- Describe how factors not directly related to biomedical HIV prevention (e.g., the labor market, law enforcement, gendered expectations) influence how Black MSM approach HIV prevention and pre-exposure prophylaxis
- Give examples of how factors across multiple levels (e.g., structural, community, interpersonal) impact how Black MSM engage with biomedical HIV prevention
- Describe what types of multi-level approaches might facilitate Black MSM’s uptake of PrEP. Describe how can we balance the development of more proximate interventions (e.g., education campaigns) with large scale interventions (e.g., expanding insurance access) that might have a larger impact
Date: September 11, 2017
Morgan Philbin, PhD, MHS
Columbia University University Mailman School of Public Health
Black men who have sex with men (MSM) are at significantly higher risk of HIV. This is due to a complex interplay between socio-structural factors and their own intersectional identities. In this webinar, Dr Philbin describes her ethnographic study examining how factors at all levels of the social-ecological model shape healthcare behavior for black MSM and how they access PreP, as well as her sub-study about structural barriers to access. Some of these barriers included misunderstanding about PreP’s effectiveness and side-effects, concerns that it would decrease others’ condom use, distrust in the pharmaceutical industry and healthcare providers, precarious housing, the structure of the labor market, gendered healthcare systems, institutional and normative gender rules, and stigma. Dr Philbin highlights the importance of reducing barriers at all levels, particularly at the structural level in areas of stigma, employment, and housing. The implications include the need to eliminate the relationship between employment and access to healthcare, enacting policies that regulate shift work (scheduling and pay), creating clinical spaces that welcome all types of men, and expanding the PreP Assistance Program.