Graduation Year

2010

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Community and Family Health

Major Professor

Bruce Levin, Dr.P.H.

Co-Major Professor

Ellen Daley, Ph.D.

Keywords

Haitians, African Americans, Immigrants, Qualitative methods, Socio-ecological, Sexual health, Health beliefs, Theory of gender and power

Abstract

Twenty five years after AIDS was first scientifically described, the disease continues to take its toll on the human population. HIV/AIDS disproportionately affects marginalized groups such as poor, underserved, minority populations. In the United States, Blacks become infected with and die from HIV/AIDS more than any other ethnic or racial group. Despite a vast body of literature on HIV/AIDS, little research has focused on black heterosexual men and even fewer studies have explored the context of risk among subgroups of black men. Using qualitative research methods and a socio-ecological framework, this study explored the intrapersonal, socio-cultural, and behavioral factors that influence sexual behaviors in ethnic subgroups of black men who identify as heterosexual. Further, the study examined black women's perceptions of the sexual behaviors of black men.

Conducted in a metropolitan area in Southwest Florida , the study consisted of two phases: 1) semi-structured in-depth interviews were conducted among U.S.-born (N=15) and Haitian-born (N=14) heterosexual men who are 18 years and older and have lived in the U.S. for at least 3 years. 2) Using focus group methodology, phase 2 explored black women's (N=23) perceptions of black male sexual behaviors. Study findings have significant implications for public health education, research and practice. Findings reveal that while Haitian-born and U.S.-born men have high levels of knowledge about HIV, they also ascribe to HIV conspiracy beliefs and practice high risk sexual behaviors such as unprotected sex and partner concurrency. Results show that black men's sexual behaviors are influenced by socio-ecological factors such as family norms, hip-hop culture and religious beliefs.

Female study participants perceived factors such as masculine ideologies, socialization, and the male-to-female ratio imbalance as critical influences on male sexual behaviors. While intrapersonal approaches are important to address HIV risk behaviors, ecological frameworks are necessary to inform the development of HIV prevention programs that address the socio-ecological factors that create an environment of risk. This inquiry underscores cultural and gender differences in the conceptualization of HIV/AIDS. Findings have implications for HIV prevention and demonstrate the need for gender-specific and culturally relevant HIV prevention approaches for U.S.-born and Haitian-born blacks.

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