Background

Gay and bisexual men who have sex with men (GBM) carry a disproportionate HIV infection burden, approximating 66% of all new HIV infections in 2017. GBM’s social networks may influence health and health risk perceptions, including HIV risk. One such social network is the bear subculture, which accounts for approximately 14–22% of the gay community. Previous research on GBM who identify as bears indicated that these men are more likely to engage in sexual practices such as condomless anal sex (CAS). The purpose of this study was to describe the sexual decision-making process among GBM who identify as bears.

Methods

Utilizing a grounded theory approach, 25 in-depth semi-structured interviews were conducted with men who identify as bears, ranging in age from 22 to 77 years. Participants were recruited using purposive and snowball sampling.

Results

A theory grounded in the data entitled The Theory of Making Sexual Decisions Among Men Who Identify as Bears emerged that described how these men may make sexual decisions. The theory is constructed of one core category, “Making Sexual Decisions,” and four categories with subcategories: “Interacting with the Bear Subculture,” “Searching for Sexual Partners,” “Engaging in Sexual Activities,” and “Reflecting on Consequences.”

Conclusions

Clinicians caring for this population should be aware of the complex nature of sexual decisions, potentially allowing for HIV risk reduction strategies for GBM who identify as bears.

Policy Implications

As HIV infection continues to disproportionately impact GBM, health policy campaigns may develop initiatives that include men who identify as bears.

中文翻译：

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被认定为熊的男性的性决策：一项扎根的理论研究

背景

男同性恋和双性恋男性 (GBM) 承受着不成比例的 HIV 感染负担，约占 2017 年所有新 HIV 感染的 66%。 GBM 的社交网络可能会影响健康和健康风险认知，包括 HIV 风险。熊亚文化就是这样一种社交网络，约占同性恋社区的 14-22%。先前对识别为熊的 GBM 的研究表明，这些男性更有可能从事无安全套肛交 (CAS) 等性行为。本研究的目的是描述被认定为熊的 GBM 的性决策过程。

方法

利用扎根理论方法，对被认定为熊的男性进行了 25 次深入的半结构化访谈，年龄从 22 岁到 77 岁不等。参与者是使用有目的的和滚雪球抽样招募的。

结果

一种基于名为“在被认定为熊的男性中做出性决定的理论”的数据的理论出现了，该理论描述了这些男性如何做出性决定。该理论由一个核心类别“做出性决定”和四个子类别构成：“与熊亚文化互动”、“寻找性伙伴”、“参与性活动”和“反思后果”。

结论

照顾这一人群的临床医生应该意识到性决定的复杂性，这可能允许为被认定为熊的 GBM 制定降低 HIV 风险的策略。

政策影响

随着 HIV 感染继续不成比例地影响 GBM，健康政策运动可能会制定举措，将被认定为熊的男性包括在内。