HIV Among Black Men Who Have Sex with Men (MSM) in the United States: A Review of the Literature

• Published in: AIDS and behavior 2014, Vol.18 (1), p.10-25
• Main Authors: Maulsby, Cathy, Millett, Greg, Lindsey, Kali, Kelley, Robin, Johnson, Kim, Montoya, Daniel, Holtgrave, David
• Format: Article
• Language: English
• Subjects: Acquired Immune Deficiency Syndrome; African Americans - psychology; African Americans - statistics & numerical data; Biomedicine; Black people; Black White Differences; Cocaine; Health Behavior; Health Psychology; Health Services Needs and Demand; Health Status Disparities; Healthcare Disparities; HIV; HIV Infections - diagnosis; HIV Infections - epidemiology; HIV Infections - psychology; Homosexuality; Homosexuality, Male; Human immunodeficiency virus; Humans; Imprisonment; Infectious Diseases; Literature Reviews; Male; Medicine; Medicine & Public Health; Mental Health; Mental Health Services; Original Paper; Public Health; Racial differences; Risk Factors; Sexual behavior; Sexual Partners; Sexually transmitted diseases; Social Discrimination; Social Isolation; Social Networks; Social Stigma; Social Support; STD; Stigma; Studies; United States - epidemiology
• ISSN: 1090-7165; 1573-3254
• DOI: 10.1007/s10461-013-0476-2

In 2006, Millett published a seminal literature review that examined 12 hypotheses to explain the high rates of HIV among black MSM. This paper augments Millett’s article by reviewing the recent literature on behavioral, biomedical, structural, social contextual, psychosocial, and social network factors that affect HIV rates among black MSM. We searched three databases: PubMed , Scopus , and Google Scholar . First we searched all articles that included black or African American and MSM and HIV. We then searched the following terms for each area: behavioral (drug use during sex, crack cocaine use, and serosorting); biomedical (circumcision, STDs, and STIs); structural (access to care, HIV care, ART, HAART, patient-provider communication, HIV quality of care); social contextual (stigma, discrimination, internalized homophobia, internalized heterosexism, medical mistrust, social isolation, and incarceration); psychosocial (peer support and mental health); and social network (sexual mixing, partner characteristics, and social networks) factors. We identified 39 articles to include in this review. We found inconclusive evidence that incarceration, stigma, discrimination, social isolation, mental health disparities, or social networks explain the elevated rates of HIV among black MSM. We found evidence that the differences in rates of HIV between black and white MSM may be explained by differences in STIs, undiagnosed seropositivity, access to care and treatment services, and use of HAART. There is an overwhelming need for HIV testing, linkage to care, retention in care, and adherence programs for black MSM.