Black gay men face the challenge of navigating their truth within a culture that values strength, sex and masculinity. They are often rejected by their families and ostracized by their communities.
This review identifies gaps in research that place HIV prevention among this community largely at the forefront of study agendas to the detriment of other health domains. Future research should take an intersectional approach.
Relationships
Black gay men often have a difficult time opening up about their sexuality to their family members. Those who do come out are often met with rejection and hostility. Family members may also use religion to justify their prejudice against same-sex relationships.
Many participants, especially those who first experienced sex with an older partner during adolescence, cited the emotional maturity of their older partners and the ability of these men to expose them to more life experiences as reasons for seeking out their company. Moreover, these older men were perceived as being stable and direct within their relationships, something that youth aspired to become.
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Sexuality
A common theme in health literature targeting Black YGBMSM is an overemphasis on sex and sexually-related health concerns. This is likely due to epidemiologic trends of disproportionate HIV and STI risk among this population. However, it is important to remember that Black YGBMSM have many other health needs as well.
The use of specific terms for sex and sexual behaviors in Black gay language reflects the richness and complexity of the culture of this group. It also demonstrates the dynamic nature of the vernacular and the power of slang to create cultural definitions. This vocabulary can be heard in their speech rhythms, tonal patterns and non-verbal behavior.
Bailey calls attention to the way in which epidemiological surveillance of unprotected sex among black gay men reinforces a pathologized and surveilled sense of their own sexuality. He suggests that a move beyond this paradigm requires the development of sex education and prevention methods that address the experience of sex as pleasure and desire rather than as a risky and transmissible practice.
Religion
In their communities, many BGBM feel that a sense of spirituality and religiosity are deeply tied to family and community. These men frequently turn to church and religious practices for support and coping. They also find these activities to be a source of identity affirmation.
However, despite the fact that most Black churches now affirm same-sex marriage, the majority of participants in this study reported that they had experienced internalized homonegativity from their upbringing in church or within Black communities. Some have disconnected from the church completely while others find ways to reconcile their religious and spiritual beliefs with their same-sex attraction.
It is important to understand how religiosity and spirituality shape sexual positioning practices for BGBM as this may affect HIV and STI risk behaviors (Dangerfield et al., 2017b). This information is critical to designing culturally congruent HIV and STI prevention messaging for this population. Specifically, messaging that reinforces the use of insertive and RAI with male partners can decrease the risk of STIs and HIV among this population.
Family
From diapers to proms, from bottles to homework a lot of work goes into being a parent. And yet for many Black gay men, a family seems out of reach.
YBGBM are at the intersection of multiple stigmatized identities that predispose them to risk and poor outcomes. Threats at interpersonal, intermediate structural and macro-structural levels impact them. These include discrimination, racial and sexual orientation bias in health care settings, lack of access to social services, mistrust of medical professionals and fear of disclosing same-sex relationships [78].
YBGBM can be protected from these threats by factors such as resilience, racial centrality, religiosity and spirituality, community connectedness and support from peers who act as parental figures when their own families reject them. Clinicians should keep in mind these promoting factors when working with YBGBM and consider the potential for using an intersectionality framework when assessing their risk for adverse health outcomes.