This revised application is being resubmitted in response to the National Institutes of Health's Program Announcement entitled, """"""""Health Disparities in HIV/AIDS: Focus on African Americans"""""""" (PA-06-069, reissued as PA-07-116), which recognizes that """"""""African Americans [represent] a group that has experienced exceptionally high rates of new HIV infections and worse survival rates than other ethnic/racial groups in this country."""""""" To be sure, as we are now in the third decade of the HIV epidemic, African American men who have sex with men remain disproportionately affected by the HIV/AIDS epidemic in the US. Perhaps the most hidden segment of this population are African American young men who have sex with men (AAYMSM), who now represent the largest proportion of new infections among men who have sex with men (MSM). Though HIV prevention efforts using bar settings or community-based organizations targeting the gay community have been met with success, research indicates that many at-risk AAYMSM do not frequent these venues. Instead, large numbers of AAYMSM can be reached through the Ball and House communities. The Ball community revolves around collectives called """"""""Houses,"""""""" which are racial, ethnic, and sexual minority defined communities that are characterized by groups of young men who create a family structure with an appointed """"""""mother,"""""""" """"""""father"""""""" and other members called """"""""the children."""""""" The Houses offer members a network of friends and a place to turn to for support, positive affirming norms, collective identity, and connectedness among AAYMSM. Often young men join a House after having been rejected by their own family. The Balls, which are held several times a month, are lavish celebrations/competitions that serve as a social event for MSM of color, particularly AAYMSM. Our own research suggests that the Ball and House communities could be ideal settings in which to conduct HIV prevention research with AAYMSM. We are therefore proposing to conduct ethnographic and survey research to better understand and examine: 1) the structural, social, and cultural characteristics of the Ball and House communities;2) Ball and House members'use of illicit drugs and involvement in HIV risk and protective behaviors, and their social and sexual networks;and 3) the role that rejection, discrimination, and internalized homophobia play with respect to encouraging drug use and HIV risk.
As we are now in the third decade of the HIV epidemic, African American men who have sex with men remain disproportionately affected by the HIV/AIDS epidemic in the US. Perhaps the most hidden segment of this population are African American young men who have sex with men (AAYMSM), who now represent the largest proportion of new infections among men who have sex with men. Our own research suggests that the Ball and House communities could be ideal settings in which to deliver HIV prevention interventions targeted to AAYMSM. We are therefore proposing to conduct ethnographic and survey research designed to characterize the risk behaviors of members of these communities, as well as identify opportunities for HIV prevention.
