D. Flores1, B. Blake2, R. Sowell3
1Emory Healthcare, Dallas, United States, 2Kennesaw State University, Nursing, Kennesaw, United States, 3Kennesaw State University, College of Health and Human Services, Kennesaw, United States
Background: In the United States, the annual rate of HIV/AIDS diagnoses among young (13 – 24 years of age) men who have sex with men (YMSM) has nearly doubled in the past ten years. Young men of color living in the southern U.S. have been disproportionately affected. Despite the number of new HIV infections among this cohort, there is little knowledge about the key elements that mold and influence their sexual identity and behaviors.
Methods: Using purposive sampling, confidential face-to-face interviews were conducted with ten YMSMs of color who had been diagnosed with HIV within the last year. Open ended questions were used to explore the formation of their sexual identity, sexual initiation, and risk factors for HIV/AIDS. Interviews were audio-taped and transcribed verbatim. Transcripts were analyzed independently by two researchers using content analysis.
Results: Data analysis revealed three major themes: violence and coercion, pornography, and denial of risk. In this study, participants reported that they were sexually attracted to men during preadolescence and violence or coercion was a part of their initial sexual experience. Participants indicated that pornographic material was how they learned about gay sex and what they assumed were appropriate behaviors during sexual encounters. They also did not perceive themselves to be at risk for HIV and it was unlikely that they would become infected.
Conclusions: YMSM of color in this study developed their sexuality under less than ideal circumstances, which included violence and coercion. Prevention interventions must therefore address personal safety, support individual decision making, and provide appropriate education about sexuality and the dynamics of gay sex. Interventions for YMSMs will also remain ineffective unless they are implemented at a time when sexual identity is forming and experimentation is occurring. Acknowledging personal factors that influence sexual behavior in YMSM is essential when developing effective HIV prevention strategies.