"The Nurse Told Her to Get Checked More Regularly Because She is Having Sex with Black Men": An Exploration of the Sexual Health Experiences of Black Heterosexual Men in London.

Abstract

Drivers of poor sexual health outcomes among Black heterosexual man are poorly understood. Previous research has identified a need to understand Black men's behavioral experiences and motivators in the UK. This study aimed to address this gap through a phenomenological exploration of the sexual health experiences and motivators of Black heterosexual men with experience of higher-risk sexual behaviors living in London. Semi-structured interviews were conducted with 10 participants (18-58 years) recruited through barbershops. Reflexive thematic analysis was used to analyze the data. Five themes were generated. For relevance, three themes are discussed in this paper: 1) The Black Man's Battle; 2) Sexual Socialization; and 3) Sexual Behaviors, Relationships, and Health. Race and gender combined to shape experience of sexual socialization. Exposure to explicit media content from a young age promoted multiple sexual partners. Racist sexual stereotypes exposed participants to fetishization and created pressure to meet sexual expectations. Condom use motivators were complex and multifaceted. Experience of institutional racism created a lack of trust in services. However, actual experiences with sexual health services were positive and counteracted the mistrust created by racism. Sexual health services should better tailor their work to Black heterosexual men and diversify their offer. Services should collaborate with Black community organizations to deliver services outside clinical settings.