Critical Consciousness-Based HIV Prevention Interventions for Black Gay and Bisexual Male Youth

Abstract

Black gay/bisexual male youth are one of the groups most affected by HIV in the United States, but few behavioral interventions have been created specifically to address this health inequity. Oppression related to these youths’ multiple social identities—including racism, heterosexism, and HIV stigma—contribute to increased health risks. Primary and secondary HIV prevention interventions created specifically for Black gay/bisexual male youth that address the negative impact of oppression are urgently needed. We present empowerment as a framework for understanding how oppression affects health, and critical consciousness as a tool to be utilized in behavioral interventions. This approach helps to move Black gay/bisexual male youth from a place of oppression and powerlessness that leads to elevated health risks to a position of empowerment that promotes feelings of control and participation in healthy behaviors. Finally, we present a case example of our own critical consciousness-based secondary HIV prevention intervention created specifically for Black gay/bisexual male youth.

Keywords:

• Critical consciousness
• Black
• gay
• HIV prevention
• empowerment

Acknowledgments

This work was supported by The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) from the National Institutes of Health [U01 HD040533 and U01 HD040474] through the National Institute of Child Health and Human Development (B. Kapogiannis, S. Lee), with supplemental funding from the National Institutes on Drug Abuse (K. Davenny, S. Kahana) and Mental Health (P. Brouwers, S. Allison). This study was scientifically reviewed by the ATN’s Behavioral Leadership Group. The authors thank the ATN Coordinating Center, Craig Wilson, MD, and Cynthia Partlow for Network scientific and logistical support, the ATN Community Advisory Board and the youth who participated in the study. We acknowledge the contribution of the investigators and staff at the following sites that participated in this study: The Children’s Hospital of Philadelphia (Douglas, Tanney, Di Benedetto), Ruth M. Rothstein CORE Center/John H. Stroger Jr. Hospital (Martinez, Henry-Reid, Bojan, Jackson), Children’s Hospital of Los Angeles (Belzer, Tucker, McAvoy-Banerjea), Montefiore Medical Center (Futterman, Campos, Enriquez-Bruce), St. Jude Children’s Research Hospital (Gaur, Flynn, Dillard, London), and Baylor College of Medicine (Paul, Cooper, Calles).