Martin Luther King MemorialAIDS 2018 PosterMenCount TeamAAMTeam Represent Staff at AIDS 2018

Resilience

Building on resilience research to improve Black men’s sexual health

 “[There are] two strikes against me: I’m Black, and I’m [an] ex-felon. So you settle like, “Okay, you can’t make it further than what we [society] allow you to.” And me myself, I can’t get stuck in that. You know, I can’t get stuck in that, ’cause [there is] so much out here for me as a Black man, so much…. Basically, if I apply for [a] job an’ they shut the door, I just go apply for another one better than that one. For instance, I went on three interviews in one day…. Keep goin’, keep goin’. I keep goin’.”

-Sean, 37 (Teti, Martin, Randade, Massie, Malebranche, Tschann & Bowleg, 2012)

HIV/AIDS is disproportionately high among Black men, who comprised 40% of all new HIV cases among men in 2014 (CDC, 2015), although they represented only 6% of the U.S. male population. And yet, not all Black men have contracted the virus. Because most HIV prevention research and interventions have followed a deficit model emphasizing sexual risk over sexual health, there is a dire need for more studies and interventions focused on how resilience may protect against sexual risk (Malebranche, in press; Herrick, Lim, Wei, Smith, Guadamuz, Friedman, & Stall, 2011). But only a few such studies and interventions exist. To address this gap, Team Represent is beginning to identify strength-based resources within individuals and neighborhoods that may protect Black men and their sexual partners from sexual HIV risk, and promote wellness.


Documenting forms of resilience within Black men and their neighborhoods

Resilience is a burgeoning field of study in behavioral and social science research that typically refers to “good outcomes in spite of serious threats to adaptation or development” (Masten, 2001). Resilience in Black adults, however, remains understudied relative to White adults (Abdou et al., 2010; Brown, 2008; Utsey et al., 2007). Empirical research has shown that social support is linked with positive mental health among Blacks (Brown, 2008) and may protect against sexual risk behaviors among Black heterosexual men (Bowleg, Teti, Massie, Patel, Malebranche, & Tschan, 2011) and Black and Latino MSM (Lauby, Marks, Bingham, Liu, Liau, Stueve, & Millett, 2012). Religiosity and spirituality have also been associated with Blacks’ psychological well-being (Ano & Vasconcelles, 2005), but only a limited number of studies have examined whether and how these factors may help decrease sexual HIV risk in Black men (Boyd-Starke, 2011; Foster, Arnold, Rebchook, & Kegeles, 2011).

Moreover, resilience has traditionally been conceptualized solely as an individual trait and, as a result, research about neighborhood-level factors that may be protective against sexual HIV risk is rare. And, like the field of HIV prevention research (as well as psychosocial and behavioral research in general), most studies and theories on neighborhood effects and health have also been shaped by a deficits perspective that emphasizes neighborhood stressors, such as poverty and crime, and not its strengths.

Consequently, we know little about how neighborhood-level resilience might protect Black men from sexual HIV risk, even in the poorest or drug and crime-ridden communities. Geospatial analyses of people living with HIV/AIDS (PLWHA) in Philadelphia, for example, found neighborhoods with “very high risk indicators” such as more neighborhood poverty and instability but with low rates of PLWHA  (Public Health Management Corporation, 2011). Acknowledging that their quantitative analyses prevented them from assessing the possible link between protective neighborhood factors and the lower rates of PLWHA, the researchers recommended qualitative research to further explain their findings.

By adopting an assets-informed perspective of HIV prevention and neighborhoods, Team Represent is investigating overlooked and untapped strengths that exist within neighborhoods, not just the absence of neighborhood poverty or crime. We use the term neighborhood resilience to refer to neighborhood processes that facilitate and encourage healthy behaviors, including those that protect against sexual risk. Such neighborhood processes include: collective efficacy, including shared values and norms and other forms of social cohesion, informal social control, and the willingness to intervene against such undesirable behaviors as truancy to maintain order. Other neighborhood processes that encourage healthy behaviors include: participation in neighborhood associations, such as crime watch groups, and shared outdoor spaces, such as parks and community gardens.

Through our research, we aim to share knowledge about the sources of strength within Black men and their neighborhoods to inform the development of urgently needed resilience-based interventions to protect Black men and their sexual partners from sexual HIV risk. For example, structural interventions could be designed to foster social cohesion in neighborhoods about the importance of knowing one’s HIV status. Neighborhood organizations and small businesses, such as corner stores and cafes, could co-host a neighborhood HIV testing fair, which they can promote at neighborhood schools with HIV testing logo or poster competitions.

To learn more about our resilience research, contact us.

 

 

 

 

Menhood investigates Black men, DC, and HIV risk from a neighborhood angle

MENHOOD is an ongoing NIH/NIMH-funded study examining the effects of neighborhood and individual-level stressors and resilience on Black men’s sexual risk. Learn more

 

Meet Lisa Bowleg

Lisa Bowleg is the Principal Investigator of Team Represent and Professor of Applied Psychology at the George Washington University. Learn more about her work.