The primary goal of this qualitative and quantitative mixed methods exploratory pilot study is to determine the oral health behaviors of Black men who have sex with men (MSM). The secondary goal of this mixed methods study is to determine if Black MSM report lack of access to and low utilization of oral health care services. The sample population was recruited in partnership with a local community-based organization in Charlotte, North Carolina to a focus group and for participation in online surveys. Paper 1 is a thorough description of the population of focus, which for this study includes Black MSM, ages 18 and older, who live in North Carolina. Paper 2 describes the Johnson conceptual framework, which utilizes the social cognitive theory for health promotion and potential behavior change. Paper 3 discusses an integrated service delivery model that could be used by community-based organizations as a model to decrease new HIV infections and engage Black MSM living with HIV into care. This paper emphasizes why integrated services like oral healthcare should be included in HIV prevention and care models. The research questions for this study are: 1) What are oral health behaviors of Black MSM; 2) What is the level of health literacy about oral health among Black MSM; and 3) What is the level of access to and utilization of oral care services for Black MSM. A semi-structured focus group with members of the community of focus was conducted to help develop the Black MSM Oral Health Behavior Survey. Quantitative data were gathered using the Black MSM Oral Health Behavior survey, and were collected December 2016 through March 2017. The three papers together demonstrate a significant relationship between oral health behaviors, oral sex practices, and the need for culturally engaged integrated services when working with Black MSM in HIV prevention and linkage to healthcare. The findings from this dissertation provide data that could be used to enhance prevention and care strategies for this population of focus, and if further studied could be potential reasoning for a need to focus on oral health in HIV prevention.
