Thomas Alex Washington

Exploring the Perspectives of Substance Abusing Black Men Who Have Sex With Men and Women in Addiction Treatment Programs A Need for a Human Sexuality Educational Model for Addiction Professionals

This study examined the perspectives of African American male injection drug users who have sex with both men and women (IDU-MSM/W) and who are involved in sex trade regarding the need for a human sexuality educational model (HSEM) for addiction professionals. Focus groups were conducted involving an exploratory sample (N = 105) of men who met the following parameters: aged 18 to 40 years, African American, engage in injection drug using behavior, have sex with male and female partners, and who frequent parks and other sex working areas in Baltimore City and surrounding areas. Data suggest that an HSEM may be useful for addiction professionals who work with substance abusing Black MSM/W. Moreover, the model should include opportunities for addiction professionals to (a) identify their personal biases about homosexuality in general (acknowledging personal biases so not to allow those personal biases to influence service); (b) understand the diversity within the Black MSM/W community (e.g., challenge assumptions that all Black MSM/W self-identify as gay); (c) understand how to, and the need for, assessing sexual trauma in Black MSM/W; and (d) understand the need to incorporate risk factors and safer sex practices that may be of concern to a subpopulation of Black MSM/W, such as “barebacking.” These findings suggest the need for, and topics to include in, an HSEM that assists professionals with exploring their biases about sexuality and MSM/W and better prepares counselors to address HIV prevention and risky behavior using language that is appropriate for the Black IDU-MSM/W population.

Recommendations for Performing Internet-Based Research on Sensitive Subject Matter with “Hidden” or Difficult-to-Reach Populations

Since the mid-1990s, the rapidly increasing popularity of the Internet has contributed to a situation in which many men turn to Web sites to find sex partners with whom they can engage in risky behaviors. Scholars only recently began to examine the role of the Internet in harm-seeking and help-seeking behaviors. They are just now beginning to study and understand how to apply public health promotion principles to people using the Internet. Due in part to the relative newness of the Internet on the public health landscape, scholars wishing to conduct research or to implement health promotion programs online should consider a variety of challenges to doing such work—challenges that differ from those typically faced when undertaking similar work in other types of venues offline. The purpose of this article is to address several of these research considerations. In particular, the present authors wish to provide researchers and health care specialists with key considerations when developing their own Internet-based research or health promotion programs. We also wish to furbish readers with some experience-based suggestions about how to avoid the potential pitfalls of conducting Internet-based studies. Moreover, our emphasis is on how to develop such programs when they are targeting hard-to-reach or “hidden” populations and/or when they deal with sensitive subject matter. Recommendations pertaining to the planning, recruitment, implementation, and evaluation stages of doing professional work online are provided.

HIV prevention needs of sex-trading injection drug-using black men who have sex with both men and women.

This study examined HIV prevention program needs from the perspective of injection drug—using men who have sex with both men and women involved in sex trade. Focus groups were conducted involving an exploratory sample (N = 105) of men who met the following parameters: African American, injection drug—using behavior, men who have sex with men and women, and men who frequent parks and other areas for sex trade in Baltimore City and surrounding areas, aged between 18 and 40 years. Data suggest that an HIV prevention program is needed that includes a safe space specifically for the IDU-MSM/W sex-trade community, comprehensive services including treatment for substance abuse and job assistance, and methods for improving HIV-prevention, such as communication skills to increase condom use during sex. These findings provide a better understanding of a population for which little is known, and identifies HIV prevention program needs for the IDU-MSM/W community involved in sex trade.

Exploring the Use of Web-Based HIV Prevention for Injection-Drug-Using Black Men Who Have Sex with Both Men and Women: A Feasibility Study

This study examined HIV prevention program needs from the perspective of injection-drug-using men who have sex with both men and women (IDU-MSM/W) involved in sex trade. Focus groups were conducted involving an exploratory sample (N = 105) of men who met the following parameters: African American, injection-drug-using behavior, men who have sex with men and women, and men who frequent parks and other areas for sex trade in Baltimore City and surrounding areas, ages 18 to 40 years. Data suggest that an HIV prevention program is needed that includes language acquisition specific to the IDU-MSM/W sex-trade community, comprehensive services including treatment for depression and other mental health needs, and methods for improving HIV prevention, such as safer-sex communication skills. These findings provide a better understanding of a population for which little is known, and identifies HIV prevention program needs for the IDU-MSM/W community involved in sex trade.

From Their Voices: Barriers to HIV Testing among Black Men Who Have Sex with Men Remain

Background: HIV testing continues to be a major priority for addressing the epidemic among young Black men who have sex with men (BMSM). Methods: This study explored barriers to HIV testing uptake, and recommendations for motivating HIV testing uptake among Black men who have sex with men (BMSM) aged 18 to 30. BMSM (N = 36) were recruited through flyers and social media for six focus groups. Results: From the perspectives and experiences of young BMSM, participants recommended that information be included in HIV testing messages that would help young BMSM do self HIV-risk appraisals. Particularly, participants recommended that more knowledge about Pre-Exposure Prophylaxis (PrEP) and the role of PrEP in safer-sex practices be provided. This information is important to help those untested, or who infrequently test, better understand their risk and need for testing. Likewise, participants recommended that more information about a person being undetectable and the risk of condomless sex with an HIV negative sex partner; this information will be helpful for both the HIV negative and HIV positive sex partner for making safer sex decisions. Participants also recommended that interventions should focus on more than drug use as risk; the risk posed by the use of alcohol before and during sex deserves attention among young BMSM. Conclusions: These findings may inform new HIV testing interventions being tailored for young BMSM. The interventions should also consider revisiting street-based peer-outreach approaches for those young BMSM with limited access to social media campaigns due to limited access or infrequent use of social media.

Drinking Patterns and HIV Risk Behaviors Among Black and Latino Men Who Have Sex Within Los Angeles County

Alcohol, the most widely used substance among men who have sex with men (85%), remains an important factor in HIV research among this high-risk population. However, research on alcohol use among Black and Latino men who have sex with men (BLMSM), a population disproportionately affected by HIV in the United States, is limited and inconclusive. This study explored sociodemographic and HIV risk with daily heavy and low-risk drinking patterns among BLMSM. BLMSM (N = 188) aged 18 to 40 years were recruited through social media, local colleges, heteronormative clubs, private men’s groups, gay establishments, and organized events in Los Angeles County. Participants completed self-administered questionnaires. Fisher’s exact tests revealed significant relationships between drinking patterns and condomless insertive anal intercourse (p = .001), race (p < .001), age (p = .02), and perception of alcohol-related HIV risk (p = .007). The Fisher’s exact tests findings for age held true in the multiple regression model (p = .014). Findings suggest that BLMSM who engage in higher risk drinking also engage in alcohol-related HIV risk. Culturally competent interventions should consider including a combined focus to explore the synergy between risky drinking patterns and HIV risk among BLMSM.

Sexual Practices and HIV Risk Behaviors Among African American Female Partners of Sex-Trading Men Who Have Sex With Men and Women: A Descriptive Analysis

African American women continue to be disproportionately burdened by HIV and AIDS. An important determinant of the risk of transmission lies in the characteristics of sexual partnerships. The current study explores the sexual risk behaviors of a vulnerable population subgroup of African American women who engage in sexual partnerships with men who are sex traders and have sex with both men and women. The sample was 106 adult African American women. Data regarding sociodemographics, drug-using behavior, sexual practices, HIV and sexually transmitted infections, and health-seeking behaviors were analyzed. Nearly 90% of participants reported unprotected vaginal sex and using crack cocaine in the previous 3 months. The recent use of heroin was significantly associated with diminished condom use. A clear majority of the participants did not know their HIV status. This study is the first to examine and document shared structural and behavioral risk profiles of this population.