white MSM who did not belong to any social groups were more likely to engage in at least one risk behavior. These findings significantly contribute to understanding variations in HIV risk behavior among members of constructed families.
Collapse
|
11
|
Levitt HM, Horne SG, Freeman-Coppadge D, Roberts T. HIV Prevention in Gay Family and House Networks: Fostering Self-Determination and Sexual Safety. AIDS Behav 2017; 21:2973-2986. [PMID: 28451890 DOI: 10.1007/s10461-017-1774-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Many gay, bisexual, and transgender (GBT) people of color (POC) join house and/or constructed family communities, which serve as support networks composed mostly of other non-biologically related GBT/POC. These networks can decrease or increase the risk of exposure to HIV via multiple mechanisms (e.g., providing informal sexual safety education versus stigmatizing family members with HIV, encouraging sexual safety practices versus unsafe escorting, teaching self-care versus substance use) but act to support family members in the face of social and economic hardship. Researchers interviewed ten members of these social networks in the Boston metro area of the US and produced a saturated grounded theory analysis to explore the role of gay family/house networks in HIV risk management. While network members utilized HIV prevention resources, interviewees described how their efficacy was related to the intentions of leadership and strength of kinship boundaries within their community, economic opportunities, and communication skills. Clinical and research implications are discussed.
Collapse
|
12
|
Cahill S, Trieweiler S, Guidry J, Rash N, Stamper L, Conron K, Turcotte N, Gratch I, Lowery P. High Rates of Access to Health Care, Disclosure of Sexuality and Gender Identity to Providers Among House and Ball Community Members in New York City. JOURNAL OF HOMOSEXUALITY 2017; 65:600-614. [PMID: 28537845 DOI: 10.1080/00918369.2017.1328221] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The House and Ball community is an important cultural manifestation of resiliency for Black and Latino gay and bisexual men and transgender women. Participants at the August 2013 House of Latex Ball in New York City were surveyed about insurance coverage, health care access, experiences in health care, and housing instability. The sample (n = 367) was 58% Black/African American and 20% Hispanic/Latino, with a mean age of 31. Fifty-five percent were gay and bisexual men. Although only 6% identified as transgender, nearly one half were gender nonconforming. Strong majorities had health insurance, were in regular medical care, and were "out" to their providers. Some were unstably housed and had recently exchanged sex for shelter or money. High rates of health care access and disclosure indicate resiliency and agency. Unstable housing and income insecurity may be structural drivers of vulnerability for this population to HIV infection and other health risks.
Collapse
Affiliation(s)
- Sean Cahill
- a The Fenway Institute , Boston , Massachusetts , USA
- b School of Public Policy and Urban Affairs , Northeastern University , Boston , Massachusetts , USA
| | - Sarah Trieweiler
- a The Fenway Institute , Boston , Massachusetts , USA
- c Department of Sociology , Northeastern University , Boston , Massachusetts , USA
| | - John Guidry
- d Department of Community Health and Research, Gay Men's Health Crisis (GMHC) , New York , New York , USA
| | - Nelisa Rash
- a The Fenway Institute , Boston , Massachusetts , USA
| | - Layla Stamper
- a The Fenway Institute , Boston , Massachusetts , USA
| | - Kerith Conron
- a The Fenway Institute , Boston , Massachusetts , USA
- e The Williams Institute, UCLA School of Law , Boston , Massachusetts , USA
| | - Nicole Turcotte
- d Department of Community Health and Research, Gay Men's Health Crisis (GMHC) , New York , New York , USA
| | - Ilana Gratch
- a The Fenway Institute , Boston , Massachusetts , USA
- f Middlebury College , Middlebury , Vermont , USA
| | - Paige Lowery
- d Department of Community Health and Research, Gay Men's Health Crisis (GMHC) , New York , New York , USA
| |
Collapse
|
13
|
Sterrett EM, Birkett M, Kuhns L, Mustanski B. Non-Parental Adults in the Social and Risk Behavior Networks of Sexual Minority Male Youth. CHILDREN AND YOUTH SERVICES REVIEW 2015; 55:62-70. [PMID: 26074655 PMCID: PMC4461068 DOI: 10.1016/j.childyouth.2015.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The presence of non-parental adults (NPAs), or adults outside of caregivers (e.g., extended family, natural mentors), in the lives of adolescents and emerging adults has received a rapidly expanding amount of empirical attention in the last decade. Sexual minority male youth (SMMY) face disproportionate risks of abuse and victimization in relationships with parents and peers. Yet, despite the fact that this group, therefore, may be both potentially vulnerable to negative interpersonal influences but also poised to benefit from additional relationships, NPA involvement in the lives of SMMY is currently not well understood in the extant literature. This study sought to examine and characterize the involvement of NPAs in the social and risk networks of SMMY (n = 175; 54% African American, 21% Hispanic/Latino, 14% Caucasian; ages 17-23). Most SMMY identified at least one NPA, such as friends and grandparents, in their networks. Three categories of relationships were identified, Strictly Social, which only involved social interactions; Complex, which were both social and involved substance use and/or sexual activity; and Risky, which purely consisted of substance use or sexual activity. Relationships were rated as emotionally "closer" among ethnic minority SMMY, although, racial/ethnic similarity between SMMY and NPAs was not associated with relationship closeness. In addition, relationships involving female and heterosexual NPAs were also rated as stronger. These findings suggest the potential usefulness of considering multiple types of relationships between SMMY and NPAs when designing intervention and prevention efforts. Moreover, African American and Latino SMMY, who represent the most vulnerable sub-groups of SMMY in terms of HIV-risk, may be particularly poised to benefit from positive NPA relationships.
Collapse
Affiliation(s)
- Emma M. Sterrett
- Couple and Family Therapy Program, Kent School of Social Work, University of Louisville, 310 N. Whittington Pkwy, Louisville, KY, 40222, U.S
| | - Michelle Birkett
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave. Ste. 2700, Chicago, IL 60611, U.S
| | - Lisa Kuhns
- Ann & Robert H. Lurie Children’s Hospital of Chicago Box 161, 225 E Chicago Ave., Chicago, IL 60611, U.S
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave. Ste. 2700, Chicago, IL 60611, U.S
| |
Collapse
|
14
|
Lemos D, Hosek SG, Bell M. Reconciling Reality with Fantasy: Exploration of the Sociocultural Factors influencing HIV Transmission among Black Young Men who have Sex with Men (BYMSM) within the House Ball Community: A Chicago Study. JOURNAL OF GAY & LESBIAN SOCIAL SERVICES 2015; 27:64-85. [PMID: 26034382 PMCID: PMC4449151 DOI: 10.1080/10538720.2015.988837] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Studies involving the House Ball Community (HBC) have found high rates of HIV prevalence and undiagnosed HIV infection, as well as unique social and sexual network-related HIV risk and protective behaviors (Murrill et al., 2008; Sanchez et al., 2010). Efforts to understand culturally-appropriate and effective methods of HIV prevention services within the relatively understudied HBC are scarce (Phillips et al., 2011). This qualitative study, utilizing a Diffusion of Innovation Theoretical framework, aimed to explore social norms regarding HIV and accessibility of HIV prevention services within the HBC. Thirty-seven participants (16 community leaders and 21 youth) engaged in focus group discussions. Participants discussed the perceptions of HIV and stigmatization within the HBC, general and HBC-specific risk factors for HIV transmission, as well as HIV prevention needs and strategies for culturally-appropriate HIV interventions. Findings from this qualitative study highlight both the vulnerability of the HBC to HIV transmission and the corresponding support for HIV prevention interventions.
Collapse
Affiliation(s)
- Diana Lemos
- Stroger Hospital of Cook County, Department of Psychiatry
| | - Sybil G. Hosek
- Stroger Hospital of Cook County, Department of Psychiatry
| | - Margo Bell
- Stroger Hospital of Cook County, Division of Adolescent Medicine
| |
Collapse
|
15
|
Dickson-Gomez J, Owczarzak J, St Lawrence J, Sitzler C, Quinn K, Pearson B, Kelly JA, Amirkhanian YA. Beyond the ball: implications for HIV risk and prevention among the constructed families of African American men who have sex with men. AIDS Behav 2014; 18:2156-68. [PMID: 24980248 DOI: 10.1007/s10461-014-0836-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
African American men who have sex with men (AAMSM) are disproportionately burdened by new and existing HIV infections. In spite of this, few HIV prevention interventions have been developed that meet the specific needs of AAMSM and that are culturally appropriate and build on strengths and resources. In this paper, we examine constructed families, including those who belong to houses and those who do not, from a three city sample of 196 AAMSM. Results show that the majority of AAMSM who belong to constructed families do not participate in houses or balls. Both house and non-house affiliated constructed families are important sources of social support among AAMSM. Participants reported limited success in spreading HIV messages at ball events, but talk about HIV within their constructed families. Social network approaches to HIV prevention may capitalize on existing social ties within constructed families to promote safer sexual behaviors.
Collapse
Affiliation(s)
- Julia Dickson-Gomez
- Center for AIDS Intervention Research, Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 2071 North Summit Ave., Milwaukee, WI, 53202, USA,
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Horne SG, Levitt HM, Sweeney KK, Puckett JA, Hampton ML. African American Gay Family Networks: An Entry Point for HIV Prevention. JOURNAL OF SEX RESEARCH 2014; 52:807-820. [PMID: 24992185 DOI: 10.1080/00224499.2014.901285] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Gay families are constructed support networks that gay, bisexual, and transgender individuals of color form, often in response to societal marginalization and rejection from biological families. Research on these family structures has been scarce, with little focus on the experience of African American gay family networks in the South. The current grounded theory qualitative study focused on the experiences of 10 African American male and transgender individuals between the ages of 18 and 29 from gay families in the Mid-South, and explored the ways these families addressed safe-sex issues and human immunodeficiency virus (HIV) risk prevention. Results revealed that families can play a role in either increasing HIV risk (e.g., ignoring HIV issues, encouraging such unsafe behaviors as exchanging sex for money or drugs, stigmatizing HIV-positive people) or decreasing it (e.g., intensive, family-level prevention efforts at safe-sex practices and family support for HIV treatment adherence). The potential of these family networks for HIV prevention and adherence efforts is considered.
Collapse
Affiliation(s)
- Sharon G Horne
- a Department of Counseling and School Psychology , University of Massachusetts Boston
| | | | | | | | | |
Collapse
|
17
|
Alio AP, Fields SD, Humes DL, Bunce CA, Wallace SE, Lewis C, Elder H, Wakefield S, Keefer MC. Project VOGUE: A partnership for increasing HIV knowledge and HIV vaccine trial awareness among House Ball leaders in Western New York. JOURNAL OF GAY & LESBIAN SOCIAL SERVICES 2014; 26:336-354. [PMID: 25642120 PMCID: PMC4308092 DOI: 10.1080/10538720.2014.924892] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Men who sleep with men (MSM) and transgender individuals of color, the largest demographic in the House Ball community (HBC) are amongst the group at highest risk for HIV infection in the United States. The HBC have limited access to culturally appropriate HIV education. This study aimed to develop a partnership with HBC leaders to uncover strategies for increasing HIV prevention knowledge, including participation in HIV vaccine trials. To this end a research institution-community-HBC partnership was established. In-depth qualitative and quantitative data were collected from the 14 HBC leaders in western New York, revealing that knowledge of HIV and related vaccine trials was limited. Barriers to increasing HIV knowledge included fear of peer judgment, having inaccurate information about HIV, and lack of education. Among the HBC, community partnerships will further aid in the development of future HIV prevention programs and increase individuals' willingness to participate in future HIV vaccine trials.
Collapse
Affiliation(s)
- Amina P Alio
- University of Rochester School of Medicine & Dentistry, Department of Public Health Sciences
| | - Sheldon D Fields
- Florida International University, College of Nursing and Health Sciences
| | | | - Catherine A Bunce
- University of Rochester School of Medicine & Dentistry, Department of Medicine, Division of Infectious Diseases
| | | | - Cindi Lewis
- University of Rochester School of Medicine & Dentistry, Department of Public Health Sciences
| | - Heather Elder
- University of Rochester School of Medicine & Dentistry, Department of Public Health Sciences
| | | | - Michael C Keefer
- University of Rochester School of Medicine & Dentistry, Department of Medicine, Division of Infectious Diseases
| |
Collapse
|
18
|
Abstract
PURPOSE OF REVIEW Recent data on the high burden of HIV among transgender women have stimulated interest in addressing HIV in this vulnerable population. This review situates the epidemiologic data on HIV among transgender women in the context of the social determinants of health and describes opportunities for effective interventions. RECENT FINDINGS Transgender women experience unique vulnerability to HIV that can be attributed to multilevel, intersecting factors that also influence the HIV treatment and care continuum. Stigma and discrimination, lack of social and legal recognition of their affirmed gender, and exclusion from employment and educational opportunities represent fundamental drivers of HIV risk in transgender women worldwide. SUMMARY Interventions to improve engagement in HIV prevention, testing, care, and treatment among transgender women should build on community strengths and address structural factors as well as psychosocial and biologic factors that increase HIV vulnerability and prevent access to HIV services.
Collapse
Affiliation(s)
- Tonia Poteat
- aDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland bThe Fenway Institute, Fenway Health cDepartment of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA dCallen-Lorde Community Health Center, New York, New York, USA
| | | | | |
Collapse
|
19
|
Rowan D, DeSousa M, Randall EM, White C, Holley L. "We're just targeted as the flock that has HIV": health care experiences of members of the house/ball culture. SOCIAL WORK IN HEALTH CARE 2014; 53:460-477. [PMID: 24835090 DOI: 10.1080/00981389.2014.896847] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The house/ball community is an understudied sub-group of young Black men who have sex with men and transgender persons in urban centers of the United States who affiliate in social structures called houses and gather at elaborate dance and performance events called balls. In Charlotte, North Carolina, 12 house/ball members were interviewed about their experiences with health care providers and their assessment of any barriers to care due to their affiliation with the rather clandestine house/ball sub-culture. Additionally, HIV-specific health care providers were interviewed, to assess their knowledge of the sub-culture. House/ball members reported both positive and negative perceptions of treatment by their health care providers with respect to their house/ball involvement. Some reported feeling stigmatized, especially around HIV status. Results showed that increased knowledge about the house/ball community could improve practitioners' cultural competence, thereby reducing stigma-related barriers to care.
Collapse
Affiliation(s)
- Diana Rowan
- a Social Work , University of North Carolina at Charlotte , Charlotte , North Carolina , USA
| | | | | | | | | |
Collapse
|
20
|
Kubicek K, McNeeley M, Holloway IW, Weiss G, Kipke MD. "It's like our own little world": resilience as a factor in participating in the Ballroom community subculture. AIDS Behav 2013; 17:1524-39. [PMID: 22618891 DOI: 10.1007/s10461-012-0205-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We are well into the third decade of the HIV epidemic. While strides have been made in HIV prevention, rates for African American men who have sex with men (AAMSM) and young AAMSM continue to increase-perhaps indicating that traditional deficit-approaches of HIV prevention are not effective for all populations. Following a recent call to investigate the resiliency of young gay men, this study identifies sources of resilience and strength within the House and Ball communities, a subculture comprised primarily of AAMSM. The mixed-methods design included survey data (N = 263) collected at community events, interviews with Ball attendees and focus group data with House members. Survey data indicate a relationship between participating in the House and Ball communities and seeking support, acceptance and entertainment. Qualitative data validate these findings and provide detail on motivations for AAMSM to participate and the perceived benefits of participation. Findings are discussed in relation to building strengths-based interventions, using concepts of resiliency including shamelessness, social creativity, social support and volunteerism.
Collapse
Affiliation(s)
- Katrina Kubicek
- Community, Health Outcomes, and Intervention Research Program, Saban Research Institute, Children's Hospital Los Angeles, 6430 Sunset Boulevard, Suite 1500, Los Angeles, CA 90028, USA.
| | | | | | | | | |
Collapse
|
21
|
Holloway IW, Traube DE, Kubicek K, Supan J, Weiss G, Kipke MD. HIV prevention service utilization in the Los Angeles House and Ball communities: past experiences and recommendations for the future. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2012; 24:431-444. [PMID: 23016504 PMCID: PMC3507445 DOI: 10.1521/aeap.2012.24.5.431] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
African-American young men who have sex with men and transgender persons are at elevated risk for HIV infection. House and Ball communities, networks of mostly African-American gay, bisexual, and transgender individuals who compete in modeling and dance, represent a prime venue for HIV prevention with these difficult-to-reach populations; however, little research exists on effective approaches to HIV prevention within these communities. Using a mixed-methods approach, the present study sought to document participation in HIV prevention activities of a sample from the Los Angeles House and Ball communities (n = 263) in order to inform future service development. While 80% of participants were tested for HIV within the past 6 months, only 26% report HIV prevention program attendance. House leaders recommend a holistic approach to HIV prevention, one that incorporates attention to social problems beyond HIV, including poverty, housing difficulties, and lack of job training.
Collapse
Affiliation(s)
- Ian W Holloway
- Department of Social Welfare, University of California, Los Angeles, 90095-1656, USA.
| | | | | | | | | | | |
Collapse
|