Saleh Lena D, Operario Don, Smith Carla Dillard, Arnold Emily, Kegeles Susan
Department of Social Policy and Intervention, University of Oxford, England, UK.
AIDS Educ Prev. 2011 Dec;23(6):521-32. doi: 10.1521/aeap.2011.23.6.521.
In the United States, there is an urgent need to provide HIV prevention services to African American men who have sex with men and women (MSMW) but who do not identify as gay or homosexual. Engaging these men in HIV prevention has historically been challenging. This study used qualitative methodology to explore the beliefs and experiences from community-based service providers (n = 21) and from African American MSMW (n = 21) regarding the provision of HIV prevention education and counseling to these men. Data analysis revealed that (a) African American MSMW who do not identify as gay can challenge service providers' assumptions about sexual behavior and sexual identity; (b) service providers' attitudes toward these men can be affected by ambivalent or negative beliefs that pervade the general community; (c) African American MSMW need safe and nonjudgmental spaces that offer HIV risk reduction, but they also might experience anxiety about disclosing same-sex behaviors to counselors. Findings highlighted the complexities related to culture, masculinity, and sexuality as determinants of HIV risk in African American MSMW, and findings also revealed tensions between these factors that may affect the quality of HIV prevention services. Service providers may need additional training to provide appropriate and non-judgmental HIV prevention counseling and education.
在美国，迫切需要为与男性和女性发生性行为的非裔美国男性（双性恋男性）提供艾滋病毒预防服务，这些男性并不认同自己为同性恋者。历史上，让这些男性参与艾滋病毒预防工作一直具有挑战性。本研究采用定性方法，探讨了社区服务提供者（21人）和非裔美国双性恋男性（21人）对于向这些男性提供艾滋病毒预防教育和咨询的信念与经历。数据分析显示：（a）不认同自己为同性恋的非裔美国双性恋男性可能会挑战服务提供者对性行为和性身份的假设；（b）服务提供者对这些男性的态度可能会受到普遍存在于社区中的矛盾或负面信念的影响；（c）非裔美国双性恋男性需要安全且无歧视的空间来降低艾滋病毒感染风险，但他们在向咨询人员披露同性性行为时可能也会感到焦虑。研究结果突显了文化、男子气概和性取向作为非裔美国双性恋男性艾滋病毒感染风险决定因素的复杂性，同时也揭示了这些因素之间可能影响艾滋病毒预防服务质量的紧张关系。服务提供者可能需要接受额外培训，以提供恰当且无歧视的艾滋病毒预防咨询和教育。
