Do the First Few Same-Sex Sexual Experiences (FSSSE) of Young Black MSM (YBMSM) Impact STD/HIV Testing Behavior?

Background:  Research suggests a relationship between timing of FSSSE and initial STD/HIV testing experiences. There is limited knowledge about how YBMSM operationalize STD/HIV risk during FSSSE and how this promotes testing behaviors. The objective of this study is to examine how YBMSM describe STD/HIV testing behavior around time of FSSSE.

Methods:  45 YBMSM 15-19 y.o., living in Baltimore, MD were recruited from clinics, venue/community-based outreach, social media, and snowball sampling over 10 months to complete face-to-face interviews. Interviews were transcribed and independently coded. Data was analyzed using categorical and contextualizing analytic methods (NVIVO software).

Results: Mean age of sample was 17.5 y.o. Most were homosexual/gay (66%) or bisexual (30%). Participants reported an average of 3.6 (SD 5) partners (prior 6 months), history of STD (16% (N=7)) or HIV (9% (N=4)). Nearly half (45%, N=20) described being worried about acquiring HIV, but few described worrying about risk around FSSSE. Two typologies of YBMSM STD/HIV screening behaviors emerged: Engaged YBMSM (proactively/reactively screening): Described general concern about STD/HIV seroconversion and future implications; network-level factors (knowledge of family member with HIV/AIDS, exposure to people/programs encouraging condom use/testing); and proactive (before sex) or reactive (after sex) testing. Disengaged YBMSM (neither proactive nor reactive screening): Described strong trust with partner(s), limited transmission knowledge, and test distrust, and nervousness/fear about knowing status. Network-level included lack of communication about STD/HIV and lack of acceptance of “homosexual lifestyle.” Intra-dyadic factors included condom-less sex norms, negative attitude about testing and trust in partner results. Screening behavior was inconsistently related to condom use.

Conclusions:  Network, dyadic, and individual level factors influenced YBMSM’s engagement or disengagement in STD/HIV testing around FSSSE and was often inconsistent with worry about acquisition. This work suggests potential areas that may improve engagement and promotion of proactive STD/HIV testing in disengaged YBMSM who are navigating their FSSSE.