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Scholars critiquing the term 'MSM' highlight that such a broad term erases diverse identities and decontextualizes same-gender sexual behavior, and the repercussions for culturally relevant prevention and promotion efforts ( Young and Meyer, 2005 Boellstorff, 2011). A keen starting point is with the category BMSM. To understand risk and vulnerability to HIV for Black men, an acknowledgement of the intersections between race, class, gender, sexuality, and power are necessary to inform their lived reality. As such, there is an urgent need to assess socio-cultural factors and local realities to better understand key determinants influencing the high HIV rate and maintenance of HIV prevalence among the BMSM community. However, the previously understood risk factors and demographic characteristics do not explain existing disparities among BMSM ( Millett et al, 2012 Millett et al, 2007). In 2010, close to 80% of all new cases of HIV were among Black Americans in the state ( Mississippi State Department of Health, 2010), and new infections increased by 38% from 2004–2005 to 2006–2007 among young BMSM in the Jackson, Mississippi metropolitan area ( CDC, 2009). For example, Mississippi ranks second in states with the greatest proportion of Black residents and among the top 10 states in HIV infection rates ( Mississippi State Department of Health, 2010). The current status of the epidemic, however, cannot be understood solely in terms of racial and gender difference, but rather geographic concentrations highlight that the largest burden of HIV is in the Southern United States ( Nunn et al, 2014 Oster et al, 2011).
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In the United States, men who have sex with men (MSM) have been disproportionately affected by HIV since the start of the epidemic, and Black MSM (BMSM) are the most affected compared to other racial/ethnic MSM groups ( CDC, 2012). Findings suggest the current monolithic approach to treating MSM may limit public health efforts in developing effective HIV prevention and promotion programs targeting same-gender-loving Black men in the Deep South. These narratives contribute to the literature by documenting the evolving understandings of the category ‘MSM’ among Black men to reflect intersections between race, socioeconomic status, sexual behavior, sexuality, subjectivities, and social context. Results suggest multiple overlapping usages of MSM as identity and behavior, reflecting internalization of behavioral categories and co-creation of identities unique to the Black community. and among the most heavily affected by the epidemic, the Deep South, we conducted four focus groups (n=29) with Black men who reported having sex with other men residing in Jackson, Mississippi.
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To better understand diversity within MSM in a geographic region with the largest proportion of Black Americans in the U.S.
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Innovative strategies are needed to support the health of this community however, public health efforts primarily approach MSM as a monolithic population erasing the diverse identities, practices, and sexualities within and beyond this category. Men who have sex with men (MSM) and other same-gender-loving men continue to be disproportionately affected by HIV and AIDS, particularly among the Black population.