New Arrivals to New York City: Vulnerability to HIV among Urban Migrant Young Gay Men

Abstract

This qualitative study explored the social experiences and HIV-related sexual practices of 30 young gay and bisexual men who moved to New York City in the past 3 years from other countries or elsewhere in the United States. For many migrants, a key basis of vulnerability to HIV was their engagement with New York City's unfamiliar sexual culture. Many recent arrivals migrated from places with small gay communities and low HIV prevalence, and some came with a practice of limited condom use. Participants described encountering an abundance of sexual opportunity in New York City, accessible to even the newest arrivals through internet sex sites. Some migrants expressed surprise that few men they met were interested in dating or establishing trust before having sex. Although frequent HIV testing was common, HIV status, testing history, and condom use were seldom discussed with sex partners for some men even with new partners or before sex without condoms. International and in-country migrants who are beginning to navigate New York City's gay sexual culture may be more vulnerable to HIV infection than established residents if they are inexperienced in encountering vast sexual opportunity, are less practiced in local norms of sexual communication, or if their lack of economic resources or social connections encourages them to have sex for money or shelter. This article suggests HIV prevention interventions for urban migrants and other men who have sex with men.

‘The big ole gay express’: sexual minority stigma, mobility and health in the small city

“…This type of weekend travel is distinct from what is described in the literature on migration to gay enclaves (Bianchi et al 2007; Egan et al 2011) Whereas gay and bisexual men's migration to large urban areas is often conceptualised as a singular event (e.g., Kobrak, Ponce, and Zielony 2015; Pachankis, Eldahan, and Golub 2016), our results point to more fluid movement between urban gay enclaves and small city locales. Similarly, whereas existing literature on gay and bisexual men's leisure travel conceptualises vacations as discrete, relatively infrequent trips to relatively faraway destinations (Clift and Forrest 1999; Hughes 1997), our findings suggest that gay and bisexual men living near urban enclaves might engage in more frequent and brief trips that nonetheless invoke a vacation mentality free from the constraints of local scrutiny and judgment.…”

“…While an existing literature has emphasised the migration of gay and bisexual men to urban gay enclaves (Bruce and Harper 2011; Egan et al 2011; Gorman-Murray 2007; Kobrak 2015; Valentine and Skelton 2003), our study finds that small cities may represent a unique and understudied destination for sexual minority men who are searching for identity affirming communities and safe spaces. Indeed, recent demographic research points to small cities as particularly attractive locales for sexual minority individuals and couples, perhaps representing a more affordable and accessible alterative to gentrifying gay enclaves (Cooke and Rapino 2007).…”

“…In addition to these epidemiological studies, some qualitative research has begun to explore how men experience these geographical variations in stigma (Bianchi et al 2007; Bruce and Harper 2011; Egan et al 2011; Frye et al 2014; Kobrak, Ponce, and Zielony 2015; Lewis 2014; Valentine and Skelton 2003; Waitt and Gorman-Murray 2011; Weston 1995). In particular, research describes migration to well-established gay enclaves as a quest for identity affirming communities, visible gay spaces, opportunities for socialising and sexualising, and greater anonymity (Bruce and Harper 2011; Egan et al 2011; Gorman-Murray 2007; Kobrak, Ponce, and Zielony 2015; Valentine and Skelton 2003).…”

“…In particular, research describes migration to well-established gay enclaves as a quest for identity affirming communities, visible gay spaces, opportunities for socialising and sexualising, and greater anonymity (Bruce and Harper 2011; Egan et al 2011; Gorman-Murray 2007; Kobrak, Ponce, and Zielony 2015; Valentine and Skelton 2003). Additionally, research describes leisure travel to gay enclaves as a way for gay and bisexual men to escape stigma in their hometowns (Hughes 1997).…”

“…On the other hand, travel and migration among gay men has been associated with substance use, sexually transmitted infections and HIV risk behaviour (Egan et al 2011), and some research finds evidence of sexual risk associated with travel between small and large cities in particular (Niccolai et al 2007). This increase in risk has been attributed to cultural norms in urban gay enclaves that encourage substance use and unsafe sex, the challenge of navigating context-dependent health norms and social identities in new settings, and the loss of social support that can lead migrants to seek connections through fleeting, high-risk sexual encounters (Kobrak, Ponce, and Zielony 2015; Hammack 2009; Pachankis, Eldahan, and Golub 2016). …”