Changes in Sexual and Gender Identity and Their Associations with Internalized Homophobia Among Black Men Who Have Sex with Men in the HPTN 061 BROTHERS Cohort

  • Gregory PhillipsIIEmail author
  • Brian A. Feinstein
  • Matthew Levy
  • Irene Kuo
  • Sara N. Glick
  • Sheldon D. Fields
  • Typhanye V. Dyer
  • Dylan Felt
  • Manya Magnus
Original Paper


Sexual and gender identity have frequently been assessed in public health research as static states. However, a substantial and growing body of evidence indicates that both identities may have greater potential for change over time than once supposed. Despite this evidence, research into adult identity change remains relatively limited. Using longitudinal data from 1553 Black men who have sex with men (BMSM) aged 18–68 years and recruited from study locations in six major cities across the country, we examined changes in sexual and gender identities over a period of 12 months. The results showed that sexual and gender identity did indeed change among adult BMSM. Additionally, we explored internalized homophobia (IH) as a potential driver of identity change and found that IH significantly impacts the degree and direction of change, with individuals who reported higher baseline IH more likely to demonstrate a shift toward a heterosexual/straight identity at 6 and 12 months. The results are discussed in light of what is known and unknown regarding identity change, and potential avenues for future research are explored.


Sexual identity Sexual orientation Gender identity Internalized homophobia HPTN 061 



HPTN 061 Grant support provided by the National Institute of Allergy and Infectious Disease (NIAID), National Institute on Drug Abuse (NIDA) and National Institute of Mental Health (NIMH): Cooperative Agreements UM1 AI068619, UM1 AI068617, and UM1 AI068613. Additional site funding—Fenway Institute CRS: Harvard University CFAR (P30 AI060354) and CTU for HIV Prevention and Microbicide Research (UM1 AI069480); George Washington University CRS (UM1 AI069503): District of Columbia CFAR (P30 AI117970); Harlem Prevention Center CRS and NY Blood Center/Union Square CRS: Columbia University CTU (5U01 AI069466) and ARRA funding (3U01 AI069466-03S1); Hope Clinic of the Emory Vaccine Center CRS and The Ponce de Leon Center CRS: Emory University HIV/AIDS CTU (5U01 AI069418), CFAR (P30 AI050409) and CTSA (UL1 RR025008); San Francisco Vaccine and Prevention CRS: ARRA funding (3U01 AI069496-03S1, 3U01 AI069496-03S2); UCLA Vine Street CRS: UCLA Department of Medicine, Division of Infectious Diseases CTU (U01 AI069424).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

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.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Department of Medical Social Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  2. 2.Institute for Sexual and Gender Minority Health and WellbeingNorthwestern UniversityChicagoUSA
  3. 3.Department of Epidemiology and Biostatistics, Milken Institute School of Public HealthThe George Washington UniversityWashingtonUSA
  4. 4.Division of Allergy and Infectious Diseases, School of MedicineUniversity of WashingtonSeattleUSA
  5. 5.School of Health ProfessionsNew York Institute of TechnologyOld WestburyUSA
  6. 6.Department of Epidemiology and Biostatistics, School of Public HealthUniversity of MarylandCollege ParkUSA

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