Pilot Study to Describe the Substance Use Experiences of HIV-Positive Young Black Men Who Have Sex with Men (MSM) Between the Ages of 18-29 in San Francisco

Friday, 25 July 2014

Austin Nation, RN, PHN, MSN
School of Nursing, University of California, San Francisco (UCSF), San Francisco, CA


The prevalence of HIV among young Black men who have sex with men (MSM) is three to four times higher than white MSM. Young black MSM are run-aways and homeless, forcing them to survive on the streets by becoming sex workers, engaging in unprotected anal intercourse because either they or their partner is under the influence of drugs or alcohol. Previous studies cite crack cocaine use, sex while high on crack cocaine, marijuana and alcohol, or sharing needles for injection drugs as strongly associated with HIV infection among young black MSM. The purpose of this presentation is to identify contributing risk factors for acquiring HIV/AIDS among young Black MSM as well as describe and explain the significance of substance use among this population


This qualitative study is to offer insight about the range of factors and enhance our understanding about the role that substance use plays in the lives of HIV-positive young Black MSM. Surprisingly, the results of this study do not draw the same conclusions as previously cited studies with HIV-positive young Black MSM in other cities. 


The themes that emerged from the coding of this qualitative narrative study describe an across-case experiential trajectory with a summary of the significant experiences of this population, contributing to the limited body of knowledge currently available about family, relocation, relationships, methamphetamine prevalence and access, testing positive for HIV and willpower, coping and the sense of hope.

This information will contribute to the development of prevention education strategies specifically tailored to this population that address issues surrounding substance abuse in HIV transmission.

a.  family and includes issues with being stigmatized due to their sexual orientation along with rejection, judgment, discrimination, and lack of acceptance and early exposure to drugs and sex in the family.

b. relocation to San Francisco, they talk about HIV, being homeless and the theme of survival, needing money for meet their basic needs including food and housing so they can have a place to sleep and shower.

c. relationships, which include feelings of abandonment, alone, lonely, and the need to find a community and have a sense of belonging.

d. methamphetamine exposure, prevalence, and access happening among their newfound community and peer pressure to do the drug, using it for emotional numbing so that they can deal with their  circumstances. They discover the sexual enhancement benefit and this leads them to engage in high risk behaviors such as URAI. 

e. testing positive for HIV, describing as a sense of relief and something they are not surprised about; there is a resignation about eventually being HIV infected.

f. willpower, coping, and a sense of hope for their future


Clinicians and researchers in all academic and practice settings will encounter HIV-positive young Black men and need to understand the prevalence of HIV/AIDS among this population as well as the importance of making a thorough sexual health and risk behavior assessment. It appears that the high exposure, prevalence, and access of methamphetamine in San Francisco among the predominantly White MSM population has had an impact on these young Black men.