Characterising social capital bonds between young, Black sexual minority men and Black women in the Southern USA: a qualitative investigation to inform a PrEP intervention.

Young, Black sexual minority men in the Southern USA experience disproportionately high HIV incidence rates, which have been linked to intersectional stigma. Interventions centred on social capital - the sum of all resources gained through social relationships - can reduce stigma and facilitate use of HIV prevention methods, including pre-exposure prophylaxis (PrEP). We sought to understand the social capital bonds between young, Black sexual minority men and Black women to inform a social network-based PrEP intervention in the US South. We conducted 30 semi-structured, in-depth interviews with members of both groups. Interviews were thematically analysed using a team-based approach. Men described receiving support from family, friends and significant others; mothers were discussed most frequently. Men most highly valued culturally tailored emotional support. Women described providing emotional and health support to young sexual minority men, however, several also shared perspectives exhibiting homophobic biases that were consistent with men's experiences of stigma within their support systems. These findings suggest that while Black women can serve as important sources of support for young, Black sexual minority men, homonegativity among some women may weaken their social capital bonds with these men. Future interventions should address such biases with theory-informed education and other actions prior to implementation.