Skip to main content
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2004 Jan;96(1):97–107.

Race and sexual identity: perceptions about medical culture and healthcare among Black men who have sex with men.

David J Malebranche 1, John L Peterson 1, Robert E Fullilove 1, Richard W Stackhouse 1
PMCID: PMC2594754  PMID: 14746359

Abstract

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 cultural competency curricula at academic institutions, targeting future research efforts on BMSM, and improving the structural and communication barriers within healthcare settings should be incorporated into our HIV prevention and routine healthcare interventions for BMSM.

Full text

PDF
100

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bird S. T., Bogart L. M. Perceived race-based and socioeconomic status(SES)-based discrimination in interactions with health care providers. Ethn Dis. 2001 Autumn;11(3):554–563. [PubMed] [Google Scholar]
  2. Bogart L. M., Catz S. L., Kelly J. A., Benotsch E. G. Factors influencing physicians' judgments of adherence and treatment decisions for patients with HIV disease. Med Decis Making. 2001 Jan-Feb;21(1):28–36. doi: 10.1177/0272989X0102100104. [DOI] [PubMed] [Google Scholar]
  3. Fiscella Kevin, Franks Peter, Doescher Mark P., Saver Barry G. Disparities in health care by race, ethnicity, and language among the insured: findings from a national sample. Med Care. 2002 Jan;40(1):52–59. doi: 10.1097/00005650-200201000-00007. [DOI] [PubMed] [Google Scholar]
  4. Fullilove M. T. Comment: abandoning "race" as a variable in public health research--an idea whose time has come. Am J Public Health. 1998 Sep;88(9):1297–1298. doi: 10.2105/ajph.88.9.1297. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fullilove M. T. Psychiatric implications of displacement: contributions from the psychology of place. Am J Psychiatry. 1996 Dec;153(12):1516–1523. doi: 10.1176/ajp.153.12.1516. [DOI] [PubMed] [Google Scholar]
  6. Heckman T. G., Kelly J. A., Bogart L. M., Kalichman S. C., Rompa D. J. HIV risk differences between African-American and white men who have sex with men. J Natl Med Assoc. 1999 Feb;91(2):92–100. [PMC free article] [PubMed] [Google Scholar]
  7. Hellinger F. J., Fleishman J. A. Location, race, and hospital care for AIDS patients: an analysis of 10 states. Inquiry. 2001 Fall;38(3):319–330. doi: 10.5034/inquiryjrnl_38.3.319. [DOI] [PubMed] [Google Scholar]
  8. Kass N., Flynn C., Jacobson L., Chmiel J. S., Bing E. G. Effect of race on insurance coverage and health service use for HIV-infected gay men. J Acquir Immune Defic Syndr Hum Retrovirol. 1999 Jan 1;20(1):85–92. doi: 10.1097/00042560-199901010-00013. [DOI] [PubMed] [Google Scholar]
  9. Kemppainen J. K., Levine R. E., Mistal M., Schmidgall D. HAART adherence in culturally diverse patients with HIV/AIDS: a study of male patients from a Veteran's Administration Hospital in northern California. AIDS Patient Care STDS. 2001 Mar;15(3):117–127. doi: 10.1089/108729101750123562. [DOI] [PubMed] [Google Scholar]
  10. Magnus M., Schmidt N., Kirkhart K., Schieffelin C., Fuchs N., Brown B., Kissinger P. J. Association between ancillary services and clinical and behavioral outcomes among HIV-infected women. AIDS Patient Care STDS. 2001 Mar;15(3):137–145. doi: 10.1089/108729101750123607. [DOI] [PubMed] [Google Scholar]
  11. Montgomery Jolynn Pratt, Gillespie Brenda W., Gentry Anne C., Mokotoff Eve D., Crane Lawrence R., James Sherman A. Does access to health care impact survival time after diagnosis of AIDS? AIDS Patient Care STDS. 2002 May;16(5):223–231. doi: 10.1089/10872910252972276. [DOI] [PubMed] [Google Scholar]
  12. Oppenheimer G. M. Paradigm lost: race, ethnicity, and the search for a new population taxonomy. Am J Public Health. 2001 Jul;91(7):1049–1055. doi: 10.2105/ajph.91.7.1049. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Peterson J. L., Coates T. J., Catania J. A., Hilliard B., Middleton L., Hearst N. Help-seeking for AIDS high-risk sexual behavior among gay and bisexual African-American men. AIDS Educ Prev. 1995 Feb;7(1):1–9. [PubMed] [Google Scholar]
  14. Peterson J. L., Coates T. J., Catania J. A., Middleton L., Hilliard B., Hearst N. High-risk sexual behavior and condom use among gay and bisexual African-American men. Am J Public Health. 1992 Nov;82(11):1490–1494. doi: 10.2105/ajph.82.11.1490. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Richter Donna L., Sowell Richard L., Pluto Delores M. Attitudes toward antiretroviral therapy among African American women. Am J Health Behav. 2002 Jan-Feb;26(1):25–33. doi: 10.5993/ajhb.26.1.3. [DOI] [PubMed] [Google Scholar]
  16. Sankar A., Luborsky M., Schuman P., Roberts G. Adherence discourse among African-American women taking HAART. AIDS Care. 2002 Apr;14(2):203–218. doi: 10.1080/09540120220104712. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Schoenberg N. E. The relationship between perceptions of social support and adherence to dietary recommendations among African-American elders with hypertension. Int J Aging Hum Dev. 1998;47(4):279–297. doi: 10.2190/0L2Y-FXVE-KJYH-318A. [DOI] [PubMed] [Google Scholar]
  18. Stokes J. P., Peterson J. L. Homophobia, self-esteem, and risk for HIV among African American men who have sex with men. AIDS Educ Prev. 1998 Jun;10(3):278–292. [PubMed] [Google Scholar]
  19. Thomas S. B. The color line: race matters in the elimination of health disparities. Am J Public Health. 2001 Jul;91(7):1046–1048. doi: 10.2105/ajph.91.7.1046. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Valleroy L. A., MacKellar D. A., Karon J. M., Rosen D. H., McFarland W., Shehan D. A., Stoyanoff S. R., LaLota M., Celentano D. D., Koblin B. A. HIV prevalence and associated risks in young men who have sex with men. Young Men's Survey Study Group. JAMA. 2000 Jul 12;284(2):198–204. doi: 10.1001/jama.284.2.198. [DOI] [PubMed] [Google Scholar]
  21. Welch K. J., Morse A. Survival patterns among HIV+ individuals based on health care utilization. J Natl Med Assoc. 2001 Jun;93(6):214–219. [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES