#PrEP4Love: success and stigma following release of the first sex-positive PrEP public health campaign.

Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing HIV transmission in high-risk groups. Despite ongoing social marketing to increase PrEP awareness, few studies have evaluated public responses. This paper contextualises negative responses to Chicago's PrEP4Love campaign. In February 2016, a sex-positive ad campaign called PrEP4Love was launched online and throughout public spaces in Chicago. A gender and sexuality inclusive campaign, PrEP4Love is intended to be culturally responsive and sex positive, while retaining a focus on risk reduction. Advertisements prominently feature Black sexual minority men, and Black transgender women, and were strategically placed in diverse Chicago neighbourhoods. In response, there were 212 new callers to the PrEPLine during the two-month study period. Negative responses were concerned with: negatively depicting Black homosexuality (4), general anti-LGBTQ comments (7), adverse effects on children (6), sexually explicit nature (5), and general stigmatisation of racial minorities (4). Discussion focuses on sex-positive frameworks, normalising intimacy, stigma and historical mistrust of medical and pharmaceutical institutions, and the social meanings of biomedical prevention technologies (e.g. PrEP) in relation to dominant norms of sexuality and gender. This study is the first to investigate public responses to a sex-positive PrEP campaign. More studies of PrEP social marketing are needed to evaluate targeted public health campaigns to guide future PrEP promotion strategies.

The Role of School and Community Involvement in the Psychosocial Health Outcomes of Black and Latinx LGBTQ Youth.

PURPOSE: Lesbian, gay, bisexual, transgender, and queer-identified (LGBTQ) youth of color face poorer psychosocial health outcomes than their non-LGBTQ peers. Research suggests school-based and community activities promote psychosocial health for LGBTQ youth, but study samples are predominantly White. This study tested whether school enrollment and seven community activities were associated with LGBTQ community connectedness, happiness, and health among Black and Latinx LGBTQ youth. METHODS: This study used a subsample of Black and Latinx LGBTQ adolescents and young adults (N = 472) from the Social Justice Sexuality project. Mean differences in study variables were examined across intersectional racial/gender identity categories. Multiple regression analyses assessed the association of school enrollment and community activities with psychosocial health outcomes, accounting for covariates. RESULTS: Social activities for LGBTQ people (ß = 0.19) and LGBTQ people of color (POC; ß = 0.15) were associated with greater LGBTQ connectedness. While moderate religious services attendance (ß = -0.13) was associated with lower LGBTQ connectedness, high attendance was associated with greater happiness (ß = 0.13) and health (ß = 0.12). Social activities for LGBTQ-POC (ß = 0.13) were also associated with better health. School enrollment was not significantly associated with any outcomes and Latinx transgender and diverse youth had the lowest happiness and health. DISCUSSION: Social activities for LGBTQ people and LGBTQ-POC may play a role in the social connectedness and health of Black and Latinx LGBTQ youth, while frequent religious service attendance may support health and happiness. Schools and faith institutions should ensure their institutions are welcoming to LGBTQ youth. Public health workers might facilitate the involvement and inclusion of LGBTQ youth, while policy should support funding for community activities.

Disclosure of Sexual Identities Across Social-Relational Contexts: Findings from a National Sample of Black Sexual Minority Men.

Black sexual minority men (BSMM) in the USA navigate a range of factors that may influence the extent to which they disclose or conceal their sexual identity in various social contexts. To date, few studies have investigated the correlates of sexual identity disclosure or concealment among BSMM across multiple life domains. Guided by a minority stress perspective and intersectionality, we analyzed data from N = 809 BSMM who participated in the Social Justice Sexuality Survey. We conducted ordinary least squares regression to examine the relative weight of perceptions of homophobia, religiosity, LGBT community connectedness, racial identity salience, and sexual identity salience on disclosure of sexual identity in six social-relational contexts: (1) family, (2) friends, (3) neighbors, (4) religious community, (5) work, and (6) online. Findings indicate that BSMM disclosed their sexual identity unevenly across social-relational contexts. Notably, LGBTQ community connectedness and sexual identity importance were consistent predictors of sexual identity disclosure across contexts. In contrast, perceptions of homophobia were not related to sexual identity disclosure, suggesting that other factors may be more salient for BSMM when deciding to disclose their sexual identity. Finally, bisexual men consistently reported lower levels of sexual identity disclosure relative to gay men in all six contexts. Study findings have important implications for future research on sexual identity disclosure with diverse samples of BSMM.

Ending the Epidemic: Assessing Sexual Health Communication, Personal Agency, and HIV Stigma among Black and Latino Youth in the U.S.

Sexual health communication warrants greater attention as it may help to reduce the rates of HIV incidence among youth. A growing body of literature suggests that conversations about sexual health among Black and Latino youth may serve as a potential strategy for HIV prevention. The current study investigates whether sexual health communication-in particular, conversations about sexual health and HIV-influences Black and Latino youth's personal agency regarding their role in achieving an HIV-free generation. For this secondary data analysis, we used the National Survey of Teens and Young Adults on attitudes towards HIV/AIDS (n = 701). Participants included youth between the ages 15 and 24, and the average was 20 years. We used a multiple regression analysis to examine whether sexual health communication contributed to youth knowledge and awareness of (1) the national plan for EHE, and (2) their role in ending the epidemic". (1) knowledge and awareness of the national plan for EHE, and (2) role in ending the epidemic. The final multiple regression model was statistically significant [R2 = 0.16 F (12, 701) = 001, p < 0.001] for both outcomes. Study results found that sexual health communication was positively related to Black and Latino youth's awareness of efforts to end the HIV epidemic (EHE) and their belief that they could play a role in achieving EHE. In addition, HIV stigma influenced personal agency and whether youth were aware of efforts to achieve EHE. Our results demonstrated that openly communicating about sexual health and HIV may contribute to a sense of personal agency among Black and Latino youth. In addition, understanding whether sexual health communication contributes to a sense of personal agency among youth may inform HIV prevention efforts to achieve the goals set forth by the national EHE plan for the U.S.

Racial and Sexual Minority Scholar Positionality: Advancing Health Status and Life Opportunity Among Sexual Minority Men of Color.

Black and Latino sexual minority men (BLSMM) scholars are well positioned to draw on their unique perspectives and expertise to address the health status and life opportunities (HSLO) of BLSMM. Increasingly, research related to the positionality of scholars of color suggests that the scholar's stance in relation to the community being researched has important implications for the research. Despite growing recognition of the importance of scholar positionality, limited attention has been paid to the relationship between scholar-of-color positionality and improving HSLO trajectories of BLSMM. Furthermore, extant literature fails to specify the mechanisms by which scholar-of-color positionality can improve HSLO among BLSMM. This article seeks to fill this gap in research by arguing that an inadequate consideration of scholar positionality in health and life opportunity research has important implications for the HSLO of BLSMM. A multilevel, mediational model addressing factors at the micro-level (i.e., intrapersonal resources)-BLSMM scholars' personal commitments to BLSMM communities, cultural knowledge and expertise, and shared life experiences; meso-level (i.e., scholar and affected community interactions)-historical membership, mutual interdependency and trust, and community and organizational gatekeeping; and macro-level (i.e., national policies and priorities regarding BLSMM)-national priorities regarding the health and social welfare of BLSMM, allocation of BLSMM research and program funding, societal sentiment, and national investment in the workforce development of BLSMM scholars and clinicians are detailed. In conclusion, we identify recommendations and strategies for advancing scientific, programmatic, and policy efforts, aimed at improving HSLO among communities of BLSMM.

#PrEP4Love: An Evaluation of a Sex-Positive HIV Prevention Campaign.

BACKGROUND: Pre-exposure prophylaxis (PrEP) is an effective but underutilized method for preventing HIV transmission in communities vulnerable to HIV. Public health campaigns aimed at increasing PrEP awareness and access have less evaluation data. OBJECTIVE: The aim of this study was to evaluate Chicago's PrEP campaign, PrEP4Love (P4L), a campaign that uses health equity and sex-positivity approaches for information dissemination. METHODS: P4L launched in February 2016 and remains an active campaign to date. The analysis period for this paper was from the launch date in February 2016 through May 15, 2016. Our analysis reviews the Web-based reach of the campaign through views on social media platforms (Facebook and Instagram), smart ads, or ads served to individuals across a variety of Web platforms based on their demographics and browsing history, and P4L website clicks. RESULTS: In total, 40,913,560 unique views were generated across various social media platforms. A total of 24,548 users clicked on P4L ads and 32,223,987 views were received from smart ads. The 3 most clicked on ads were STD Signs & Symptoms-More Information on STD Symptoms, HIV & AIDS Prevention, and HIV Prevention Medication. An additional 6,970,127 views were gained through Facebook and another 1,719,446 views through Instagram. There was an average of 182 clicks per day on the P4L website. CONCLUSIONS: This is the first study investigating public responses to a health equity and sex-positive social marketing campaign for PrEP. Overall, the campaign reached millions of individuals. More studies of PrEP social marketing are needed to evaluate the relationship of targeted public health campaigns on stigma and to guide future PrEP promotion strategies.

The relationship between Black and gay community involvement and HIV-related risk behaviors among Black men who have sex with men.

Blackgay men must navigate identities and stigmas related to being gay and Black, and report higher HIV incidence relative to their white male counterparts although they report lower rates of drug use and risky sexual behaviors. This study examined whether closeness to the gay or Black community correlated with HIV related risk and protective behaviors. Data were drawn from uConnect, a population-based cohort study of YBMSM on Chicago's South Side. The sample consists of 618 Black MSM ranging in age from 16-29. Cross sectional measures for this study include Black and gay community closeness, drug use, sexual risk behaviors, HIV testing and health promotion behaviors. Closeness with the gay community was associated with greater PrEP knowledge as well as participating in health promotion programs along with higher rates of transactional sex and having sex under the influence of substances, and increased odds of self-reported HIV seropositivity. Involvement in the Black community was associated with lower odds of reporting being HIV positive. Findings suggest that programs and initiatives are needed to help promote the positive aspects of the Black and gay communities, while minimizing the negative correlates of such involvements.