In March 2020, Black heterosexual men were invited to a discussion using referrals from social networks and among personal relationships with HAHSTA staff. The group of five participants nevertheless reflected a range of ages, marital statuses, income levels, educational attainment, and other factors.
The main issues identified by Black heterosexual men in our conversation were: spirituality, family, and financial security. Access to health care was not noted as a major concern. One participant said that not going to the doctor is a sign of manhood. In the perception of some Black men, the appearance of health, fitness, and strength are synonymous with masculinity, and a disease diagnosis would make them feel less manly. The desire to avoid this feeling can result in disengagement with the health care system. Other participants noted that they were discouraged about accessing care because of family members’ poor experiences.
The discussion revealed a strong sense of responsibility to family, as well as — through a conversation about gentrification — a deep concern for the Black community as a whole.
In general, a message about health for its own sake did not resonate with Black men in our conversation. However, the strong sense of responsibility to family and concern for community could be used to make a case for personal health — being present and healthy for one’s children, for example. Messaging about health and HIV targeted toward heterosexual Black men can incorporate these themes. Messaging for this group should focus on health generally and not HIV exclusively, since participants did not perceive themselves to be at risk of exposure to HIV.