Skip to main content

Advertisement

SpringerLink
Log in

What’s In an Identity Label? Correlates of Sociodemographics, Psychosocial Characteristics, and Sexual Behavior Among African American Men Who Have Sex With Men

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

African American men who have sex with men (AAMSM) are vastly overrepresented among people with HIV/AIDS. Using data from 595 AAMSM in Philadelphia, we explored differences in sociodemographics, psychosocial characteristics related to beliefs about ethnicity, sexuality and masculinity, and sexual behavior with men and women by self-reported sexual identity (gay, bisexual, down low, straight). Roughly equivalent numbers identified as gay (40.6 %) and bisexual (41.3 %), while fewer identified as straight (7.6 %) or down low (10.5 %), with significant differences in age, income, history of incarceration, HIV status, alcohol and drug problems, childhood sexual abuse, and connection to the gay community evident among these groups. Analysis of psychosocial characteristics theorized to be related to identity and sexual behavior indicated significant differences in masculinity, homophobia, and outness as MSM. Gay and straight men appeared to be poles on a continuum of frequency of sexual behavior, with bisexual and down low men being sometimes more similar to gay men and sometimes more similar to straight men. The percentage of men having total intercourse of any kind was highest among down low and lowest among gay men. Gay men had less intercourse with women, but more receptive anal intercourse with men than the other identities. There were no significant differences by identity in frequency of condomless insertive anal intercourse with men, but gay men had significantly more condomless receptive anal intercourse. There were significant differences by identity for condomless vaginal and anal intercourse with women. This study demonstrates the importance of exploring differences in types of sex behavior for AAMSM by considering sexual identity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • AIDS Activity Coordinating Office. (2014). Surveillance Report 2013 HIV/AIDS in Philadelphia: Cases reported through June 2014. Philadelphia: Philadelphia Department of Public Health.

    Google Scholar 

  • Battle, J., Cohen, C. J., Warren, D., Fergerson, G., & Audam, S. (2002). Say it loud: I’m Black and I’m proud; Black Pride Survey 2000. New York: The Policy Institute of the National Gay and Lesbian Task Force.

    Google Scholar 

  • Blosnich, J. R., Farmer, G. W., Lee, J. G., Silenzio, V. M., & Bowen, D. J. (2014). Health inequalities among sexual minority adults: Evidence from ten US states, 2010. American Journal of Preventive Medicine, 46(4), 337–349.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bowleg, L. (2012). The problem with the phrase women and minorities: Intersectionality—An important theoretical framework for public health. American Journal of Public Health, 102(7), 1267–1273.

    Article  PubMed  PubMed Central  Google 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.

    Article  Google Scholar 

  • Brewer, R. A., Magnus, M., Kuo, I., Wang, L., Liu-T, Y., & Mayer, K. H. (2014). The high prevalence of incarceration history among Black men who have sex with men in the United States: Associations and implications. American Journal of Public Health, 104, 448–454.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carlos, J. A., Bingham, T. A., Stueve, A., Lauby, J., Ayala, G., Millett, G. A., & Wheeler, D. (2010). The role of peer support on condom use among Black and Latino MSM in three urban areas. AIDS Education and Prevention, 22(5), 430–444.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2012, December). Estimated HIV incidence in the United States, 2007–2010. HIV Surveillance Supplemental Report, 17(4). http://www.cdc.gov/hiv/topics/surveillance/resources/reports/#supplemental. Accessed March 8, 2015.

  • Dodge, B., Jeffries, W. L., & Sandfort, T. G. M. (2008). Beyond the down low: Sexual risk, protection, and disclosure among at-risk black men who have sex with both men and women (MSMW). Archives of Sexual Behavior, 37(5), 683–696. doi:10.1007/s10508-008-9356-7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dyer, T. P., Regan, R., Pacek, L. R., Acheampong, A., & Khan, M. R. (2015). Psychosocial vulnerability and HIV-related sexual risk among men who have sex with men and women in the United States. Archives of Sexual Behavior, 44(2), 429–441.

    Article  PubMed  Google Scholar 

  • Dyer, T. P., Regan, R., Wilton, L., Harawa, N. T., Wang, L., & Shoptaw, S. (2013). Differences in substance use, psychosocial characteristics and HIV-related sexual risk behavior between Black men who have sex with men only (BMSMO) and Black men who have sex with men and women (BMSMW) in six US cities. Journal of Urban Health, 90(6), 1181–1193.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ewing, J. A. (1984). Detecting alcoholism: The CAGE questionnaire. Jama, 252(14), 1905–1907.

    Article  PubMed  Google Scholar 

  • Fields, E. L., Bogart, L. M., Smith, K. C., Malebranche, D. J., Ellen, J., & Schuster, M. A. (2015). “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. American Journal of Public Health, 105, 122–131.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fischgrund, B. N., Halkitis, P. N., & Carroll, R. A. (2012). Conceptions of hypermasculinity and mental health states in gay and bisexual men. Psychology of Men & Masculinity, 13(2), 123.

    Article  Google Scholar 

  • Ford, C. L., Whetten, K. D., Hall, S. A., Kaufman, J. S., & Thrasher, A. D. (2007). Black sexuality, social construction, and research targeting ‘The Down Low’ (‘The DL’). Annals of Epidemiology, 17(3), 209–216.

    Article  PubMed  Google Scholar 

  • Griffith, D. M., Gunter, K., & Watkins, D. C. (2012). Measuring masculinity in research on men of color: Findings and future directions. American Journal of Public Health, 102(S2), S187–S194.

    Article  PubMed  PubMed Central  Google Scholar 

  • Han, C. S., Rutledge, S. E., Bond, L., Lauby, J., & LaPollo, A. B. (2014). You’re better respected when you carry yourself as a man: Black men’s personal accounts of the down low “lifestyle”. Sexuality and Culture, 18(1), 89–102.

    Article  Google Scholar 

  • Harawa, N., & Adimora, A. (2008). Incarceration, African Americans, and HIV: Advancing a research agenda. Journal of the National Medical Association, 100(1), 57–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Harawa, N., Wilton, L., Wang, L., Mao, C., Kuo, I., Penniman, T., … Mayer, K. (2014). Types of female partners reported by Black men who have sex with men and women (MSMW) and associations with intercourse frequency, unprotected sex and HIV and STI prevalence. AIDS and Behavior, 18(8), 1548–1559.

  • Hatcher, A. M., Colvin, C. J., Ndlovu, N., & Dworkin, S. L. (2014). Intimate partner violence among rural South African men: Alcohol use, sexual decision-making, and partner communication. Culture, Health & Sexuality, 16(9), 1023–1039.

    Article  Google Scholar 

  • Higa, D. H., Crepaz, N., Marshall, K. J., Kay, L., Vosburgh, H. W., Spikes, P., … Purcell, D. W. (2013). A systematic review to identify challenges of demonstrating efficacy of HIV behavioral interventions for gay, bisexual, and other men who have sex with men (MSM). AIDS and Behavior, 17, 1231–1244.

  • Icard, L. D. (1986). Black gay men and conflicting social identities: Sexual orientation versus racial identity. Journal of Social Work & Human Sexuality, 4(1–2), 83–93.

    Article  Google Scholar 

  • Icard, L. D. (1996). Assessing the psychosocial well-being of African American gays: A multidimensional perspective. Journal of Gay & Lesbian Social Services, 5(2–3), 25–50.

    Article  Google Scholar 

  • Irwin, T. W., Morgenstern, J., Parsons, J. T., Wainberg, M., & Labouvie, E. (2006). Alcohol and sexual HIV risk behavior among problem drinking men who have sex with men: An event level analysis of timeline followback data. AIDS and Behavior, 10(3), 299–307.

    Article  PubMed  Google Scholar 

  • Jeffries, W. L. IV, Marks, G., Lauby, J., Murrill, C. S., & Millett, G. A. (2013). Homophobia is associated with sexual behavior that increases risk of acquiring and transmitting HIV infection among black men who have sex with men. AIDS and Behavior, 17(4), 1442–1453.

    Article  PubMed  Google Scholar 

  • Jemmott, J. B. III, Jemmott, L. S., O’Leary, A., Icard, L. D., Rutledge, S. E., Stevens, R., … Stephens, A. J. (2014). On the efficacy and mediation of a one-on-one HIV risk-reduction intervention for African American men who have sex with men: A randomized controlled trial. AIDS and Behavior, 19(7), 1247–1262.

  • Kisler, K. A., & Williams, J. K. (2012). Image versus health: The role of perceptions of masculinity on sexual risk behaviors among HIV-positive African American men who have sex with men and women. Journal of AIDS & Clinical Research, (Spec Iss 1), S1–S8.

  • LaPollo, A. B., Bond, L., & Lauby, J. L. (2014). Hypermasculinity and sexual risk among Black and White men who have sex with men and women. American Journal of Men’s Health, 8(5), 362–372.

    Article  PubMed  Google Scholar 

  • Larsen, K. S., Reed, M., & Hoffman, S. (1980). Attitudes of heterosexuals toward homosexuality: A Likert-type scale and construct validity. Journal of Sex Research, 16(3), 245–257.

    Article  Google Scholar 

  • Latkin, C., Yang, C., Tobin, K., Penniman, T., Patterson, J., & Spikes, P. (2011). Differences in the social networks of African American men who have sex with men only and those who have sex with men and women. American Journal of Public Health, 101(10), e18–e23.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lifson, A. R. (1992). Men who have sex with men: Continued challenges for preventing HIV infection and AIDS. American Journal of Public Health, 82(2), 166–167.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lowmaster, S. E., Morey, L. C., Baker, K. L., & Hopwood, C. J. (2010). Structure, reliability, and predictive validity of the Texas Christian University Correctional Residential Self-Rating Form at Intake in a residential substance abuse treatment facility. Journal of Substance Abuse Treatment, 39(2), 180–187.

    Article  PubMed  Google Scholar 

  • Magnus, M., Jones, K., Phillips, G., Binson, D., Hightow-Weidman, L. B., Richards-Clarke, C., … YMSM of Color Special Projects of National Significance Initiative Study Group. (2010). Characteristics associated with retention among African American and Latino adolescent HIV-positive men: Results from the outreach, care, and prevention to engage HIV-seropositive young MSM of Color special project of national significance initiative. Journal of Acquired Immune Deficiency Syndromes, 53(4), 529–536.

  • Malebranche, D. J. (2003). Black men who have sex with men and the HIV epidemic: Next steps for public health. American Journal of Public Health, 93, 862–865.

    Article  PubMed  PubMed Central  Google Scholar 

  • Malebranche, D. J. (2008). Bisexually active Black men in the United States and HIV: Acknowledging more than the “down low”. Archives of Sexual Behavior, 37(5), 810–816.

    Article  PubMed  Google Scholar 

  • Malebranche, D. J., Fields, E. L., Bryant, L. O., & Harper, S. R. (2009). Masculine socialization and sexual risk behaviors among Black men who have sex with men: A qualitative exploration. Men and Masculinities, 12, 90–112.

    Article  Google Scholar 

  • Maulsby, C., Millett, G., Lindsey, K., Kelley, R., Johnson, K., Montoya, D., & Holtgrave, D. (2014). HIV among black men who have sex with men (MSM) in the United States: A review of the literature. AIDS and Behavior, 18, 10–25.

    Article  PubMed  Google Scholar 

  • Mayer, K. H., Bradford, J. B., Makadon, H. J., Stall, R., Goldhammer, H., & Landers, S. (2008). Sexual and gender minority health: What we know and what needs to be done. American Journal of Public Health, 98(6), 989–995.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mays, V. M., Cochran, S. D., & Zamudio, A. (2004). HIV prevention research: Are we meeting the needs of African American men who have sex with men? Journal of Black Psychology, 30, 78–105.

    Article  PubMed  PubMed Central  Google Scholar 

  • Millett, G. A., Ding, H., Marks, G., Jeffries IV, W. L., Bingham, T., Lauby, J., … Stueve, A. (2011). Mistaken assumptions and missed opportunities: Correlates of undiagnosed HIV infection among black and Latino men who have sex with men. Journal of Acquired Immune Deficiency Syndromes, 58, 64–71.

  • Millett, G. A., Flores, S. A., Peterson, J. L., & Bakeman, R. (2007). Explaining disparities in HIV infection among black and white men who have sex with men: A meta-analysis of HIV risk behaviors. AIDS, 21, 2083–2091.

    Article  PubMed  Google Scholar 

  • Millett, G., Malebranche, D., Mason, B., & Spikes, P. (2005). Focusing “down low”: Bisexual men, HIV risk and heterosexual transmission. Journal of the National Medical Association, 97, 52S–59S.

    PubMed  PubMed Central  Google Scholar 

  • Millett, G. A., Peterson, J. L., Wolitski, R. J., & Stall, R. (2006). Greater risk for HIV infection of black men who have sex with men: A critical literature review. American Journal of Public Health, 96, 1007–1019.

    Article  PubMed  PubMed Central  Google Scholar 

  • O’Leary, A., Fisher, H. H., Purcell, D. W., Spikes, P. S., & Gomez, C. A. (2007). Correlates of risk patterns and race/ethnicity among HIV-positive men who have sex with men. AIDS and Behavior, 11(5), 706–715.

    Article  PubMed  Google Scholar 

  • O’Leary, A., Jemmott, J. B, III, Jemmott, L. S., Bellamy, S., Ngwane, Z., Icard, I., & Gueits, L. (2012). Moderation and mediation of an effective HIV risk-reduction intervention for South African adolescents. Annals of Behavioral Medicine, 44(2), 181–191.

    Article  PubMed  PubMed Central  Google Scholar 

  • O’Leary, A., Jemmott, J. B, III, Stevens, R., Rutledge, S. E., & Icard, L. D. (2014). Optimism and education buffer the effects of syndemic conditions on HIV status among African American men who have sex with men. AIDS and Behavior, 18, 2080–2088.

    Article  PubMed  PubMed Central  Google Scholar 

  • O’Leary, A., & Jones, K. T. (2006). Bisexual men and heterosexual women: How big is the bridge? How can we know? Sexually Transmitted Diseases, 33(10), 594–595.

    Article  PubMed  Google Scholar 

  • O’Leary, A., Purcell, D., Remien, R. H., & Gomez, C. (2003). Childhood sexual abuse and sexual transmission risk behaviour among HIV-positive men who have sex with men. AIDS Care, 15(1), 17–26.

    Article  PubMed  Google Scholar 

  • Oster, A. M., Wertheim, J. O., Hernandez, A. L., Bañez, O. M., Saduvala, N., & Irene, H. H. (2015). Using molecular HIV surveillance data to understand transmission between subpopulations in the United States. Journal of Acquired Immune Deficiency Syndromes, 70, 444–451.

    Article  PubMed  PubMed Central  Google Scholar 

  • Oster, A. M., Wiegand, R. E., Sionean, C., Miles, I. J., Thomas, P. E., Melendez-Morales, L., … Millett, G. A. (2011). Understanding disparities in HIV infection between black and white MSM in the United States. AIDS, 25, 1103–1112.

  • Purcell, D. W., Johnson, C. H., Lansky, A., Prejean, J., Stein, R., Denning, P., … Crepaz, N. (2012). Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. The Open AIDS Journal, 6, 98–107.

    Article  PubMed  PubMed Central  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale a self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.

    Article  Google Scholar 

  • Raj, A., & Bowleg, L. (2012). Heterosexual risk for HIV among black men in the United States: A call to action against a neglected crisis in black communities. American Journal of Men’s Health, 6, 178–181.

    Article  PubMed  Google Scholar 

  • Reisner, S. L., Mimiaga, M. J., Skeer, M., Bright, D., Cranston, K., Isenberg, D., … Mayer, K. H. (2009). Clinically significant depressive symptoms as a risk factor for HIV infection among black MSM in Massachusetts. AIDS and Behavior, 13(4), 798–810.

  • Ross, M. W., Essien, E. J., Williams, M. L., & Fernandez-Esquer, M. E. (2003). Concordance between sexual behavior and sexual identity in street outreach samples of four racial/ethnic groups. Sexually Transmitted Diseases, 30(2), 110–113.

    Article  PubMed  Google Scholar 

  • Sandfort, T. G., & Dodge, B. (2008). “… And then there was the down low”: Introduction to Black and Latino male bisexualities. Archives of Sexual Behavior, 37(5), 675–682.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sellers, R. M., Rowley, S. A., Chavous, T. M., Shelton, J. N., & Smith, M. A. (1997). Multidimensional Inventory of Black Identity: A preliminary investigation of reliability and construct validity. Journal of Personality and Social Psychology, 73(4), 805–815.

    Article  Google Scholar 

  • Straus, M. A., Hamby, S. L., Boney-McCoy, S., & Sugarman, D. B. (1996). The revised conflict tactics scales (CTS2) development and preliminary psychometric data. Journal of Family Issues, 17(3), 283–316.

    Article  Google Scholar 

  • Ward, E. G. (2005). Homophobia, hypermasculinity and the US black church. Culture, Health and Sexuality, 7, 493–504.

    Article  PubMed  Google Scholar 

  • Wheeler, D. P., Lauby, J. L., Liu, K. L., Van Sluytman, L. G., & Murrill, C. (2008). A comparative analysis of sexual risk characteristics of black men who have sex with men or with men and women. Archives of Sexual Behavior, 37(5), 697–707.

    Article  PubMed  Google Scholar 

  • Wilson, P. (2008). A dynamic-ecological model of identity formation and conflict among bisexually behaving African-American men. Archives of Sexual Behavior, 37(5), 794–809. doi:10.1007/s10508-008-9362-9.

    Article  PubMed  Google Scholar 

  • Wolitski, R. J., Jones, K. T., Wasserman, J. L., & Smith, J. C. (2006). Self-identification as “down low” among men who have sex with men (MSM) from 12 US cities. AIDS and Behavior, 10, 519–529.

    Article  PubMed  Google Scholar 

  • Woodyard, J. L., Peterson, J. L., & Stokes, J. P. (2000). “Let us go into the house of the Lord”: Participation in African American churches among young African American men who have sex with men. Journal of Pastoral Care, 54, 451–460.

    Article  PubMed  Google Scholar 

  • World Health Organization. (2015). Core epidemiological slides: HIV/AIDS estimates. Retrieved from http://www.unaids.org/en/resources/documents/2015/20150714_coreepidemiologyslides_ppt.

  • Wyatt, G. E., Lawrence, J., Vodounon, A., & Mickey, M. R. (1993). The Wyatt Sex History Questionnaire: A structured interview for female sexual history taking. Journal of Child Sexual Abuse, 1(4), 51–68.

    Article  Google Scholar 

  • Young, R. M., & Meyer, I. H. (2005). The trouble with “MSM” and “WSW”: Erasure of the sexual-minority person in public health discourse. American Journal of Public Health, 95, 1144–1149.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

This study was funded by Research Grant 1 RO1 MH079736 from the National Institute of Mental Health. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of NIH or the Centers for Disease Control and Prevention.

Author information

Authors and Affiliations

  1. School of Social Work, College of Public Health, Temple University, Philadelphia, PA, 19122, USA

    Scott Edward Rutledge & Larry D. Icard

  2. Department of Psychiatry, Perelman School of Medicine and Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA

    John B. Jemmott III

  3. Centers for Disease Control and Prevention, Atlanta, GA, USA

    Ann O’Leary

Authors
  1. Scott Edward Rutledge
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John B. Jemmott III
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ann O’Leary
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Larry D. Icard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Scott Edward Rutledge.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rutledge, S.E., Jemmott, J.B., O’Leary, A. et al. What’s In an Identity Label? Correlates of Sociodemographics, Psychosocial Characteristics, and Sexual Behavior Among African American Men Who Have Sex With Men. Arch Sex Behav 47, 157–167 (2018). https://doi.org/10.1007/s10508-016-0776-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-016-0776-5

Keywords

Search

Navigation