Substance use, intimate partner violence, history of incarceration and vulnerability to HIV among young Black men who have sex with men in a Southern US city

Abstract

In this longitudinal qualitative study we explored the lived experiences of young Black men who have sex with men in Dallas, Texas in relation to methamphetamine use, intimate partner violence and a history of incarceration as syndemic conditions that may contribute to their risk of transmitting or acquiring HIV. We conducted a total of 106 interviews (four repeat interviews every six months) with a cohort of 30 participants. Some reported condomless sex and no discussion about condom use or HIV status with sexual partners. Fifteen participants reported that they were living with HIV. Methamphetamine use contributed to participants’ unstable housing, job loss, destructive relationships and HIV risk. One third of participants reported a history of intimate partner violence. About half had a history of incarceration resulting from intimate partner violence, substance use/dealing and/or other activities. Post-release, having a criminal record limited job opportunities and impacted financial stability. Consequently, some men engaged in survival work involving HIV risk (sex work, organising/participating in sex parties). Methamphetamine use, intimate partner violence and incarceration may constitute syndemic conditions that increase young Black men who have sex with men’s risk for HIV acquisition and transmission. HIV prevention interventions must address syndemics and include structural factors and the wider social environment.

Keywords:

• Young Black men who have sex with men
• methamphetamine use
• intimate partner violence
• incarceration
• HIV vulnerability

Acknowledgements

The authors thank the interview participants for sharing part of their life stories with us and being part of our study.

Notes

1 Slang terms for methamphetamine.

Additional information

Funding

This study was supported by the US National Institute of Mental Health, grant # R01 MH-096690. The authors’ views expressed in this publication do not necessarily reflect the views of the National Institute of Mental Health or the US government.