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Given these generational differences, young MSM might be more likely to engage in risk behaviors due to feelings of HIV not being as lethal as it was initially, coupled with their increased ability to meet partners and develop relationships. Regarding sexual identity development, younger cohorts of MSM are currently developing during a time in which social and structural changes such as legalization of same-sex marriage might reflect a more tolerant social climate regarding same-sex relationships, and could impact gay and bisexual identification. Comparatively, those born during and after that time witnessed a different epidemic in which the disease became increasingly treatable and subsequently more preventable.
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Men born prior to the 1980s came of age during the first generation of the HIV/AIDS epidemic and witnessed the terminal consequences of infection, since most people came to medical attention in the later stages of disease and when effective treatments were unavailable.
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ĭue to the differing exposures to HIV risk, prevention messaging, and changing social environments surrounding same-sex relationships among those born before and after the onset of biomedical interventions and prevention options (i.e., highly active anti-retroviral treatment and pre-exposure prophylaxis ), the lives and health outcomes of BMSM are affected in part by both generational differences and age-related developmental issues. The continued disparity in HIV and STI rates among young BMSM in particular has increased attention to the role of age and sexual identity development on the sexual risk among BMSM. The need to focus on efforts to protect young BMSM from HIV has been widely acknowledged. Despite having comparable or greater proportions of prevention behaviors-condom use, HIV testing, fewer sex partners-and less drug use before or during sex, Black MSM (BMSM) are still more likely to become HIV-positive and report a history of sexually transmitted infections (STIs) than other U.S. who have sex with men (MSM) have a 50% lifetime risk of HIV infection. Clarifying the sexual development and HIV/STI risk contexts among BMSM could better inform current treatment and prevention needs.Īccording to a 2016 report from the Centers for Disease Control and Prevention (CDC), Black gay, bisexual, and other men in the U.S. BMSM also assumed sexual positioning using masculinity stereotypes and body language. Childhood sexual abuse and internalized homonegativity impacted personal development, sexual positioning, and condom negotiation. Varying exposure to HIV treatment and prevention options and venues to meet male partners revealed generational differences in sexual risks. Thematic analysis evaluated domains including major life events, substance use, social support, and partner selection.
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Twenty-six Black gay and bisexual men ages 24–61 completed life history interviews in Los Angeles, California, between September and November 2015. This study examined BMSM’s life course sexual positioning practices and accompanying HIV/STI risks. Increased attention has highlighted the role of age and sexual development on HIV risk among Black MSM (BMSM) limited focus has been given to the relationship of sexual positioning to HIV risk along the life course.