Public Health Commons^™

Hiv Testing Practices Among Black Primary Care Physicians In The United States, Eric Y. Wong, Wilbert C. Jordan, David J. Malebranche, Lori L. Delaitsch, Rebecca Abravanel, Alisha Bermudez, Bryan P. Baugh

David J Malebranche

Background: The Centers for Disease Control and Prevention recommends routine HIV testing in all healthcaresettings, but it is unclear how consistently physicians adopt the recommendation. Making the most of each interaction between black physicians and their patients is extremely important to address the HIV health disparities that disproportionately afflict the black community. The goal of this survey-based study was to evaluate the perceptions and practices of black, primary care physicians regarding HIV testing.

Methods: A physician survey was administered at the 2010 National Medical Association Annual Convention, via online physician panels, and by email. Physician eligibility criteria: black race; practicing …

Health Care And Hiv Testing Experiences Among Black Men In The South: Implications For "Seek, Test, Treat And Retain" Hiv Prevention Strategies, Rupali K. Doshi, David J. Malebranche, Lisa Bowleg, Thurka Sangaramoorthy

David J Malebranche

Few studies have explored how overall general health care and HIV/STI testing experiences may influence receipt of ‘‘Seek, Test, Treat, and Retain’’ (STTR) HIV prevention approaches among Black men in the southern United States. Using in-depth qualitative interviews with 78 HIV-negative/unknown Black men in Georgia, we explored factors influencing their general health care and HIV/STI testing experiences. The Andersen behavioral model of health care utilization (Andersen model) offers a useful framework through which to examine the general health care experiences and HIV testing practices of Black men. It has four primary domains: Environment, Population characteristics, Health behavior, and Outcomes. Within …

Common Roots: A Contextual Review Of Hiv Epidemics In Black Men Who Have Sex With Men Across The African Diaspora, Gregorio A. Millett, William L. Jeffries 4h, John L. Peterson, David J. Malebranche, Tim Lane, Stephen A. Flores, Kevin A. Fenton, Patrick A. Wilson, Riley Steiner, Charles M. Heilig

David J Malebranche

Pooled estimates from across the African diaspora show that black men who have sex with men (MSM) are 15 times more likely to be HIV positive compared with general populations and 8·5 times more likely compared with black populations. Disparities in the prevalence of HIV infection are greater in African and Caribbean countries that criminalise homosexual activity than in those that do not criminalise such behaviour. With the exception of US and African epidemiological studies, most studies of black MSM mainly focus on outcomes associated with HIV behavioural risk rather than on prevalence, incidence, or undiagnosed infection. Nevertheless, black MSM …

Parents, Peers And Pornography: The Influence Of Formative Sexual Scripts On Adult Hiv Sexual Risk Behaviour Among Black Men In The Usa, Sophia A. Hussen, Lisa Bowleg, Thurka Sangaramoorthy, David J. Malebranche

David J Malebranche

Black men in the USA experience disproportionately high rates of HIV infection, particularly in the Southeastern part of the country. We conducted 90 qualitative in-depth interviews with Black men living in the state of Georgia and analysed the transcripts using Sexual Script Theory to: (1) characterise the sources and content of sexual scripts that Black men were exposed to during their childhood and adolescence and (2) describe the potential influence of formative scripts on adult HIV sexual risk behaviour. Our analyses highlighted salient sources of cultural scenarios (parents, peers, pornography, sexual education and television), interpersonal scripts (early sexplay, older female …

With His Hands, David J. Malebranche

David J Malebranche

No abstract provided.

Sexual Health And Life Experiences: Voices From Behaviourally Bisexual Latino Men In The Midwestern Usa, Omar Martinez, Brian Dodge, Michael Reece, Phillip W. Schnarrs, Scott D. Rhodes, Gabriel Goncalves, Miguel Munoz-Laboy, David J. Malebranche, Barbara Van Der Pol, Ryan Nix, Guadalupe Kelle, J Dennis Fortenberry

David J Malebranche

Research on behaviourally bisexual Latino men in the USA has not yet examined sexual health issues among men living in diverse areas of the nation, including the Midwest. A community-based participatory research approach was used to engage a diverse sample of 75 behaviourally bisexual men (25 White, 25 Black and 25 Latino). Semi-structured interviews were conducted and standard qualitative analysis procedures were used to explore data from the 25 Latino participants. Men described their unique migration experiences as behaviourally bisexual men in this area of the USA, as well as related sexual risk behaviours and health concerns. Lack of culturally …

What Does It Take To Be A Man? What Is A Real Man?': Ideologies Of Masculinity And Hiv Sexual Risk Among Black Heterosexual Men, David J. Malebranche, Lisa Bowleg, Michelle Teti, Jenne S. Massie, Aditi Patel, Jeanne M. Tschann

David J Malebranche

Research documents the link between traditional ideologies of masculinity and sexual risk among multi-ethnic male adolescents and White male college students, but similar research with Black heterosexual men is scarce. This exploratory study addressed this gap through six focus groups with 41 Black, low- to middle-income heterosexual men aged 19 to 51 years in Philadelphia, PA. Analyses highlighted two explicit ideologies of masculinity: that Black men should have sex with multiple women, often concurrently, and that Black men should not be gay or bisexual. Analyses also identified two implicit masculinity ideologies: the perception that Black heterosexual men cannot decline sex, …

The Relationship Between Gender Role Conflict And Condom Use Among Black Msm, David J. Malebranche, Roman Gvetadze, Gregorio A. Millett, Madeline Y. Sutton

David J Malebranche

Gender role conflict may influence condom use among black MSM. We examined relationships between the Gender Role Conflict Scale (GRCS), social/demographic variables and condom use among 456 black MSM. Higher total GRCS scores did not predict unprotected insertive anal intercourse (UIAI) or unprotected receptive anal intercourse (URAI) with men, but were associated with unprotected vaginal or anal intercourse (UVI/UAI) with women among bisexually active participants (n = 69). Higher perceived HIV risk reduced the likelihood of both UIAI and URAI with men. Internet recruitment venues, sexual discrimination experiences, higher numbers of sex partners and UVI/UAI with women all increased the …

Hiv Risk And Perceptions Of Masculinity Among Young Black Men Who Have Sex With Men, Errol L. Fields, Laura M. Bogart, Katherine C. Smith, David J. Malebranche, Jonathan Ellen, Mark A. Schuster

David J Malebranche

Purpose: Young black men who have sex with men (YBMSM) are known to have the highest rates of HIV infection in the United States. Although reported rates of unprotected anal intercourse are similar to the rates ofmen who have sex with men of other racial/ethnic backgrounds, YBMSM aged 15–22 years are five times more likely to be HIV-infected than the comparably aged white men who have sex with men. We explored contextual social-environmental factors that may influence how YBMSM assess risk, choose partners, and make decisions about condom use.

Methods: We analyzed semi-structured interviews with 35 YBMSM (age: 18–24 years) …

Becoming A Father, David J. Malebranche

David J Malebranche

No abstract provided.

Exploring The "Bisexual Bridge": A Qualitative Study Of Risk Behavior And Disclosure Of Same-Sex Behavior Among Black Bisexual Men, David J. Malebranche, Kim Arriola, Tyrrell R. Jenkins, Emily Dauria, Shilpa N. Patel

David J Malebranche

Objectives. We explored factors influencing sexual behavior, disclosure of same-sex behavior, and condom-use practices among Black bisexual men. Methods. We conducted semistructured interviews with 38 Black men in Atlanta, Georgia, who reported having had oral, vaginal, or anal sex with both men and women in the prior 6 months. Results. Participants described approaches to disclosure of same-sex behavior as part of a complex decisional balance influenced by both situational and individual factors and ranging from full disclosure to total secrecy. Influences on sexual behavior and condom-use practices included: (1) type of relationship, (2) gender-specific considerations, (3) perceptions of comfort or …

Masculine Socialization And Sexual Risk Behaviors Among Black Men Who Have Sex With Men: A Qualitative Exploration, David J. Malebranche, Errol L. Fields, Lawrence O. Bryant, Shaun R. Harper

David J Malebranche

Aspects of masculine socialization among Black men who have sex with men (MSM) and potential corresponding influences on high-risk sexual behaviors are explored in this study. Individual interviews were conducted with 29 Black MSM in Atlanta, Georgia. Findings included (1) formative masculine socialization experiences marked by an absence of biological fathers and Black male role models, (2) negative perceptions of “gay” identities and communities, (3) race and racial identification as intersecting influences on masculine and sexual identities, (4) the influences of masculine socialization and beliefs on partner selection and sexual behaviors, and (5) general themes of trust, control, “heat of …

Childhood Sexual Abuse In Black Men Who Have Sex With Men: Results From Three Qualitative Studies, Sheldon D. Fields, David J. Malebranche, Sonja Feist-Price

David J Malebranche

This report describes the high prevalence and context of childhood sexual abuse (CSA) among Black men who have sex with men (MSM) across 3 independent qualitative studies. Semistructured one-on-one interviews were conducted with 87 Black MSM across 3 cities (Rochester, NY, n=28; Lexington, KY/Atlanta, GA, n=30; and Atlanta, GA, n =29). A combined CSA prevalence of 32% (28/87) was found among the 3 samples, despite variation in geographic location, mean age, and sexual identification. Common themes emerging across the 3 samples included prolonged and repeated abuse by a close male relative; blaming of same-sex desire on CSA; and descriptions of …

Bisexually Active Black Men In The United States And Hiv: Acknowledging More Than The "Down Low", David J. Malebranche

David J Malebranche

HIV is disproportionately impacting Black men who have sex with men and heterosexual women in theUnited States. Current speculation posits a ‘‘bisexual bridge’’ of HIV transmission connecting these two subpopulations of the Black community. Specifically, bisexually active Black men who identify as heterosexual but do not disclose their same-sex behavior, or ‘‘down low’’ (DL) men, have received the most attention and blame as the primary group fueling this epidemic. This essay explores the current knowledge and limitations of public health research on bisexually active Black men. Implications for future research initiatives are discussed.

Partner Notification: A Promising Approach To Addressing The Hiv/Aids Racial Disparity In The United States, David J. Malebranche, Patricia Kissinger

David J Malebranche

No abstract provided.

Hiv/Aids Prevention Research Among Black Men Who Have Sex With Men: Current Progress And Future Directions, Gregorio A. Millett, David J. Malebranche, John L. Peterson

David J Malebranche

No abstract provided.

Eye Of The Needle, David J. Malebranche

David J Malebranche

No abstract provided.

One In Three, David J. Malebranche

David J Malebranche

No abstract provided.

Community-Acquired Methicillin-Resistant Staphylococcus Aureus: Time To Address The Problem, David J. Malebranche

David J Malebranche

No abstract provided.

Adverse Health Outcomes Among Black Americans: Living With Hiv - Nature Or Nurture?, David J. Malebranche

David J Malebranche

No abstract provided.

Focusing "Down Low": Bisexual Black Men, Hiv Risk And Heterosexual Transmission, Gregorio Millett, David Malebranche, Byron Mason, Pilgrim Spikes

David J Malebranche

Introduction: Black men who have sex with men (MSM) and women but who do not identify as gay or disclose their bisexual activities to main female partners, also known as men “on the down-low,” have been cited as the main reason for the increase in HIV infections in black women. Methods: Three online databases (PsychInfo, MEDLINE and AIDSLINE) were searched for scientific articles related to men on the down-low. A total of 24 articles and two conference abstracts were selected for review. Results: Data from existing studies of MSM reveal low agreement between professed sexual identity and corresponding sexual behavior …

Race And Sexual Identity: Perceptions About Medical Culture And Healthcare Among Black Men Who Have Sex With Men, David J. Malebranche, John L. Peterson, Robert E. Fullilove, Richard W. Stackhouse

David J Malebranche

Black men who have sex with men (BMSM) in the United States are disproportionately affected by HIV. Using a qualitative approach, the authors describe the healthcare experiences of BMSM in New York State and Atlanta, GA, exploring the social issues that influence barriers to care, communication, and adherence in medical settings. Racial and sexual discrimination socially displace BMSM, and are often compounded by negative encounters within medical institutions. The internalization of these experiences influences healthcare utilization, HIV testing, communication, and adherence behaviors among members of this population. Increasing the number of ethnic and sexual minority providers, expanding current definitions of …

Learning About Medicine And Race, David J. Malebranche

David J Malebranche

No abstract provided.

Black Men Who Have Sex With Men And The Hiv Epidemic: Next Steps For Public Health, David J. Malebranche

David J Malebranche

No abstract provided.