Shared communities, structural contexts, and HIV risk: prioritizing the HIV risk and prevention needs of Black...

Area of Science:

• Public Health
• Epidemiology
• Social Sciences

Background:

• Heterosexual contact is the leading HIV exposure category for Black heterosexual men (BHM).
• HIV/AIDS disproportionately affects BHM, exacerbated by socioeconomic factors like poverty, unemployment, and incarceration.
• The "down low" myth has been debunked, yet stigma persists, hindering prevention efforts.

Purpose of the Study:

• To highlight the structural contexts contributing to HIV risk among BHM.
• To underscore the urgent need for prioritized HIV prevention research, policy, and interventions for BHM.
• To identify and discuss community-based approaches for HIV risk reduction and prevention tailored to BHM.

Main Methods:

• Literature review and synthesis of existing empirical data on HIV risk factors for BHM.
• Analysis of structural determinants impacting HIV risk, including socioeconomic and criminal justice system factors.
• Identification and description of four community-based intervention strategies.

Main Results:

• Structural factors such as poverty, unemployment, and incarceration are significantly linked to increased HIV risk for BHM.
• Existing HIV prevention efforts inadequately address the specific needs and contexts of BHM.
• Four promising community-based approaches include men's health programs, workforce/re-entry programs, linkages to women's programs, and faith-based initiatives.

Conclusions:

• Prioritizing HIV prevention for BHM is essential, given the changing epidemiology and social determinants of health.
• Community-based programs addressing structural barriers and tailored to the lived experiences of BHM are critical for effective HIV prevention.
• Integrated approaches, including men's health, employment support, and faith-based partnerships, show promise for reducing HIV risk in this population.