Identifying Factors That Protect HIV Sero-Negative Status In Young Black Men Who Have Sex With Men

Human Immunodeficiency Virus (HIV) infection in the United States continues to rise disproportionately among Black men who have sex with men (BMSM). Traditional strategies to reduce HIV infection among this subgroup have been formulated from a deficit perspective, wherein it is assumed that BMSM are likely to become HIV positive. The purpose of this study was to describe the behavioral practices, perceptions, and influences that contribute to the maintenance of a sero-negative HIV status among young Black men who have sex with men who are actively engaged in sex with men (YBMSM(-)).;A qualitative descriptive design was used to survey 31 YBMSM (-) from two cities in Western New York. Data were generated through semi-structured individual (n=24) interviews and one focus group (n=7). Quantitative measures were administered to provide complementary data. YBMSM(-) were recruited from community-based organizations and health clinics. Participants had a mean age of 20.06 years, demonstrated a mean HIV knowledge score of 76%, and most frequently engaged in sexual behaviors that were low risk for HIV transmission.;YBMSM(-) were consciously engaged in a process of self-preservation that was facilitated by identity integration and resolution of tensions that arose from bi-cultural expectations. YBMSM(-) experienced tension while navigating between the appeals and threats of racial and sexual peer groups. Pornography demystified early sexual desire and provided a repertoire of sexual positing and roles through visual instruction, and as YBMSM (-) developed into manhood, resilience was enhanced by their ability to integrate their racial and sexual identity histories.;YBMSM(-) who actively pursued self-preservation saw themselves as role models and were working to alter the image of BMSM. Exposure to pornography in early adolescence provided a sense of mastery and confidence, as well as literal and behavioral vocabularies; sexual activity between men transcended physical pleasure to encourage communication of emotions and shared experiences with other purposefully selected trustworthy individuals; and YBMSM (-) believed self-awareness increased self-esteem and self-control in situations that threatened their HIV status.;These findings show that the YBMSM(-)'s desire to remain HIV negative is integrated throughout racial, sexual and overall identity development. Clinicians and researchers can best assist YBMSM(-) by helping them to recognize assets and resources already present for self-preservation, encouraging discussions about sexual history including childhood sexual abuse, and investigating the influence of pornography on self-image and sexual behaviors.