Working with positive men: HIV prevention with black men who have sex with men

There is limited empirical evidence on effective HIV/AIDS prevention for Black MSM. Few studies have been undertaken to examine the specific ways in which Black MSM construct their health and help-seeking practices relative to HIV/AIDS. In this article I examine the role of patients and providers as a collaborative unit to bring about productive HIV/AIDS outcomes. I report on a qualitative study of 50 men who participated in semistructured focus groups and individual interviews. Major themes are presented and discussed: the personal costs of adherence and perceptions about HIV medications and their utility (outcomes), quality of life concerns, impact and importance of the relationship with the primary care provider, elements of the treatment milieu (proximal variables); and personal-historical experiences that shape views of health care and health seeking (antecedent). A sociocultural model of interaction between patient, provider and setting is offered as a framework for working with Black MSM in service delivery and further research.