Parker Caroline M, Garcia Jonathan, Philbin Morgan M, Wilson Patrick A, Parker Richard G, Hirsch Jennifer S
a Department of Sociomedical Sciences , Mailman School of Public Health, Columbia University , New York , USA.
b College of Public Health and Human Sciences , Oregon State University , Corvallis , OR , USA.
Cult Health Sex. 2017 Mar;19(3):323-337. doi: 10.1080/13691058.2016.1216604. Epub 2016 Aug 23.
Black men who have sex with men in the USA face disproportionate incidence rates of HIV. This paper presents findings from an ethnographic study conducted in New York City that explored the structural and socio-cultural factors shaping men's sexual relationships with the goal of furthering understandings of their HIV-related vulnerability. Methods included participant observation and in-depth interviews with 31 Black men who have sex with men (three times each) and 17 key informants. We found that HIV vulnerability is perceived as produced through structural inequalities including economic insecurity, housing instability, and stigma and discrimination. The theoretical concepts of social risk, intersectional stigma, and the social production of space are offered as lenses through which to analyse how structural inequalities shape HIV vulnerability. We found that social risk shaped HIV vulnerability by influencing men's decisions in four domains: 1) where to find sexual partners, 2) where to engage in sexual relationships, 3) what kinds of relationships to seek, and 4) whether to carry and to use condoms. Advancing conceptualisations of social risk, we show that intersectional stigma and the social production of space are key processes through which social risk generates HIV vulnerability among Black men who have sex with men.
在美国，与男性发生性行为的黑人面临着不成比例的艾滋病毒感染率。本文介绍了在纽约市进行的一项人种学研究的结果，该研究探讨了影响男性性关系的结构和社会文化因素，旨在进一步了解他们与艾滋病毒相关的脆弱性。研究方法包括参与观察以及对31名与男性发生性行为的黑人（每人访谈三次）和17名关键信息提供者进行深入访谈。我们发现，人们认为艾滋病毒脆弱性是由包括经济不安全、住房不稳定以及耻辱和歧视在内的结构不平等造成的。社会风险、交叉耻辱和空间的社会生产等理论概念被作为分析结构不平等如何塑造艾滋病毒脆弱性的视角。我们发现，社会风险通过在四个领域影响男性的决定来塑造艾滋病毒脆弱性：1） 在哪里寻找性伴侣，2） 在哪里建立性关系，3） 寻求何种关系，4） 是否携带和使用避孕套。在推进社会风险概念化的过程中，我们表明交叉耻辱和空间的社会生产是社会风险在与男性发生性行为的黑人中产生艾滋病毒脆弱性的关键过程。
