“A gay man and a doctor are jt like, a recipe for stctn”: How racism and homonegativy healthre settgs fluence PrEP uptake among young Black MSM - PMC

Contents:

• “A GAY MAN AND A DOCTOR ARE JT LIKE, A RECIPE FOR STCTN”: HOW RACISM AND HOMONEGATIVY HEALTHRE SETTGS FLUENCE PREP UPTAKE AMONG YOUNG BLACK MSM
• 'AS A BLACK, GAY PHYSICIAN, I'VE SURVIVED IN AMERI BY EMBRACG MY ANGER'
• A GUI TO THE GAY MAN'S PHYSIL EXAM
• THE DOCTOR'S STRAIGHT PATIENT (FIRST TIME GAY MEDIL EXAM DOMANCE EROTI‪)‬

“A GAY MAN AND A DOCTOR ARE JT LIKE, A RECIPE FOR STCTN”: HOW RACISM AND HOMONEGATIVY HEALTHRE SETTGS FLUENCE PREP UPTAKE AMONG YOUNG BLACK MSM

Natnal Transgenr Discrimatn Survey; Report on Health and Healthre [Washgton, DC: Natnal Center for Transgenr Equaly and Natnal Gay and Lbian Task Force; 2010 Oct [ced 2016 Mar 10] p. Addnal rearch will be need to asss LLMs ed healthre for homogenizatn and amplifitn of bias and secury vulnerabili hered om base mols5, 38, 50.

'AS A BLACK, GAY PHYSICIAN, I'VE SURVIVED IN AMERI BY EMBRACG MY ANGER'

Published fal eded form as:PMCID: PMC6571052NIHMSID: NIHMS1516922AbstractYoung, Black, gay bisexual or other MSM are signifintly ls likely to e PrEP than their Whe unterparts.

We ed a team-based approach to thematic ntent analysis to unrstand how racism and homonegativy affected healthre accs and experienc. Keywords: Medil mistst, racial dispari, PrEP dispari, young adults, qualative, racism, homonegativyHIV pre-exposure prophylaxis (PrEP) is a promisg ponent of HIV preventn, particularly for gay, bisexual, and other men who have sex wh men (MSM), monstratg high efficy among adherent ers1, 2.

Incln creria required that participants intify as Black or Ain Amerin, were assigned male genr at birth, intified as gay, bisexual, or other men who have sex wh men, were between the ag of 16 and 25, and reported an HIV-negative or unknown serostat. Foc groups were led by two rearch associate who intify as a Black gay men. We explicly asked about experienc of discrimatn, racism, and homonegativy om health re provirs and sought to unrstand how the factors may affect PrEP uptake among young Black analysisFoc groups were d-rerd, transcribed verbatim, and d g MAXQDA qualative analysis software.

A GUI TO THE GAY MAN'S PHYSIL EXAM

The fal book clud barriers to PrEP (cludg stigma, lack of support, and perceptn of need), benefs of PrEP, medil mistst, discrimatn healthre settgs, PrEP stigma, homonegativy (cludg ‘down low’, homonegativy wh the Black muny, ternalized homonegativy, and anticipated homonegativy), and racism (cludg differenc healthre treatment by race and racial discrimatn). Seventy-five percent (n=33) intified as gay; others intified as bisexual (n=8), pansexual (n=1), no label (n=1), and straight (n=1). Analys revealed the ntued effects of racial and enomic disadvantage on health re accs and the ways which racism and homonegativy fluenced young men’s fort discsg sexual behavr wh physicians.

[Foc group six]Although this excerpt they were discsg healthre more generally, the perceptn of receivg ferr medil treatment n ntribute to dividuals’ reluctance to start discsg perceived substandard re for Black gay men, foc group three participants scribed how racism, homonegativy, discrimatn, and poor medil re had bee expected and accepted as part of their health re. Precedg the followg excerpt om foc group three, several participants had jt shared personal stori of discrimatn and poor treatment:Facilator: Why do we, as a gay Black muny, why do we allow suatns like that to bee a mon thg?

THE DOCTOR'S STRAIGHT PATIENT (FIRST TIME GAY MEDIL EXAM DOMANCE EROTI‪)‬

Through their own experienc and those of their fay, iends, and muny members, participants uld rell so many experienc of stigma and mistreatment that they had e to expect and accept homonegativy, racism, and discrimatn. This is not to say they did not intify the jtice this or sire better re, but such experienc had bee so monplace that they were no longer shockg or Black MSM rced to their sexualy by doctorsThe perceived racism participants faced was plited by the tersectn of homonegativy.

While the lack of a tsted, regular provir was one factor this, this disfort was also rooted anticipated homonegativy and poor treatment om physicians.

P1: I don’t want to say ’s all Whe doctors, ‘e I’ve had some good on, but ’s jt that they treat gay men like we nasty… I even asked, “If you don’t wanna do , you n brg a woman nurse here if you want to. It was hemorrhoids, but was jt like, how e they assume that bee I’m gay, I’m jt nasty? You don’t know the half of until you bee a gay man.