This article was reported by Medical Xpress.
Medical Xpress reported on a study of family and cultural pressures to exhibit prescribed masculine behaviors among young black men who have sex with men (MSM). Errol Fields, M.D., Ph.D., an adolescent medicine expert at the Johns Hopkins Children's Center, and colleagues analyzed interview responses of 35 black openly gay and bisexual men and MSM who do not identify as gay or bisexual between the ages of 18 and 24.
The participants were raised in families and communities with homophobic attitudes and traditional views of masculinity. Participants reported that if they did not conform to expected behaviors, then they were ridiculed and ostracized. Under such pressures, participants were: more likely to engage in risky sexual behaviors; less likely to have monogamous relationships; and more likely to participate in unprotected sex. In addition, family rejection resulted in seeking affirmation and acceptance through sex, which often led to unsafe sex. According to some participants, unprotected sex was an expression of a sexual partner's love and trust.
According to Fields, the findings show "a clear clash between internal sexual identity and external expectations at a critical developmental stage," resulting in loneliness and low self-esteem, which led to risky behaviors. Researchers noted that in their desire to assimilate, youth engaged in risk-taking behaviors including fighting, aggression, drinking, and using drugs to prove their manhood. Also, the constant effort to present a straight appearance resulted in chronic anxiety and fear of discovery. Participants who were overtly masculine in public were more likely to avoid HIV prevention messages and services focusing on the gay community.
Researchers concluded that gay black youth may face more severe distress due to their homosexuality than youth from other racial groups and the resulting compensatory behavior may contribute to their high HIV infection rate. Fields emphasized the need for public health and primary care physicians to be aware of these cultural dynamics and provide appropriate sexual health counseling and interventions.
The full report, "'I Always Felt I Had to Prove My Manhood': Homosexuality, Masculinity, Gender Role Strain, and HIV Risk Among Young Black Men Who Have Sex With Men," was published online ahead of print in the American Journal of Public Health (2014; doi: 10.2105/AJPH.2013.301866).