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Sexual Positioning Practices and Sexual Risk Among Black Gay and Bisexual Men: A Life Course Perspective

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Abstract

Increased attention has highlighted the role of age and sexual development on HIV risk among Black MSM (BMSM); limited focus has been given to the relationship of sexual positioning to HIV risk along the life course. This study examined BMSM’s life course sexual positioning practices and accompanying HIV/STI risks. Twenty-six Black gay and bisexual men ages 24–61 completed life history interviews in Los Angeles, California, between September and November 2015. Thematic analysis evaluated domains including major life events, substance use, social support, and partner selection. Varying exposure to HIV treatment and prevention options and venues to meet male partners revealed generational differences in sexual risks. Childhood sexual abuse and internalized homonegativity impacted personal development, sexual positioning, and condom negotiation. BMSM also assumed sexual positioning using masculinity stereotypes and body language. Clarifying the sexual development and HIV/STI risk contexts among BMSM could better inform current treatment and prevention needs.

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Acknowledgements

We acknowledge and thank Greg Wilson and the staff at REACH LA for all their support as the research site for this study.

Funding

This research was funded by the National Science Foundation Graduate Research Fellowship Program (Award Year 2013). Additional support was also provided by NIDA grant K01 DA039767.

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Authors and Affiliations

  1. The REACH Initiative, Johns Hopkins School of Nursing, Baltimore, MD, 2120532, USA

    Derek T. Dangerfield II & Jason Farley

  2. Division of Global Public Health, University of California, La Jolla, San Diego, CA, USA

    Laramie R. Smith

  3. Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA

    Janeane N. Anderson

  4. Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA

    Omar J. Bruce

  5. Department of Community Public Health, Johns Hopkins School of Nursing, Baltimore, MD, USA

    Jason Farley

  6. Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Ricky Bluthenthal

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  1. Derek T. Dangerfield II
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Correspondence to Derek T. Dangerfield II.

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Dangerfield, D.T., Smith, L.R., Anderson, J.N. et al. Sexual Positioning Practices and Sexual Risk Among Black Gay and Bisexual Men: A Life Course Perspective. AIDS Behav 22, 1919–1931 (2018). https://doi.org/10.1007/s10461-017-1948-6

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