Is Homophobia a Factor in HIV Racial Gap?
October 20, 2010
In the United States, perceptions about homosexuality differ greatly by race, which may partly explain disparities in HIV infection rates between black and white men who have sex with men (MSM), a new study suggests.
Researchers used data from the General Social Survey to describe race-specific trends in attitudes about homosexuality, self-reports of male-to-male sex, and behaviors that could mediate stigma and HIV transmission among MSM.
In the 2008 survey, the proportion of blacks who indicated that homosexuality is "always wrong" was 72.3 percent, a figure relatively unchanged since the survey began in the 1970s. In contrast, among white respondents 51.6 percent expressed that view in 2008, down from 70.8 percent in 1973.
A similar gap was seen among MSM themselves. Of black MSM, 57.1 percent reported that homosexuality is "always wrong," compared with 26.8 percent of white MSM (P=0.003). MSM reporting "always wrong" were less likely to say they ever tested for HIV compared with MSM holding more favorable attitudes (relative risk, 0.50; 95 percent confidence interval, 0.31-0.78).
The correlation raises the possibility, but does not prove, that homophobia is a factor in the disparity of HIV infection rates between black and white MSM, the authors said.
"Negative attitudes toward homosexuality, either from their surrounding community or from within themselves, could make it difficult for [MSM] to acknowledge their risk for HIV and seek testing," said study leader Sara Nelson Glick of the University of Washington-Seattle.
A 2008 CDC survey in 21 US cities found HIV prevalence among black MSM was 28 percent, compared with 18 percent for Hispanic MSM and 16 percent for white MSM. HIV-infected black MSM also were less likely to be aware of their infection, 59 percent were unaware, compared with 46 percent of infected Hispanics and 26 percent of white MSM with HIV.
The new study, "Persistence of Racial Differences in Attitudes Toward Homosexuality in the United States," was published in the Journal of Acquired Immune Deficiency Syndromes (doi: 10.1097/QAI.0b013e3181f275e0).
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