Using peer ethnography to address health disparities among young urban Black and Latino men who have sex with men.

OBJECTIVES: We examined the effectiveness of peer ethnography to gain insider views on substance use and sex among a diverse range of high-risk substance-using Black and Latino young men who have sex with men. METHODS: We recruited 9 peer ethnographers aged 21 to 24 years from youth programs for the lesbian, gay, bisexual, and transgender community in Los Angeles, California, and trained them in ethnography, study protocol, and human participant protection. Peer ethnographers collected 137 single-spaced pages of field notes in 2009 and 2010 derived from observation of 150 members of the target population. RESULTS: Peer ethnography revealed local language and phrasing and provided a window into new and different social contexts. Peers provided valuable information on current trends in substance use, revealing themes that needed to be addressed in further research, such as the use of substances during sex to "clock coin" (exchange sex for money and substances). These data enabled us to refine our recruitment strategies and ask more culturally relevant questions in a later phase of the study. CONCLUSIONS: The peer ethnography method can provide a sound basis for further research phases in multistage studies on numerous other social issues and with other hard-to-reach populations.