DO MENTORS & PROVIDERS MATTER?: UNDERSTANDING ACCESSIBLE ROLE MODELS IN TRANSFORMING RISK INTO WELLNESS IN YOUNG BLACK AND LATINX MEN WHO HAVE SEX WITH MEN AND TRANSGENDER WOMEN

• Published in: Journal of adolescent health 2020-02, Vol.66 (2S), p.S82
• Main Authors: Arrington-Sanders, Renata, Hailey-Fair, Kimberly, Dangerfield, Derek T, Conley, James, D'Angelo, Lawrence, Kwait, Jennafer, Brooks, Durryle, Dowshen, Nadia, Beyrer, Chris, Celentano, David, Wirtz, Andrea
• Format: Article
• Language: English
• Subjects: Anal intercourse; Condoms; Friendship; Gender identity; Health status; HIV; Homosexuality; Human immunodeficiency virus; Interviews; Leverage; LGBTQ people; Marijuana; Men; Men who have sex with men; Mentoring; Mentoring programs; Mentors; Mothers; Nonuse; Role models; Sexual behavior; Sexual health; Sexuality; Substance abuse; Teachers; Teams; Transgender persons; Violence
• ISSN: 1054-139X; 1879-1972

Purpose: Young Black and Latinx men who have sex with men and transwomen (YBLMSM/TW) are at higher risk of engaging in sexual behaviors and experiencing HIV-related outcomes. Improving access to supportive relationships through role models and mentoring can potentially reduce the impact of such risks. Prior work suggests that sexual and gender minority youth are more likely to have inaccessible role-models (e.g., parents) and may seek advice from other adults in their day-to-day lives. We used mixed methods research to understand YBLMSM/TW experiences with role models and mentorship and the potential for these relationships to mitigate risk. Methods: YBLMSM/TW were recruited to complete an electronic survey on demographics, sexual health, and risk behaviors. Frequency tabulations of survey data were used to describe behavioral risks. A sub-sample of 23 participants who reported condom-nonuse were subsequently asked to participate in a 45-minute in-depth qualitative interview about experiences with role models and mentorship in their community. Interviews were transcribed verbatim and coded using inductive and open coding in which sections of text were read and coded, with memos written for each code. Codes were then refined and elaborated using the constant comparison method. Axial coding was used to group similar codes so that grouped and categorized codes could be examined for emergent themes. Results: The sample consisted of 180 YBLMSM/TW aged 15-24 (mean=21.4; SD=2.6), of which most self-identified as gay (63%, n=113), Black (81%, n=145), cis-gendered males (88%, n=159). Most (87%) reported prior sex without a condom, prior STI (54%), and substance use (marijuana 74%, n=132; alcohol 75%, n=135). Thirteenpercent reported being coerced to engage in anal sex without a condom in last 3 months; 36% (n=77) were living with HIV at time of enrollment. Qualitative interviews yielded themes related to: types of mentorship, needs and support received. Four qualitative participants described coerced sex or physical violence in their last relationship. Most (n=20, 87%) participants interviewed reported having a mentor/ role model in their life, with most support coming from a teacher/ program(6), gay mother(4), and older friends(3). Over half (n=13) viewed their provider team as additional support. Only 4 (17%) described important support from the LGBT community. Mentors who were also gay/trans identified: were viewed as role models, providing emotional and tangibl