Contributions of Qualitative Research in Informing HIV/AIDS Interventions Targeting Black MSM in the United States.

This article presents a systematic review of qualitative studies focusing on human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among Black men who have sex with men (BMSM) in the United States. We reviewed studies that were published between 1980 and 2014. Qualitative methods employed in the studies reviewed include in-depth interviews, focus groups, participant observation, and ethnography. We searched several databases (PubMed, PsychINFO, JSTOR, ERIC, Sociological Abstracts, and Google Scholar) for relevant articles using the following broad terms: "Black men" "Black gay/bisexual" or "Black men who have sex with men," and "qualitative" and/or "ethnography." We include 70 studies in this review. The key themes observed across studies were (1) heterogeneity, (2) layered stigma and intersectionality, (3) risk behaviors, (4) mental health, (5) resilience, and (6) community engagement. The review suggests that sexual behavior and HIV-status disclosure, sexual risk taking, substance use, and psychological well-being were contextually situated. Interventions occurring at multiple levels and within multiple contexts are needed to reduce stigma within the Black community. Similarly, structural interventions targeting religious groups, schools, and health care systems are needed to improve the health outcomes among BMSM. Community engagement and using community-based participatory research methods may facilitate the development and implementation of culturally appropriate HIV/AIDS interventions targeting BMSM.

Exploring migratory dynamics on HIV transmission: the case of Mexicans in New York City and Puebla, Mexico.

Migration and population movement are increasingly viewed as important factors associated with HIV transmission risk. With growing awareness of the potential impact of migration on HIV transmission, several perspectives have emerged that posit differing dynamics of risk. We considered available data on the role of migration on HIV transmission among Mexican migrants in New York City and Puebla, Mexico. Specifically, we examined 3 distinct models of migratory dynamics of HIV transmission-namely, the structural model, the local contextual model, and the interplay model. In doing so, we reframed current public health perspectives on the role of migration on HIV transmission.

Beyond faith-based organizations: using comparative institutional ethnography to understand religious responses to HIV and AIDS in Brazil.

Religious institutions, which contribute to understanding of and mobilization in response to illness, play a major role in structuring social, political, and cultural responses to HIV and AIDS. We used institutional ethnography to explore how religious traditions--Catholic, Evangelical, and Afro-Brazilian--in Brazil have influenced HIV prevention, treatment, and care at the local and national levels over time. We present a typology of Brazil's division of labor and uncover overlapping foci grounded in religious ideology and tradition: care of people living with HIV among Catholics and Afro-Brazilians, abstinence education among Catholics and Evangelicals, prevention within marginalized communities among Evangelicals and Afro-Brazilians, and access to treatment among all traditions. We conclude that institutional ethnography, which allows for multilevel and interlevel analysis, is a useful methodology.

Familism and sexual regulation among bisexual Latino men.

As the AIDS epidemic continues to disproportionately affect the Latino and African American communities in the United States, little is still known about bisexual behavior and sexual risk of Latino and African American men. This article explores the construct of familism (i.e., the cultural value that weighs on the interdependence among nuclear and extended family members for support, emotional connectedness, familial honor, loyalty, and solidarity) as an analytical point of departure from which to conceptualize sexual risk for bisexual Latino men. Data collection methods involved detailed sexual histories of 18 bisexually-active Latino men in the metropolitan New York City area. The results of this study indicate that familism, as defined by familial support, emotional interconnectedness, and familial honor, shapes the sexual decisions of bisexual teenage and adult Latino men.

Condom use and hip hop culture: the case of urban young men in New York City.

OBJECTIVES: We explored how young men's perceptions of and participation in hip hop culture--urban social and artistic expressions, such as clothing style, breakdancing, graffiti, and rap music--and how contextual factors of the hip hop scene may be associated with their condom use, condom-use self-efficacy, and sense of community. METHODS: We conducted a cross-sectional survey of 95 African American and Latino men aged 15 to 25 years as part of a 4-year ethnographic study in New York City. RESULTS: Differences in young men's perceptions of and levels of affiliation with hip hop culture were not statistically associated with differences in their sense of community or condom-use self-efficacy. Frequency of participation in the hip hop nightclub scene was the strongest factor negatively associated with condom use. CONCLUSIONS: Popular discourses on young men's health risks often blame youths' cultures such as the hip hop culture for increased risk practices but do not critically examine how risk emerges in urban young men's lives and what aspects of youths' culture can be protective. Further research needs to focus on contextual factors of risk such as the role of hip hop nightlife on increased HIV risk.

Sexual place, spatial change, and the social reorganization of sexual culture.

This paper describes how the landscape of a public place in a New York City park embodies larger external structures within which sexual subjects actively organize local sexual culture. Controlling the configuration and utilization of such space is a technique of power used by the state apparatus. Based upon ethnographic fieldwork, we describe how the sexual culture situated within this public space is produced and reproduced in the micro-social practices of sexual subjects in the face of structural constraints. The social reorganization of sexuality occurs when subjects creatively refashion their local sexual culture through subtle alterations in the way they practice it. Such practical alterations occur in dialogue with larger structures. Ultimately, this analysis of sexual space in San José Park provides for an examination of the deployment of power and local sexual culture as the nexus of structure and agency.

Beyond 'MSM': Sexual Desire Among Bisexually-Active Latino Men in New York City.

Latino male bisexuality has been studied for the most part with a focus on men who have sex with men (MSM) and with little attention to sexual desire. The goal of this article is to present a comprehensive understanding of how sexual desire is organized, enacted through sexual activity, and interpreted in the sexual lives of bisexually-active Latino men. To achieve this aim, an analysis was made of 18 sexual histories of bisexually active Latino men who participated in a two-year ethnographic study. Four configurations of sexual desire were constructed to reflect what was found in this population of bisexually-active Latino men: (a) lifetime homoerotic desire and casual sex with women; (b) lifetime heteroerotic desire, but commercial sex with men; (c) lifetime heteroerotic/transgender desire; (d) lifetime sexual desire for women and men. These configurations are explored in detail in this article. The analysis presented here is intended to offer insights into the overall study of Latino male bisexuality and into the foundations for the design of HIV and STI prevention programs directed toward bisexually-active Latino men and their partners.