Dangerfield DT, Anderson JN, Tinnell T. Cultural acceptability of STI screening guidelines and sexual positioning assessments among black sexual minority men.
J Adv Nurs 2024;
80:3253-3263. [PMID:
38151805 DOI:
10.1111/jan.16017]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 11/16/2023] [Accepted: 11/26/2023] [Indexed: 12/29/2023]
Abstract
AIM
To identify attitudes towards HIV/STI screening guidelines and explore the acceptability of assessing sexual positioning practices among Black sexual minority men (SMM).
BACKGROUND
Risks for HIV/STIs vary by sexual positioning practices. However, clinicians and Black SMM do not always discuss sexuality with each other. Therefore, HIV/STI screening and testing remain suboptimal.
DESIGN
Qualitative study using focus groups.
METHODS
Data were obtained from 12 focus groups and one in-depth interview conducted in Baltimore, MD among HIV-negative Black SMM between October 2019 and May 2020 (N = 39). Groups were stratified into three age categories: 18-24, 25-34 and 35+. Participants were given the "5 P's" from the CDC's 2015 Sexual History Screening Guidelines and asked to discuss attitudes towards existing questions regarding sexual positioning practices. Themes were identified using an electronic pile sorting approach.
RESULTS
Most identified as homosexual/gay/same gender-loving (68%), were employed (69%) and single (66%). Additionally, 34% had ever been diagnosed with an STI, of whom 38% had a history of repeated STI acquisition in their lifetime. Participants across age groups said clinicians should use the words "top" and "bottom" to demonstrate cultural familiarity and build trust. Some said that screening for sexual positioning was unnecessary and intrusive; others said that questions should be justified. Younger men wanted clinicians to ask questions in ways that make them feel cared for.
DISCUSSION
Guidelines should include language for clinicians to use culturally specific language and better ways to prepare Black SMM patients for screening.
IMPACT TO NURSING PRACTICE
Some Black SMM will not discuss sexual positioning practices without clinicians' demonstration of cultural understanding and respect. Screening should incorporate culturally responsive language, justification and convey care.
REPORTING METHOD
Consolidated criteria for reporting qualitative research (COREQ).
NO PATIENT OR PUBLIC CONTRIBUTION
There was no patient or public involvement in the design or drafting of this discursive paper.
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