Sexual Identity Disclosure and Awareness of HIV Prevention Methods Among Black Men Who Have Sex With Men

Abstract

Black men who have sex with men (BMSM) are disproportionately affected by the human immunodeficiency virus (HIV) epidemic, yet we know little about how HIV-negative BMSM of different sexual orientations access HIV prevention strategies. Identity development, minority stress, and disclosure theories suggest that for people of different sexual orientations, disclosure of sexual identity may be related to health behaviors. We performed a latent class analysis on a sample of 650 BMSM (M_age = 33.78, SD = 11.44) from Atlanta, Georgia, to explore whether sexual orientation, disclosure of sexual identity, and relationship status were related to HIV prevention strategies, including awareness of PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) and frequency of HIV testing. We found three distinct BMSM classes referred to as (1) closeted bisexuals, (2) sexual identity managers, and (3) gay, out, and open; all classes primarily engaged in casual sex. Classes differed in their awareness and access to HIV prevention strategies. The closeted bisexual class was least aware of and least likely to access HIV prevention. Findings have important implications for future research, namely the consideration of sexual identity and disclosure among BMSM. With this knowledge, we may be able to engage BMSM in HIV/sexually transmitted infection (STI) prevention services.

Funding

The authors acknowledge funding support for this research from the National Institutes of Health (R01MH094230, and R01MH109409). Fish acknowledges support from the National Institute on Alcohol Abuse and Alcoholism (F32AA023138) and from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD042849) awarded to the Population Research Center at the University of Texas at Austin. In addition, Allen’s contribution to this article was supported by a National Institute of Mental Health training grant (T32MH074387).

Additional information

Funding

The authors acknowledge funding support for this research from the National Institutes of Health (R01MH094230, and R01MH109409). Fish acknowledges support from the National Institute on Alcohol Abuse and Alcoholism (F32AA023138) and from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD042849) awarded to the Population Research Center at the University of Texas at Austin. In addition, Allen’s contribution to this article was supported by a National Institute of Mental Health training grant (T32MH074387).