Social networks and social support to reduce HIV-related risk behavior for young African American men who have sex with men (YAAMSM)
E. Arnold, D. Williams, D. Pierceson, S. Kegeles
University of California, San Francisco, Center for AIDS Prevention Studies, San Francisco, CA, United States
Background: The urgency of the HIV epidemic among young African American men who have sex with men (YAAMSM) mandates prevention scientists to identify culturally appropriate and sustainable forms of intervention for this population. Examining social networks situated within the African American lesbian, gay, bisexual, transgender (LGBT) community may shed light on organically occurring forms of social support, including emotional support (such as giving advice about relationships and sex) and material support (such as providing money or temporary housing). Mapping existing social support structures offers a window into the impact of social support on HIV-related risk behavior for YAAMSM.
Methods: From 2007-2009, we conducted an ethnographic study in the San Francisco Bay Area to examine forms of social support available to YAAMSM. We conducted 67 in-depth interviews with YAAMSM, LGBT community leaders, and HIV service providers. We also conducted participant observation at formal social events, including drag balls, and more informal social gatherings. Data were analyzed using grounded theory.
Results: Structural conditions such as unstable housing, estrangement from biological family, poverty, and lack of employment and educational opportunities contributed to HIV-related risk behavior among YAAMSM. However, affiliations with community leaders, who often played ‘parenting’ roles for YAAMSM, and involvement in kinship-like social support networks, called ‘houses’ or ‘gay families,’ lessened the impact of these difficult structural conditions and reduced vulnerability to HIV through the provision of material and emotional social support. Some community leaders also integrated HIV prevention messages and materials into social events they hosted, providing culturally appropriate, relevant mechanisms of intervention by promoting condom use, HIV testing, and HIV-status disclosure.
Conclusions: Social support networks are central to sustaining communities, particularly for LGBT populations. HIV prevention programs should find creative strategies for engaging with social support networks, to utilize and build on healthy forms of social support occurring within existing community structures.