Feasibility of recruiting nondisclosing Black MSM/W for drug use /HIV research

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DESCRIPTION (provided by applicant): This project will investigate the feasibility of conducting ethnographic research on HIV risk among drug-using Black men who have sex with men and women but do not identify as gay or homosexual and do not disclose their same-sex activity to their female partners. Because these men do not identify as gay or homosexual, there is concern that they are not being reached by programs aimed at gay-identified communities. The specific aims are: 1) To locate and recruit for interviewing drug-using Black men who have sex with men and women (MSM/W) but do not disclose their same-sex activity to their female partners. 2) To gain a preliminary understanding of how Black MSM/W decide whether and what to disclose about their HIV risk behaviors including drug use and high risk sexual practices. Because male-to-male sexual contact is the most commonly reported HIV/AIDS transmission category among men, there is a growing body of research on MSM, including Black MSM/W. However, there appear to be no systematic investigations of patterns of drug use among Black MSM/W or on the issue of disclosing same-sex activity to female partners. There is speculation that Black MSM/W constitute a "bridge" population facilitating HIV infection among Black women but there is insufficient empirical evidence to substantiate the claim. The broad goal of this project is to foster further research on the relationship between drug use and HIV risk among Black adults, in order to develop a better understanding of the severe racial disparities in HIV/AIDS infection. Black men are six times more likely than White men to be infected, and Black women are 19 times as likely as White women to be infected. This project will employ two ethnographers to recruit men through four sources: 1) existing social networks established in our previous research in low-income, high-HIV neighborhoods; 2) known MSM venues such as clubs, bars, parks and street locations; 3) Internet sites and 4) groups and organizations serving drug users and ex-offenders. Five small focus groups at two points in the study will help to enhance our recruitment strategy and shape lines of inquiry regarding decisions to conceal or disclose behavior. Ethnographers will also cultivate relationships with and conduct individual interviews with 30 men to obtain preliminary insights into drug use and MSM activity, knowledge and management of HIV risk and factors influencing disclosure decisions. If the proposed feasibility study yields a successful strategy for recruiting and interviewing Black MSM/W, it can be incorporated into a subsequent larger effort (an R01) designed to collect more extensive data that can inform appropriate risk-reduction interventions. PUBLIC HEALTH RELEVANCE: This feasibility study is designed to improve research on HIV risk and protective factors among drug-involved men who have sex with men and women. The study is focused on Black men who do not identify as gay or homosexual and do not disclose their same-sex activity to their female partners. Because these men do not identify as gay or homosexual, they may not be reached by prevention programs aimed at gay-identified communities. This study will identify successful strategies for recruiting and interviewing these men, with the longer-term goals of generating knowledge that can contribute to more effective interventions that may ultimately reduce racial disparities in HIV/AIDS.