The sexual health experiences and motivators of Black heterosexual men in London. A qualitative study including higher-risk behaviours

Nwaosu, Uzochi

Abstract

Background: Black ethnic groups in the UK disproportionately experience poor sexual health outcomes. This appears to be more pronounced amongst Black men and has been attributed to a complex interplay of individual, behavioural, cultural and structural factors. Drivers of these disparities are poorly understood and remain under-researched. Previous research has identified a gap around understanding of Black men’s behavioural experiences and factors motivating protective behaviours in a UK context. This study aimed to address this gap through exploring the sexual health experiences and motivators of Black heterosexual men in London.

Methods: A qualitative design with in-depth semi-structured interviews was adopted to obtain a rich account of experiences. The sample consisted of 10 participants aged between 18-58 years. Participants were recruited through three Barbershops in London. Reflexive thematic analysis was used to analyse transcribed interview data.

Findings: Five themes were constructed: 1) Accountability and responsibility: a real man; 2) The Black man’s battle; 3) Sexual socialisation; 4) Liberal London; and 5) Sexual behaviours, relationships, and health. Perceptions of masculinity shifted with age. During adolescence, masculinity was signalled through multiple sexual partners. As participants aged and matured, perceptions of masculinity developed to largely revolve around meeting the needs of family and loved ones. Race and gender combined to significantly influence participants’ experience of sexual socialisation. Exposure to explicit media content from a young age promoted multiple sexual partners. Racist sexual stereotypes resulted in participants experiencing fetishization of their Black male bodies and created pressure to meet expectations regarding sexual activity. Condom use motivators were complex and multifaceted. Trust, perceived STI threat and perceived potential parenting were all described as influential factors in condom use decision making. Sexual health service use was influenced by previous experience of institutional racism and the fear of stereotyped Black male sexuality which in turn underpinned a lack of trust in services. However, actual experiences with sexual health services were largely positive and counteracted the mistrust created by racism.

Implications: The study findings highlight the need for sexual health services to better tailor their work to Black heterosexual men and diversify their offer. Services should build relationships with Black community organisations to facilitate service provision outside the clinical setting.

• Thesis Type: Thesis
• Deposit Date: Dec 6, 2022
• Publicly Available Date: May 2, 2023
• Public URL: https://uwe-repository.worktribe.com/output/10226067
• Award Date: May 2, 2023