Exploring Associations of Autonomy Supportive Sexual Health Communication, Needs Satisfaction, and Sexual Health Behaviors for Black MSM in the House Ball Community

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Abstract Black and Latinx men who have sex with men (MSM) have the highest risk of HIV of any group in the U.S. with overall prevalence ranging from 21% to 28%. This ratio could be even higher among Black and Latinx MSM belonging to the House Ball Community (HBC), an understudied subculture comprised primarily of Black and Latinx sexual and gender minorities (primarily gay and bisexual men), with documented HIV prevalence ranging from 4% to 38%, the majority (76%) of which remain undiagnosed. These data mandate urgency to build upon and expand the repertoire of culturally-congruent interventions that reduce HIV risk for Black and Latinx MSM, especially among members of the House Ball Community (HBC). HBC-MSM often seek sexual health advice from trusted and influential members of social and/or sexual network members and such advice has been linked with less sexual risk behavior, although evidence is mixed. Basic Psychological Needs Theory, a sub-theory of Self-Determination Theory (SDT), will be utilized as a framework to further understand how sexual health communication influences sexual health behaviors of HBC- MSM. The proposed quantitative study will advance this goal by describing characteristics of sexual health communication embedded within social and sexual networks, and identifying the effects of sexual health communication on sexual health behaviors among a sample of Black and Latinx HBC-MSM. Such knowledge is necessary to expand understanding of how sexual health communication impacts sexual health behaviors. The study provides an unprecedented perspective on sexual health preferences and motivations as participants socialize and function in HBC. The information generated on the effects of autonomy support on sexual-risk behaviors will help improve current HIV prevention interventions, as well as inform the development of future interventions, tailored to HBC-MSM.