In 2010, there was an estimated 10,600 new infections among Black men who have sex with men (MSM); and in 2011, Black MSM accounted for over 12,000 cases (39%) of all HIV diagnoses in all MSM, even though Blacks are only 12% of the general U.S. population. According to the CDC, seroprevalence data indicate that the Black MSM population is the most affected across all major demographic subgroups and categories of risk (gender, age, race, and behavior), even though they engage in less high-risk behaviors than other MSM. For example, they are more likely to use condoms and report less unprotected anal intercourse in mixed serostatus relationships. Although factors associated with higher rates of HIV infection in Black MSM have been identified (e.g., undiagnosed HIV infection and sexually transmitted infections), Black MSM who maintain seronegativity have not received much attention. HIV prevention aims to keep seronegatives negative, yet researchers have understudied the strategies, tactics, and mental health strengths and resilience of this group of Black MSM. Increasing our knowledge about their approach to remaining seronegative can augment the current HIV prevention portfolio. The scientific literature has not considered the mental health strengths and resilience of Black MSM in any depth. My study will address the critical need to fill the gap in the literature about behaviors, circumstances, or mental health-related strengths and resilience seronegative that Black MSM report enable them to remain seronegative. This study is intended to facilitate my long-term goal: To develop culturally congruent HIV prevention interventions constructed on the mental health-related strengths and resilience of Black MSM. The overall objective of this proposed study is to identify and understand the mental health-related strengths and resilience that contribute to sustained HIV-seronegativity in many Black MSM in New York City (NYC), a high HIV seroprevalence area. The rationale for the proposed study is that with the exception of my NIMH-funded pilot study that identified several protective factors Black MSM favored, such as alternatives to penetrative sex and managed alcohol and drug use and a recent study by Hussen and colleagues (2013), about Black MSM's HIV testing patterns, we know little about these men's approach to maintaining a seronegative status. I will accomplish this objective by pursuing the following two specific aims: 1) To identify and understand the mental health-related strengths and resilience that contribute to the maintenance of seronegativity in Black MSM and 2) To understand how and why Black MSM employed strategies and tactics found in the pilot as a means of maintaining their seronegative status.
In 2010, there was an estimated 10,600 new infections among Black men who have sex with men (MSM) (Centers for Disease Control and Prevention [CDC], 2013b) and in 2011, Black MSM accounted for over 12,000 cases (39%) of all HIV diagnoses in all MSM (CDC, 2013a), even though Blacks are only 12% of the general U.S. population. Although factors associated with higher rates of HIV infection among Black MSM have been identified (e.g., undiagnosed HIV infection and sexually transmitted infections; [CDC, 2013b]), Black MSM who maintain seronegativity have not received much attention. HIV prevention aims to keep seronegative individuals negative, yet researchers have understudied the strategies, tactics, and mental health strengths and resilience of this group of Black MSM.
