“Let Me Help You Help Me”: HIV Prevention in Churches for Young Black Men Who Have Sex with Men

Young Black men who have sex with men (YBMSM) between the ages of 13 and 24 years old have been disproportionately burdened by HIV, accounting for approximately 45% of all new cases of infection among men who have sex with men. Despite well-documented efforts to reduce HIV transmission and acquisition within this population, HIV rates continue to rise. As a result, there is an urgent need to develop and test comprehensive, culturally sensitive HIV prevention programs for YBMSM that have sufficient reach, power, and sustainability. Previous research has suggested that the Black church is well positioned to be a strategic partner in the fight against HIV/AIDS among YBMSM; however, few have engaged YBMSM in the development of effective approaches to facilitate such partnerships. Therefore, the purpose of this study was to solicit strategies from YBMSM for Black churches to address HIV prevention among YBMSM.

A semi-structured interview guide was used to conduct in-depth interviews with 30 YBMSM living in Baltimore, Maryland. Participants ranged from 18 to 25 years old (M = 22.5 years). Over half (53%) of participants reported attending church once a month or more (regular attendees). Over 80% of participants reported high school completion. Twenty-three percent of the sample (n = 7) was HIV-positive. Fewer than half (43%) were currently using drugs. Interviews were digitally recorded, transcribed verbatim, verified by a research team member, imported into a qualitative software program (Atlas 7.0), and analyzed inductively using a qualitative content analytic approach.

Findings describe the receptivity of YBMSM to church-based HIV prevention efforts that can be integrated into a church’s existing programs. Participants identified two main strategies for churches to address HIV prevention efforts among YBMSM. First, participants proposed reducing homosexuality stigma in Black churches by fostering acceptance at the individual and institutional level. It is crucial that we identify, understand, and address homosexuality stigma and the tensions that exist within Black churches as we consider comprehensive HIV prevention in these settings. Second, respondents argued that sexual health is a component of total health, which could be addressed universally as well as within specific groups. Future researchers might consider partnering with churches to  develop HIV prevention programs that focus on the determinants of HIV risk that place all individuals, not just YBMSM, at risk for contracting the virus. Results reinforce the need for systematic, intergenerational approaches that incorporate personal, social, and cultural factors to HIV prevention efforts among YBMSM.