A mixed methods study of health and social disparities among substance-using African American/Black men who have sex with men.

African American/Black men who have sex with men (MSM) in the U.S. experience health and social disparities at greater rates than MSM of other races/ethnicities, including HIV infection and substance use. This mixed methods paper presents: 1) a quantitative examination of health and social disparities among a sample of substance-using African American/Black MSM (N=108), compared to Caucasian/White MSM (N=250), and 2) in-depth qualitative data from a subsample of African American/Black MSM (N=21) in order to contextualize the quantitative data. Findings indicate that compared to Caucasian/White MSM, African American/Black MSM experienced a wide range of health and social disparities including: substance use and dependence; buying, trading or selling sex; educational attainment; employment; homelessness; identifying as gay; HIV status; arrest history; social support; and satisfaction with one's living situation. Qualitative data suggests that structural interventions that address homophobia and the social environment would be likely to mitigate many of the health and social disparities experienced by African American/Black MSM.