Triple jeopardy: targeting older men of color who have sex with men.

This article presents selected findings from a needs assessment conducted for a community-based organization in Chicago that targeted black and Latino men 50 years and older who have sex with men (MSM). A convenience sample of 110 self-identified minority MSM was recruited through agency sources and administered a 73-question survey. Most men surveyed (>90%) reported sex with other men, with 20% reporting unprotected receptive anal sex and most reporting drug use in conjunction with sex. The data showed varying sexual self-identification, with 45% identified as either bisexual or mostly or completely straight and a substantial proportion (36%) reporting sexual activity with women. A large percentage disclosed being relatively secretive about their same-sex behaviors to others, however, and ranked homosexual-related and HIV-related stigma high. Most men (74%) perceived themselves to be at minimal risk for contracting HIV infection, and 50% ranked their level of worry about contracting HIV infection as low. Noteworthy among the findings were the linked variables of age and race, revealing that older minority MSM may be at elevated risk because they are sexually active, often have multiple partners, and include drug use as part of their sexual episodes. Race and age also may play an important role in determining patterns of sexual identity formation, whether older minority MSM disclose same-sex practices to others or perceive gay-related or HIV-related stigmatization. Implications of these data for interventions targeting older minority MSM suggest the need for culturally sensitive and specific dissemination of basic HIV prevention information and promotion of HIV testing.