Saturday, February 6, 2016

The Social Environmental Elements of Resilience among Vulnerable African American/Black Men Who Have Sex with Men

Resilience theory has been suggested as a strong framework for research on HIV prevention among men who have sex with men (MSM). Among this population, literature indicates that African American/Black MSM are particularly vulnerable to health and social disparities associated with HIV transmission risk. Conceptualizing resilience as a part of one’s social environment, this qualitative study investigates the specific elements of resilience, and the associated contexts and relationships, among a sample of 21 substance-using African American/Black MSM. Data indicate that: 1) elements contributing to resilience are multiple and co-occurring, including inner strengths, social relationships, diversity of experience, religion/spirituality, altruism, and creativity; 2) as an element of resilience, social support was experienced differently among men who did and did not have supportive relationships with other gay and bisexual men, which has implications for social service provision and intervention approaches; and 3) diversity of experiences and relationships is an important influencing factor on expressions of resilience. Social services or interventions that facilitate the development of these elements of resilience will likely be especially beneficial for vulnerable African American/Black MSM.

The primary elements of resilience, as described during the interviews were inner strengths, social relationships, diversity of experience, religion/spirituality, altruism, and creativity. The data were themed in order to illustrate the distinct elements of resilience. Yet, men’s discussions of resilience indicate that key elements are interwoven, with each one contributing to a unified whole. Religion/spirituality is a key theme that illustrates how elements of resilience are interwoven. For many men, the distinction between internal assets and external resources was somewhat blurry. Men described the positive influence of religion and spirituality on the development and utilization of inner strengths. At the same time, religion and spirituality provides external resources for these men including social support and relationships and basic needs.

Similarly, the influence of diversity is woven into the development and expression of resilience. As is seen in the interviews, diversity allows men to see other ways of understanding the world, and thus, not being so constrained by the political, economic, or social structures in which they are embedded. While diversity is not apparent in the literature as an element of resilience, descriptions from men in the study indicate that it is an important influencing factor in the development of resilience. Diversity plays a role in drawing attention to and revealing the existence of resources, in addition to fostering resourcefulness and agency necessary to obtain needed resources.

External resources, especially social relationships, were also key elements of resilience. Sources of social support, however, varied somewhat among the respondents. Though a small number of men described connections with other gay men, for a large majority of respondents, supportive social relationships were found with non-gay individuals, such as family members or co-workers. This difference could potentially be an important aspect in the expression of resilience among MSM. The study of resilience must address the questions of when, how, and for whom resources matter (); thus, further study of this phenomenon, comparing men who do and do not have supportive relationships with other gay individuals, may generate useful information about the expression of resilience as it relates to providing social services and developing interventions designed to facilitate resilient outcomes. Such a study would be especially relevant given the recently proposed hypothesis from HIV prevention researchers that connection to a sexual minority community may be a key element of resilience for MSM ().

A small number of men expressed that their supportive social relationships were with other gay or bisexual men. For these respondents, individual agency was expressed by seeking out and making connections to the gay community and creating a social environment in which their sexual orientation or same-sex behaviors could be freely disclosed. Thus, social support was more accessible for these men in a culturally meaningful way than for other men. Yet, future research on resilience among this population may do well to examine how the expression of individual agency could be expanded to negotiate for structural changes that contribute to health and social disparities. Such an approach would focus on the availability of resources, such as culturally-meaningful social support, in addition to the resourcefulness and agency of MSM to change their social environment (). As has been noted by others, such a model that is focused on “changing the odds” in one’s social environment is preferable to one in which individuals simply “beat the odds” stacked against them (, p. 441; , pp. 220–221). Moreover, understanding resilience in this way would likely benefit the development of structural interventions or community approaches to ending the HIV epidemic among this population…

Full article at:

Mance E. Buttram, Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, 2 NE 40th Street, Suite 404, Miami, FL 33137, Tel: 305-571-2774; Fax: 305-571-8468, Email: ude.avon@marttub.ecnam;

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