Implementing an intervention to bring black men who have sex with men together increased their self-acceptance and willingness to seek health care, a poster presentation at the U.S. Conference on AIDS revealed.
My Brother's Keeper, Inc., a community-based organization that provides HIV treatment, prevention medical services, and case management in the Jackson, Mississippi metro area and in southern Mississippi, conducted the study using surveys completed by 147 black men who have sex with men who attended their "Connect With Us" programs in 2018. The program was partially built on the MANDATE model -- in which black gay men host community conversations on a range of topics over food in someone's home. MANDATE was first developed out of Washington, D.C. and has since been adapted in several other cities.
"The question we asked ourselves was, 'If we create a safe space where African-American gay and bisexual men can come together and have open and honest dialog about their sexual health and other health issues, can we see a change in four main areas -- sense of belonging, intention to seek medical services, knowledge of sexual health practices, and intention to use safe sexual practices?'" said Obie S. McNair, M.P.H., former clinical research coordinator at My Brother's Keeper.
Using the MANDATE model of community-led social spaces, they selected five peer leaders from the community who were respected in different networks and had a desire to lead sessions on various topics. They provided some additional facilitation training to the peer leaders, who then used their own networks to promote community "fishbowl" sessions with interested black gay and bisexual men in and around Jackson. The participants got to choose what health topics they wanted to discuss on that particular day. If more issues arose from the discussion that needed a deep dive, My Brother's Keeper offered an "expert session" to participants with health providers and other professionals to present more detailed workshops on that issue.
At the end of the year, My Brother's Keeper held one joint block party for all participants so they would have the opportunity to connect with each other. Then, they reviewed their pre- and post-intervention surveys to see how successful they were in achieving their goals.
When evaluating the participants' responses on the survey before the intervention started versus after the intervention, researchers found the results were mostly positive. Participants reported a change in their sense of community, higher rates of self-acceptance, and more knowledge of the importance of condom and pre-exposure prophylaxis (PrEP) use. When asked about their intention to seek sexually transmitted infection (STI) and HIV testing every three months, use condoms with partners, and speak to their partners more about their STI and HIV status, more participants responded positively after the intervention than did prior to it. The one area where participants expressed less of a commitment at the end of the intervention was in their interest in sharing their sexual orientation with providers.
"This community has a history of medical mistrust of providers," said McNair. "And we know that specifically here in Mississippi, black gay and bisexual men have more likelihood to experience social isolationism due to stigma and being in the buckle of the Bible belt."
McNair also said that because the group participants openly shared their stories of prior experiences with providers, some of which weren't pleasant, this may have impacted their responses about opening up to providers.
"So one thing we want to work on moving forward is how to continue to improve the patient-provider relationships," he said.
He also noted that My Brother's Keeper has been running the intervention in 2019 and will be comparing results from this year with their results from 2018 as well, to continue to refine the intervention in the future.