Health : High Risk For HIV Transmission
Report from the Field: Experience of online outreach for black MSM populations at high risk for HIV transmission
Minority men who have sex with men (MSM) are among the most difficult population to access for HIV risk reduction, and have among the highest incidence rates of HIV in the US. Black men and women accounted for 44% of all new HIV infections in the US in2010, and of these, black MSM accounted for 51% (CDC, 2016).
The BARRE (Bareback Assertive Risk Reduction Education) Project collected data engaging men who have sex with men (MSM) from the Internet in Houston, Texas from November 2013 to June 2015 (36 months). On sexual partner seeking websites, 400 MSM advertising for bareback sex were contacted 1 on 1 online for synchronous or asynchronous chats, and responded. Texting took on average about 15 minutes, and phone conversations a little less than 20 minutes. The interviewer was a black gay man trained in outreach and working in close coordination with the local health department. Men who responded were young (51.8% were aged 18-29, the remainder 30-54); 78% were African American, 18.5% Latino, and the remainder white. Over half (59.5%) identified as HIV negative, 19.5% were unknown, or did not disclose, their HIV status, and 21% identified as HIV positive; and 67% had tested for HIV in the past 12 months. Those with unknown HIV status were twice as likely as those who knew they were HIV positive or believed they were HIV negative, to have had unprotected anal sex at last intercourse.
In the interactions online, respondents received information about HIV testing, risk reduction strategies, and linkage to STI or HIV testing services. Respondents were encouraged to “do the right thing” by disclosing HIV status before intercourse and testing regularly. Individuals who reported they were HIV negative were informed about PrEP and linked to providers. On discussion, there were a number of contributing factors to risk behavior: 34% had traded sex for money or drugs in the 30 days prior to the risky behavior with ≥20 different partners; recreational drug use (crystal methamphetamine, cocaine, Ecstasy and marijuana) and volatile nitrites was high and reported in 66% of respondents having sex with multiple online strangers (≥20 per week). The interviewer indicated that he gained the impression of high levels of substance use, alcohol use, and depression in the population. Shame, guilt and embarrassment were commonly expressed about their MSM behavior in the context of the African American or Latino population, which contributed to the desire to remain anonymous or travel to areas where they would be anonymous to engage in risk behavior.
Sites of risk behavior included bathhouses, bookstores, sex parties, Craigslist and anonymous online hookups, with the latter constituting 54% of risk. In terms of outcomes, of 400 contacts (who gave informed consent for BARRE to track their testing history), 26.5% received a referral and online health education, 30% received an STD test, and 43.5% received an HIV test as a result of the BARRE program. This constitutes >8 per month tested for STDs or HIV, not including online referral and health education. Responding to questions about comfort with the online service approach, 89% stated that they were comfortable with this, with the remainder having no opinion.
This pilot study indicates that online outreach can effectively access and engage African American and other minority MSM using Internet sex sites and social media, involve them in health education and risk reduction conversations, and provide referrals to HIV and STD testing (73.5% leading to testing). Internet and social media outreach promises to be an effective way of accessing highest risk (barebacking) MSM minority populations. These men accessed wanted to discuss bareback risks anonymously and access testing and health education information one-on-one. This pilot program suggests that internet site/social media outreach may be an appropriate way to engage those minority MSM at highest risk of HIV transmission.
Centers for Disease Control (2016). HIV among African Americans.
Cortney Smith, BARRE, Public Health Educator of HEARTS, Houston
Maggie White, MSN MPH, Nurse Practitioner, Private Practice, Houston
Michael W Ross, PhD MD MPH, Program in Human Sexuality, University of Minnesota
Another attempt to sh*t on black people? Those stats are from the CITY OF HOUSTON ONLY. Expand it out and you get more balanced stats.BUT the average person who reads this isn’t gonna be bright enough to tell that this is just 1 city. And no, this is coming from a white guy here guys. Carry on…
Step back..and REALLY. This survey EXACTLY MIRRORS my experience with black men, especially poz black tops you want to gift white boys. There’s plenty enough to shit on in the black community…you people need to get off your asses and REALIZE that YOU HAVE PROBLEMS.
Another article about minority men, more specifically black men with hiv. We already know this.
How about articles approaching the “whys” or “how to fix?”. Regurgitating the same facts every year gets us no where.
Furthurmore, how about more articles about the advancement of HIV medicine? For example, the past few months have been gargantuan in the discovery for the cure of HIV. Look up temple university.
ama: I will ask them to provide the “why”
While I’m happy to read the reports that this type of “outreach” was successful in bridging the gap between crusing online and becoming educated, or ultimately leading to testing, I also find that this type of reporting, hyper-focus on one gender and ethnicity, and conculsion based from non face-to-face interactions, have the possibility of being biased and more damaging than educational. This information must not be thrown about online lightly or out of context because this type of information can lead to a continued fear, homophibia, stigma, and segregation of the GLBT communities at large.
Matters like this should always be approached with a sensitive, delicate, and inclusive tone as to not spread irrational fears or misunderstandings. As an HIV- single male, I want to avoid contracting this disease, so I practice safe sex as best I can, and prefer my partners to do so also, but the only sure guarantee of this goal a non-sexual lifestyle. More times than not I see that “research” like this creates just creates alarm, panic, and fear that leads to the cruel and unjust treatment of others.
With that said, please play safe, be kind to others, and remember that we’re all human.
A4A profile: Onixstar
Hot! This is just one more thing that makes getting gang banged by BBC so exciting!
scott : really? wow….
Another Millennial that’ll be on the taxpayer dole for free Truvada pretty soon….”just take a pill!”…and he’ll be dead by 45.
just goes to prove trust NO ONE when having sex. there is no such thing as monogamy anymore.
@scott
Guys like you who fetishize black men as nothing but bbc sex play things are why I am slowly losing interest in white guys.
Like 75% of replies from white guys are just looking for some dl thug type with a 10 inch dick to play with. Then they learn I’m nothing like that and Im a bottom and to the block list I go! Lol
wow, talk about your Black Attack ads. With enough money anyone can promote an agenda and call it “fact”, even if this is from the CDC. It’s the same reason why some junk is allowed through the FDA, money. Those statistics are actually in reverse, and anyone can check it themselves.
If you go through the Search function on Adam4Adam, pick any State, then on HIV Status select “Positive” “Undetectable” & “Don’t Know”, then individually search by Ethnicity, you will find that there are more White’s than Blacks. Even in the south-eastern States where the black population is highest, the highest numbers for people to have or potentially have HIV is still White.
Nice try, but that’s all a lie…per LA County Dept of Public Health, black MSMs are EIGHT TIMES MORE LIKELY to be poz and their numbers are now greater than whites. Quit being the whiney reverse racists and FIX YOUR OWN PEOPLE!
Fuck LA county stats racial lies, stereotypes and bias are formed against people of color by whites with notepads, degrees and money. Fix your fuckin people jerk. U r our headaches. Liars, thieves and rapists systematically and methodically.
and in a few days we’ll see some porn ad featuring barebacking
Yet Another special statusinterest group, ‘poor usthem’ article….
just give the minority more programs to help with money. 1. people would be fucking less for a meal. 2. people could feel “privileged” to feel like they can live like a normal person being able to buy things since society bombards us with so many business stuff… like marketing is so advance they are tapping into the subconscious. idk… they should have more clubs or organization willing to give 2 day getaways for people with little to no money because at the end of the day, we all don’t want to spend our last days in misery. rich people go to ibiza and poor people go down the block for dick hoping to get high for free because dealing with real emotions with money is super heavy.
No more programs for minorities for ME. I’m moving to a “least tax” state…I’m tired of funding stupid, lazy people who like to spread disease.
So sad to target one particular race in this lifestyle knowing the gay male community as a whole is at risk of HIV/AID. Far more advertisements are promoting bareback sex which is at the top of the list of careless acts that keeps gay men at high risk. How about providing statistics when you write blogs such as these about how the virus is slowly killing our community as a whole and not just black men? Sad
Wake up…facts are facts…the blacks are the biggest HIV spreaders BY FAR. NIH, LA County Dept of Public Health, Texas State Dept of Public Health, the CDC and various private studies CONFIRM THIS.
Consequences of being a BBC lover!
More like “consequences of being friggin’ STUPID.”
This is not an attack on black men. Yes they did research on Houston, but it is the same statistics in all large US cities. Black people account for a large number or the majority of HIV cases. No one is out to get black people. The information on why is out there the information on how to prevent it is out there. Black people need to take accountability for their actions. No one is out to get the it is not a conspiracy. And I am a black man who us saying this. I am just sick of the woe is me attitude in this community.
Not sure what’s the point of this research. Best to assume that every guy (regardless of race) is poz and act accordingly.
Stats don’t lie in this and MANY OTHER STUDIES…blacks are the BIGGEST spreaders of HIV now.
The average idiot who reads this isn’t gonna be bright enough to tell that this is just 1 city and think every black they come across is positive. Like he said expand that out. This is also coming from a white guy.
Blah Blah Blah. Its not that serious. Just take thoust meds. All be well
…and die in 20 years. idiot. You need to have your nuts cut off.
Wow, I was in Harlem, NY a couple of weeks ago attending a Maria Davis MAD Wednesday talent showcase at the Shrine their sound system was sad… But, I heard Ms Davis spoke about the rise in HIV cases in the minority community in NYC but didn’t realize how powerful this disease is impacting its presence still is today.
In all these so called advancements in medicines I fail to hear a cure for HIV/AIDS. Pharmaceutical companies with endorsements to hospital are more and more achieving this idea of normalizing HIV/AIDS and at some point you will heard a doctor say it better than having Diabetes…. HIV/AIDS is life changing and you will be hooked to expensive meds each day for the rest of you’re life… Imagine those HIV/AIDS all in one pills at a $100 a pill…$3000.00 a bottle of 30 pills.
Maria Davis spoke about surviving 20yrs with HIV/AIDS sad but in all that time and all the money collected no cure HIV/AIDS… Ebola came and they cured white Doctors less than a 6 months and Zeka Virus soon cure wtf Gay America we don’t see a need check our Science Researcher to see wtf they’re doing in the labs…. we seem too relaxed and comfortable running of old information when HIV/AIDS surfaced in the 80’s meanwhile new diseases appear and somehow are cured…. I guess if the disease is aggressive and white rich hetero-American are most affected it is cured. HIV/AIDS “education” to “cure”…
I agree with Scott 1000%
THIS IS NOT A BLACK OR WHITE OR ANY OTHER COLOR ISSUE….ITS A GAY MENS ISSUE AND OTHER PROMISCUIOUS PEOPLE’S ISSUE AND NOT BEING MONOGAMOUS IN WHO YOU HAVE SEX WITH…
Ever heard of a third wheel…..it very much applies to this topic…..you all AND ESPECIALLY gay men have a responsibility to be honest about your wanting sex FIRST OFF……ITS NOT A REQUIREMENT AND YOU ALL KNOW DAMN WELL ITS A DESIRE…..HEY IM A GUY I LIKE SEX….I ENJOY IT…BUT ITS NOT AN ABSOLUTE NECESSITY VERSUS CATCHING SOMETHING YOU CANT GET RID OF OR THAT COULD KILL YOU…AND YES I KNOW….I ALMOST DID DIE ALMOST A YEAR AGO DUE TO CONTRACTING IT AND NOT KNOWING IT…..and AND ITS WHO YOUARE HAVING SEX AND OTHERWISE IN who you have it with…
I stand on that with very strong conviction as to that I caught it by a kiss….I HAD A Still open (not healed) wisdom tooth extraction….and the guy……wasn’t BEING Honest clearly.
So don’t think its just where you put your dick or who you let inside you…any contraction can take place where blood or INFECTED body fluids can transfer..Stop being stupid to think this is a race issue…ITS EVERYONES PROBLEM AND EVERYONES RESPONSIBILITY WHO YOU HAVE SEX WITH ….BECUZ IT COULD KILL YOU!!
PULL YOUR HEADS OUT OF YOUR A***S
@blog….it is if ur already POZ!…we don’t stress and worry about HIV anymore 🙂
Thank you for this well researched data. Annalyzing anecdotal data is one more helpful component of one’s sexual risk management. Like flying, skydiving and other endeavors, risk management is a key component to safety and enjoyment. ‘Never stop learning’ is my moto. Thanks again.
I hate when they do studies like this. I worked a research assistant for a couple years. First, the sample is hardly representative of the population. Second, they always make race the factor they are investigating when they should examine socioeconomic background. Poor people have less access to proper education, HIV and mental illness treatment, and support systems. African Americans and Latino Americans have high populations under the poverty line. Third, I’m sure if they investigated Caucasians then they would find that a vast majority of people under the poverty line are at high risk as well. (White guy as well for what it’s worth)
Instead of stigmatizing and isolating groups of people maybe we should be trying to make PreP and HIV medication more accessible/affordable to everyone.
To the black guy, it’s sad that you don’t realize that these numbers are out here to get you to hate yourself. True data shows that most of the new infections are white guys. They are tricking you saying that black people have a higher percentage and disproportionate. But in fact, look at the totals instead of the percentages, who’s really injecting who? Bug chasers and gift givers. Are those black terms?? I’m white but more black than you it seems
@ really for you to say that you are more black than I am is so condescending. How? because I am not saying that the world is out to get me? You don’t know what I have been through. Where do you think the term DL was invented not the white community. Who do you think is paying for and having unprotected sex? It is like if you’re black in America you have to agree with everything that the black community says. I don’t hate being black. I am more upset with the fact that we (black people) that always get upset that the data is there but not willing to do something about it. Let’s educate each other. So Mr blacker than me what are you doing to help the black community?
In 2016 HIV is a pretty benign chronic illness. Take ur pill, eat ur veggies, exercise, relax and everything will b ok.
U neg guys…you really have no business pontificating about how bad HIV is, the cost, etc…U don’t know…we just roll our eyes at the ludicrous things u come up with.
Your fear of HIV has damaged you more than the virus ever could!
Hmm, another article that ignores all the rest of the diseases transmitted the exact same way as HIV is, yet they are not as dangerous, fatal or easily transmitted by the very lack of responsible activity of using a barrier (condom) to PREVENT AND PROTECT. So lets ignore HepC or Ebola or anything else that industrial cleanser and scrub pads wont get rid of like Herpes or anal warts(fucking gross)and resultant cancers….
So now i will be attacked because they are not 100 percent effective, but miles better than using none (or common sense for that matter) at all. Yeah, yeah i get it, bareback is is awesome.. so is living and breathi g without throwing your guts up until you die or your HIV meds quit working or bypass the Prep magic pill “protection (sic) for the results.
BTW, its not a race thing but it is instructive nonetheless. Careless attitudes by all of the gay population is to blame for this. To be offended by one article and one microcosm of study in epidemiology, is just dumb. You miss the pertinent lesson of the study, prevention and behavior IS WHAT MATTERS.
The point of this research and any other research targeted at one group is to understand what is unique about that group, not to segregate it. By attaching data to a problem, we identify and legitimize an issue which then makes it a lot easier to get funding. Yes, we all have the same health issues but we do not all live in the same environment.
@Scott… It’s serial killers like you targeting economically and culturally vulnerable black men that contribute to the crisis.
@Jeremy part of the problem is people not tell in the facts and spreading non factual information. This info comes from a web site called THE BODY . Sorry to say if you got HIV from kissing you are the only one on this planet .
HIV is spread through contact with the following body fluids:
Blood (including menstrual blood and any blood in saliva, urine, and feces)
Semen (“cum”) and other male sexual fluids (“pre-cum”)
Vaginal fluids
Breast milk
HIV is also spread through contact with these body fluids; however, usually only health care workers come into contact with these fluids:
Fluid around the brain and spinal cord (cerebrospinal fluid)
Fluid around the joints (synovial fluid)
Fluid around a developing fetus (amniotic fluid)
HIV is not spread through contact with these body fluids:
Sweat
Tears
Saliva (spit)
Feces (poop)
Urine (pee)
In other words, you CANNOT get HIV by touching or hugging someone who is HIV+, kissing someone living with HIV, or by using a toilet also used by someone living with HIV.
@Asskissari…the only cereal I’m killing is my frosted flakes….their greaaat!
Thank you all for the posts!
I knew that we’d get the usual reverse-racist rants in there. LISTEN UP…my personal experience in the Southern California area PERFECTLY MIRRORS THIS SURVEY. I’ll give you something MORE chilling, and this guy’s on A4A RIGHT NOW. Black guy, fresh out of prison, HIV+, wants to “bfeed my ass.” I let the subject of my infection by him slide for awhile, and he started with the “hurry up I need to get off in your tight ass” BS, THEN I laid it on him, and here’s what I got back…”It ain’t that bad, and you white boys need to suck up.” WHAT THE FUCKING HELL??? I discriminate against ALL blacks for sex as a safety precaution, and this just verified what I’ve been saying for about 10 years…blacks are disease carriers and “gifters,” because they just plain don’t give a shit.
And on the slim chance that you ARE white, my friend, all you’re doing is revealing your untreated mental illness. All of this histrionic rhetoric..yet you claim to not sleep with black men. So remind us all what it is exactly you’re ranting and raving about?
Sickofit I am sick of your racist bigoted ass