HIV is disproportionately impacting Black men in the South, and the role of mental health determinants (e.g., perceived stress, depression, gender role conflict) and culturally-specific coping strategies (e.g., John Henryism, Cool Pose items) in this epidemic has been understudied. We plan to examine a socially and demographically diverse group of Black men living in three distinct metropolitan statistical areas (MSA) in Georgia (metropolitan Atlanta, Columbus and Valdosta), and examine how mental health determinants and culturally-specific coping strategies influence their HIV risk promoting (unprotected vaginal/anal sex, multiple sexual partners) and protective (consistent condom use, recent HIV testing) behaviors. Our proposal hypothosizes that mental health determinants will mediate the effects of demographic factors on HIV risk promoting and protective behavior. The study's specific aims are to: 1) Explore how the social context of mental health determinants and culturally-specific coping strategies factor in the lives of Black men and influence their HIV risk promoting and protective behaviors;2) Assess how mental health determinants and culturally-specific coping strategies predict the HIV risk promoting and protective behaviors of Black men;3) Examine how mental health determinants mediate the relationship between social (e.g., racism experiences, SES) &demographic (e.g., MSA, age) factors and HIV risk promoting and protective behaviors of Black men;and 4) Investigate how culturally-specific coping strategies of Black men moderate the relationship between mental health determinants and their HIV risk promoting and protective behaviors To achieve these objectives, we will be employing a mixed-methods approach, involving: 1) qualitative one-on-one interviews with 90 men to gain a culturally grounded understanding of the mental health determinants and culturally-specific coping strategies in these men's lives (Phase I);2) focus groups, cognitive interviews and pilot testing with 30 men to develop survey items from Phase I findings;and 3) quantitative surveys using random digit-dialing (RDD) methods with 1200 participants to test associations between these domains and sexual behavior and HIV testing outcomes (Phase II). Our long term goals are to identify and understand the unique cultural determinants of the mental health and coping strategies among Black men in Georgia that will inform future HIV prevention initiatives.
This project is particularly relevant to public health as it will provide both qualitative and quantitative information on the influence of mental health determinants (e.g., perceived stress, depression and gender role conflict) and culturally-specific coping strategies (e.g. John Henryism, Cool Pose items) on the HIV risk promoting (unprotected vaginal/anal sex, multiple sexual partners) and protective (consistent condom use, recent HIV testing) behaviors among a socially and demographically diverse sample of Black men in Georgia. Despite the high prevalence of HIV among all Black men in this county, few studies have conducted studies outside of predominantly metropolitan and MSM samples of Black men. The information gathered from this innovative study will be invaluable in improving our understanding of the understudied role of mental health determinants and culturally-specific coping strategies in the current HIV epidemic among Black men, but will also be helpful in informing our future general health and HIV interventions for this population.
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| Hussen, Sophia A; Bowleg, Lisa; Sangaramoorthy, Thurka et al. (2012) Parents, peers and pornography: the influence of formative sexual scripts on adult HIV sexual risk behaviour among Black men in the USA. Cult Health Sex 14:863-77 |
