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“I consider being gay a very high risk factor”: How Perceptions of a Partner’s Sexual Identity Influence Perceptions of HIV Risk Among Gay and Bisexual Men


Gay and bisexual men (GBM) in the USA experience a disproportionate burden of new HIV infections. Previous studies demonstrate that gay self-identification and outness are associated with GBM’s sexual risk-taking behaviors. However, little is known about the extent to which GBM make sexual decisions based on the level of HIV risk they associate with a male partner’s sexual identity. Using qualitative interviews with 13 GBM, we examine how a partner’s gay identification, outness, and sex with women influence perceptions of HIV risk and decisions about condoms. Participants discussed a reduced HIV risk perception for partners who were not gay-identified, not out, or having sex with women, based on the belief that they were not having sex with other men. Some participants stated that this could lead to condomless sex. Participants perceived lower risk despite stating that these partners had reduced exposure to HIV prevention interventions and increased substance use during intercourse. These findings indicate a potential discrepancy between how GBM perceive HIV risk and the behavioral factors associated with risk. HIV prevention messages and policies should focus on tackling the myth that a non-gay identity is protective of HIV and decentralize messages and policies from being only about gay men.

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  • Allison, S., & Messick, D. (1985). Group attribution error. Journal of Experimental Social Psychology, 21(6), 563–579.

    Article  Google Scholar 

  • Allport, G. (1954). The nature of prejudice. Cambridge, Mass.: Addison-Wesley Pub.

    Google Scholar 

  • Ayala, G., Makofane, K., Santos, G.-M., Beck, J., Do, T. D., Hebert, P., Wilson, P. A., Pyun, T., & Arreola, S. (2013). Access to basic HIV-related services and PrEP acceptability among men who have sex with men worldwide: barriers, facilitators, and implications for combination prevention. Journal of Sexually Transmitted Diseases, 2013. doi:10.1155/2013/953123.

  • Berry, M., Raymond, H. F., & Mcfarland, W. (2007). Same race and older partner selection may explain higher HIV prevalence among black men who have sex with men. Aids, 21(17), 2349–2350.

    Article  PubMed  Google Scholar 

  • Bingham, T. A., Harawa, N. T., Johnson, D. F., Secura, G. M., Mackellar, D. A., & Valleroy, L. A. (2003). The effect of partner characteristics on HIV infection among African American men who have sex with men in the Young Men’s Survey, Los Angeles, 1999–2000. AIDS Education and Prevention, 15(1 Supplement), 39–52.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2012). Estimated HIV incidence in the United States, 2007–2010. HIV Surveillance Supplemental Report, Retrieved from

    Google Scholar 

  • Centers for Disease Control and Prevention. (2015). Diagnosis of HIV infection in the United States and dependent areas, 2013 surveillance report. Retrieved from

  • Choi, K. H., Lui, H., Guo, Y., Han, L., & Mandel, J. S. (2006). Lack of HIV testing and awareness of HIV infection among men who have sex with men, Beijing, China. AIDS Education & Prevention, 18(1), 33–43.

    Article  Google Scholar 

  • Gerrard, M., Gibbons, F. X., & Bushman, B. J. (1996). Relation between perceived vulnerability to HIV and precautionary sexual behavior. Psychological Bulletin, 119(3), 390.

    Article  PubMed  Google Scholar 

  • Golden, M. R., Stekler, J., Hughes, J. P., & Wood, R. W. (2008). HIV serosorting in men who have sex with men: is it safe? JAIDS Journal of Acquired Immune Deficiency Syndromes, 49(2), 212–218.

    Article  PubMed  Google Scholar 

  • Goldenberg, T., Finneran, C., Andes, K. L., & Stephenson, R. (2014). ‘Sometimes people let love conquer them’: how love, intimacy, and trust in relationships between men who have sex with men influence perceptions of sexual risk and sexual decision-making. Culture, Health & Sexuality, 17(5), 607–622.

  • Goldenberg. T., Finneran, C., Andes, K. L., & Stephenson, R. (2016). Using participant-empowered visual relationship timelines in a qualitative study of sexual behaviour. Global Public Health. doi:10.1080/17441692.2016.1170869.

  • Huebner, D. M., Davis, M. C., Nemeroff, C. J., & Aiken, L. S. (2002). The impact of internalized homophobia on HIV preventive interventions. American Journal of Community Psychology, 30(3), 327–348.

    Article  PubMed  Google Scholar 

  • Lapinski, M. L., Braz, M. E., & Maloney, E. K. (2010). The down low, social stigma, and risky sexual behaviors: insights from African-American men who have sex with men. Journal of Homosexuality, 57(5), 610–633. doi:10.1080/00918361003712020.

    Article  PubMed  Google Scholar 

  • Mao, L., Crawford, J. M., Hospers, H. J., Prestage, G. P., Grulich, A. E., Kaldor, J. M., & Kippax, S. C. (2006). ‘Serosorting’ in casual anal sex of HIV-negative gay men is noteworthy and is increasing in Sydney, Australia. Aids, 20(8), 1204–1206.

    Article  PubMed  Google Scholar 

  • Mustanski, B., & Parsons, J. T. (2014). Introduction to the special section on sexual health in gay and bisexual male couples. Archives of Sexual Behavior, 43(1), 17–19. Retrieved from

    Article  PubMed  Google Scholar 

  • Newcomb, M. E., & Mustanski, B. (2011). Moderators of the relationship between internalized homophobia and risky sexual behavior in men who have sex with men: a meta-analysis. Archives of Sexual Behavior, 40(1), 189–199.

    Article  PubMed  Google Scholar 

  • Parsons, J. T., Schrimshaw, E. W., Wolitski, R. J., Halkitis, P. N., Purcell, D. W., Hoff, C. C., & Gómez, C. A. (2005). Sexual harm reduction practices of HIV-seropositive gay and bisexual men: serosorting, strategic positioning, and withdrawal before ejaculation. Aids, 19, S13–S25.

    Article  PubMed  Google Scholar 

  • Pettigrew, T. (1979). The ultimate attribution error: Extending allport's cognitive analysis of prejudice. Personality and Social Psychology Bulletin, 5(4), 461–476.

  • Purcell, D., Mizuno, Y., Smith, D., Grabbe, K., Courtenay-Quirk, C., Tomlinson, H., & Mermin, J. (2014). Incorporating couples-based approaches into HIV prevention for gay and bisexual men: opportunities and challenges. Archives of Sexual Behavior, 43(1), 35–46. Retrieved from

    Article  PubMed  PubMed Central  Google Scholar 

  • Pyun, T., Santos, G.-M., Arreola, S., Do, T., Hebert, P., Beck, J., Makofane, K., Wilson, P.A., & Ayala, G. (2014). Internalized homophobia and reduced HIV testing among men who have sex with men in China. Asia-Pacific Journal of Public Health, 26(2), 118–125.

  • Raymond, H. F., & Mcfarland, W. (2009). Racial mixing and HIV risk among men who have sex with men. AIDS and Behavior, 13(4), 630–637.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ross, M., Kajubi, P., Mandel, J., Mcfarland, W., & Raymond, H. (2013a). Internalized homonegativity/homophobia is associated with HIV-risk behaviours among Ugandan gay and bisexual men. International Journal of STD & AIDS, 24(5), 409–413.

    Article  Google Scholar 

  • Ross, M. W., Berg, R. C., Schmidt, A. J., Hospers, H. J., Breveglieri, M., Furegato, M., & Weatherburn, P. (2013). Internalised homonegativity predicts HIV-associated risk behavior in European men who have sex with men in a 38-country cross-sectional study: some public health implications of homophobia. BMJ Open, 3(2). doi:10.1136/bmjopen-2012-001928

  • Ross, M. W., Rosser, B. R. S., Bauer, G. R., Bockting, W. O., Robinson, B. B. E., Rugg, D. L., & Coleman, E. (2001). Drug use, unsafe sexual behavior, and internalized homonegativity in men who have sex with men. AIDS and Behavior, 5(1), 97–103.

    Article  Google Scholar 

  • Rosser, B., Horvath, K., Hatfield, L., Peterson, J., Jacoby, S., Stately, A., & Team, P. C. (2008). Predictors of HIV disclosure to secondary partners and sexual risk behavior among a high-risk sample of HIV-positive MSM: results from six epicenters in the US. AIDS Care, 20(8), 925–930.

    Article  PubMed Central  Google Scholar 

  • Shoptaw, S., Weiss, R. E., Munjas, B., Hucks-Ortiz, C., Young, S. D., Larkins, S., Victorianne, G. D., & Gorbach, P. M. (2009). Homonegativity, substance use, sexual risk behaviors, and HIV status in poor and ethnic men who have sex with men in Los Angeles. Journal of Urban Health, 86(1), 77–92.

    Article  PubMed  PubMed Central  Google Scholar 

  • Smolenski, D. J., Stigler, M. H., Ross, M. W., & Rosser, B. R. S. (2011). Direct and indirect associations between internalized homonegativity and high-risk sex. Archives of Sexual Behavior, 40(4), 785–792. doi:10.1007/s10508-010-9705-1.

    Article  PubMed  PubMed Central  Google Scholar 

  • Suarez, T., & Kauth, M. R. (2001). Assessing basic HIV transmission risks and the contextual factors associated with HIV risk behavior in men who have sex with men. Journal of Clinical Psychology, 57(5), 655–669.

    Article  PubMed  Google Scholar 

  • Suarez, T., & Miller, J. (2001). Negotiating risks in context: a perspective on unprotected anal intercourse and barebacking among men who have sex with men—where do we go from here? Archives of Sexual Behavior, 30(3), 287–300.

    Article  PubMed  Google Scholar 

  • White, D., & Stephenson, R. (2014). Identity formation, outness, and sexual risk among gay and bisexual men. American Journal of Men’s Health, 8(2), 98–109.

    Article  PubMed  Google Scholar 

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Correspondence to Tamar Goldenberg.

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This study was funded by the University Research Committee at Emory University.

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All procedures were performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and within the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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

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The authors declare that they have no conflict of interest.

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Goldenberg, T., Finneran, C., Sullivan, S.P. et al. “I consider being gay a very high risk factor”: How Perceptions of a Partner’s Sexual Identity Influence Perceptions of HIV Risk Among Gay and Bisexual Men. Sex Res Soc Policy 14, 32–41 (2017).

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  • Men who have sex with men
  • HIV
  • Sexual identity
  • Risk perceptions