Among those living with HIV, church-based homonegativity also affects treatment adherence and viral suppression ( Balaji et al. Church-based homonegativity reduces self-acceptance, increases sexual risk-taking, and negatively impacts HIV and sexual health disparities for BSMM ( Klein and Lomonaco 2016 Quinn, Dickson-Gomez and Young 2016 Dangerfield II et al.

2012) and for whom HIV and other sexual health disparities persist in the USA ( Grey et al. However, homonegative and stigmatising churches are a continual source of stress for BSMM ( Balaji et al. In US-based studies individuals who attend church services have lower rates of morbidity and mortality than those who do not ( Chida, Steptoe and Powell 2009 Zimmer et al. A secondary theme identified involvement in the house and ballroom community as an LGBT-affirming religious experience. Three primary themes identified: (1) preferring traditional church environments over LGBT-affirming churches (2) experiencing the LGBT-affirming church as a space of acceptance, emotional healing, and modelling loving same-sex relationships and (3) perceiving LGBT-affirming churches as opportunities to engage community members to promote the well-being of BSMM. Thematic analysis evaluated domains related to how men perceived, experienced, and engaged with LGBT-affirming churches. Nine focus groups (N=52) were conducted in Baltimore City, Maryland between December 2017 to April 2018. This study explored the role of LGBT-affirming churches in the lives of BSMM. Lesbian, gay, bisexual, and transgender (LGBT) affirming churches may offer support, but little is known about the role of LGBT-affirming churches in the lives of BSMM and how they may impact HIV and other health outcomes. Individuals who attend church have lower rates of morbidity and mortality than those that do not however, church attendance presents a paradox of being protective for some health outcomes and a risk for others among this population. In the USA, Black sexual minority men (BSMM) remain disproportionately impacted upon by HIV and other sexual health issues.

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