Investigating perception of identity, community and stigma for a community health program

  • Project Type: Qualitative research, community program
  • Team: Jason Lam, Tiffany Veinot, Bradley Lott
  • Contribution: Data analysis, community meetings, writing

BACKGROUND

Gay, bisexual and other men who have sex with men (GBMSM) represent half of the HIV cases in the United States and two-thirds of new infections. Effective HIV-prevention approaches are needed to address this disproportionate burden. One successful approach has been community-level interventions: collaborative, multilevel, culturally situated interventions aimed at creating sustainable community level impact. Most community-level HIV-prevention interventions have focused on higher-risk subpopulations and/or settings within cities. However, research is needed to accurately define and target GBMSMs’ communities forcommunity-level interventions. Little is known about how different GBMSM groups define community, and whether GBMSM feel as if they belong to any community. This is important because GBMSM often express ambivalence towards gay communities. Community-level intervention design must also attend to racial and class-based differences. Black and Latino GBMSM may not identify with gay communities. Latino GBMSM may feel more part of the overallLatino community than the Latino gay community or the larger gay community. Working-class GBMSM are less likely than affluent peers to identify as gay orparticipate in gay communities. Thus, interventions involving these groups must account for such differences.

OBJECTIVE

  • Assess how do GBMSM define “community”?
  • Determine how GBMSM feel like they are part of gay and/or non-gay communities? Why or why not?

PROCESS

DATA COLLECTION

Participants were recruited via social media, dating websites, health clinics, bars/clubs, public postings, and LGBT organizations. Eligible participants identified as men, were aged 18-29 (interviews) or 18 or over (focus groups), self-reported sex with men, and lived in Metropolitan Detroit. We conducted 45- to 90-minute in-depth, semi-structured interviews with open-ended questions and probes (Rubin & Rubin, 2005) focused on perceptions of community. Participants received $30 gift cards. Nine focus groups were conducted with 64 adult GBMSM. Three groups were specifically for HIV-positive GBMSM. Focus groups followed a discussion guide, and averaged two hours. Participants completed a demographic survey and received a $25 gift card.

DATA COLLECTION

Both datasets were audiotaped and transcribed. Structural coding was initially performed to identify transcript sections which addressed research questions. I inductively coded existing structural anddescriptive to create themes designating the meaning of data units. For dependability, this coding was reviewed and discussed approximately weekly toevaluate supporting evidence for themes. Analytical memos were written throughout second- and third-round coding. Quotations have been lightly edited for readability.

RESULT

Most GBMSM in Metropolitan Detroit belonged to communities, while a significant minority did not. Community belonging was felt towards those outside of gay communities more than inside them. Participants defined community as common bonds, emotional support, working together, and spatial proximity. The gained community belonging by bridging multiple communities, seeking emotionally supportive people, putting in work, and regular interactions. Reasons for not having communities included feeling different from other GBMSM due to interests or culture; and recent relocation. While participants perceived a lack of emotional support between GBMSM, they often found it elsewhere.

IMPACT

Our results were protested at a health conference and paper is being reviewed for submission.