The Association Between Men’s Concern About Demonstrating Masculine Characteristics and Their Sexual Risk Behaviors: Findings from the Dominican Republic
Quantitative analyses exploring the relationship between masculinities and men’s sexual risk behaviors have most commonly used one dimension of masculinities: men’s gender ideology. Examining other dimensions may enhance our understanding of and ability to intervene upon this relationship. In this article, we examined the association between gender role conflict/stress (GRC/S)—men’s concern about demonstrating masculine characteristics—and three different sexual risk behaviors (having two or more sex partners in the last 30 days; never/inconsistent condom use with non-steady partners; and drinking alcohol at last sex) among a sample of heterosexual men in the Dominican Republic who were participating in an HIV prevention intervention (n = 293). The GRC/S Scale we used was adapted for this specific cultural context and has 17 items (α = 0.75). We used logistic regression to assess the relationship between GRC/S and each sexual behavior, controlling for sociodemographic characteristics. In adjusted models, a higher GRC/S score was significantly associated with increased odds of having two or more sex partners in the past 30 days (AOR 1.33, 95 % CI 1.01–1.74), never/inconsistent condom use with non-steady partners (AOR 1.45, 95 % CI 1.04–2.01), and drinking alcohol at last sex (AOR 1.56, 95 % CI 1.13–2.17). These results highlight the importance of expanding beyond gender ideology to understanding the influence of GRC/S on men’s sexual risk behaviors. Interventions should address men’s concern about demonstrating masculine characteristics to reduce the social and internalized pressure men feel to engage in sexual risk behaviors.
KeywordsMasculinity Condoms Alcohol Gender Sexual concurrency HIV
We would like to thank Martha Perez, Miriam Nova, Riqui Rosario, and Nicolas González for their assistance in recruitment and data collection. This project was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR000050. We are grateful to the Carolina Population Center for training support (T32 HD007168) and for general support (R24 HD050924). P.J. Fleming was supported by the UNC STD/HIV training Grant (T32AI007001) and subsequently by a NIDA training Grant (T32DA023356). Fieldwork was generously supported by the Explorations in Global Health Award from the UNC Institute for Global Health and Infectious Disease, UNC Carolina Population Center’s Research Residency Award, the Mellon Dissertation Fellowship from UNC’s Institute for the Study of the Americas, and the Koch Travel Award from the Gillings School of Global Public Health at UNC.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
- Barrington, C. (2007). Social networks, norms, and the HIV-related behaviors among the male partners of female sex workers in La Romana, Dominican Republic. Unpublished doctoral disseration, Johns Hopkins University, Baltimore, MD.Google Scholar
- Barrington, C., Latkin, C., Sweat, M. D., Moreno, L., Ellen, J., & Kerrigan, D. (2009). Talking the talk, walking the walk: Social network norms, communication patterns, and condom use among the male partners of female sex workers in La Romana, Dominican Republic. Social Science and Medicine, 68, 2037–2044. doi: 10.1016/j.socscimed.2009.03.009.CrossRefPubMedPubMedCentralGoogle Scholar
- Bowleg, L., Teti, M., Massie, J. S., Patel, A., Malebranche, D. J., & Tschann, J. M. (2011). ‘What does it take to be a man? What is a real man?’: Ideologies of masculinity and HIV sexual risk among Black heterosexual men. Culture, Health & Sexuality, 13, 545–559. doi: 10.1080/13691058.2011.556201.CrossRefGoogle Scholar
- Brito, M. O., Lerebours, L., Volquez, C., Basora, E., Khosla, S., Lantigua, F., … Bailey, R. C. (2015). A clinical trial to introduce voluntary medical male circumcision for HIV prevention in areas of high prevalence in the Dominican Republic. PLoS ONE, 10(9), e0137376. doi: 10.1371/journal.pone.0137376.CrossRefPubMedPubMedCentralGoogle Scholar
- Connell, R. W. (1987). Gender and power. Stanford, CA: Stanford University Press.Google Scholar
- Connell, R. W. (1995). Masculinities. Berkeley: University of California Press.Google Scholar
- de Moya, E. A. (2003). Versiones y subversiones de la masculinidad en la cultura dominicana. Perspectivas Psicológicas, 3, 184–190.Google Scholar
- de Moya, E. A. (2004). Power games and totalitarian masculinity in the Dominican Republic. In R. Reddock (Ed.), Interrogating Caribbean masculinities: Theoretical and empirical analyses (pp. 68–102). Kingston: University of West Indies Press.Google Scholar
- DIGECITSS. (2014). El Estado Epidemico del VIH en Republica Dominicana [The state of the HIV epidemic in the Dominican Republic]. Santo Domingo: DIGECITSS.Google Scholar
- Fleming, P. J., Barrington, C., Pearce, L. D., Lerebours, L., Donastorg, Y., & Brito, M. O. (2016a). “I feel like more of a man”: A mixed methods study of masculinity, sexual performance, and circumcision for HIV prevention. Journal of Sex Research. doi: 10.1080/00224499.2015.1137539.PubMedPubMedCentralGoogle Scholar
- Fleming, P. J., Harris, K. M., Halpern, C. T. (2016c). Description and evaluation of a measurement technique for assessment of performing gender. Sex Roles. doi: 10.1007/s11199-016-0657-3.
- Gilmore, D. D. (1990). Manhood in the making: Cultural concepts of masculinity. New Haven, CT: Yale University Press.Google Scholar
- Glanz, K., & Schwartz, M. D. (2008). Stress, coping, and health behavior. In K. Glanz, B. K. Rimer, & K. Viswanath (Eds.), Health behavior and health education: Theory, research, and practice (pp. 211–236). San Francisco, CA: Jossey-Bass.Google Scholar
- Gottert, A., Barrington, C., Pettifor, A., McNaughton-Reyes, H. L., Maman, S., MacPhail, C., … Lippman, S. A. (2016). Measuring men’s gender norms and Gender Role Conflict/Stress in a high HIV-prevalence South African setting. AIDS and Behavior, 20(8), 1785–1795. doi: 10.1007/s10461-016-1374-1.
- Gupta, G. R. (2000). HIV/AIDS: The what, the why and the how. Paper presented at the International AIDS Conference, Durban, South Africa. Retrieved from http://siteresources.worldbank.org/EXTAFRREGTOPGENDER/Resources/durban_speech.pdf
- Levant, R. F., Hirsch, L. S., Celentano, E., & Cozza, T. M. (1992). The male role: An investigation of contemporary norms. Journal of Mental Health Counseling, 14, 325–337.Google Scholar
- Matser, A., Heiligenberg, M., Geskus, R., Heijman, T., Low, N., Kretzschmar, M., & van der Loeff, M. S. (2014). The importance of partnership factors and individual factors associated with absent or inconsistent condom use in heterosexuals: A cross-sectional study. Sexually Transmitted Infections, 90(4), 325–331. doi: 10.1136/sextrans-2013-051087.CrossRefPubMedGoogle Scholar
- Messner, M. A. (1997). Politics of masculinities: Men in movements. Lanham, MD: Altamira Press.Google Scholar
- Montano, D. E., & Kasprzyk, D. (2008). Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. In K. Glanz, B. Rimer, & K. Viswanath (Eds.), Health behavior: Theory, research and practice (4th ed., pp. 67–96). San Francisco, CA: Jossey-Bass.Google Scholar
- Padilla, M. (2008). Caribbean pleasure industry: Tourism, sexuality, and AIDS in the Dominican Republic. Chicago, IL: University of Chicago Press.Google Scholar
- Pleck, J. H. (1981). The myth of masculinity. Cambridge, MA: MIT Press.Google Scholar
- Pleck, J. H. (1995). The gender role strain paradigm: An update. In R. F. Levant & W. S. Pollack (Eds.), A new psychology of men (pp. 11–32). New York, NY: Basic Books.Google Scholar
- Smiler, A. P., & Epstein, M. (2010). Measuring gender: Options and issues. In J. C. Chrisler & D. R. McCreary (Eds.), Handbook of gender research in psychology: Gender research in general and experimental psychology (Vol. 1, pp. 133–157). New York: Springer.Google Scholar
- Van den Berg, W., Hendricks, L., Hatcher, A., Peacock, D., Godana, P., & Dworkin, S. (2013). ‘One man can’: Shifts in fatherhood beliefs and parenting practices following a gender-transformative programme in Eastern Cape, South Africa. Gender & Development, 21, 111–125. doi: 10.1080/13552074.2013.769775.CrossRefGoogle Scholar