This article is more than 5 years old. Information may no longer be current.

Gender role strain may increase HIV risk among young black MSM

Young gay black men who conform to masculine behaviors because of family and cultural pressures led to social isolation and distress, as well as seeking approval and acceptance through risky sexual behaviors, according to recent study findings published in the American Journal of Public Health.

“HIV risk is the sum total of many factors, but social and family stress is a well-known driver of all types of risk-taking behaviors, and our findings clearly support the notion this holds true when it comes to HIV risk,” Errol Lamont Fields, MD, PhD, MPH, of Johns Hopkins Children’s Center, said in a press release.

Fields and colleagues evaluated 35 black men who have sex with men (MSM) aged 18 to 24 years to determine the effect of growing up in families and communities with anti-gay attitudes and traditional views of masculinity. Results were based on interviews with the participants.

Participants reported a need to improve their masculinity, deep psychological distress, pressure to conform, and a desire to camouflage their homosexuality. They also reported that these pressures led to risky sexual behaviors, such as unprotected sex and not forming or maintaining monogamous relationships.

Seeking acceptance through sex was also common among the participants who reported rejection by important loved ones. Some participants reported that unprotected sex was seen as an expression of love and trust from their partners.

Family, friends and community expectations led some participants to be overly masculine, aggressive and free from effeminate behaviors, whereas those who reported not conforming reported being ridiculed and ostracized. Trying to conform to perceived “social norms” led to other risky behaviors such as fighting, aggression, drinking and taking drugs.

“The findings of our study reveal a clear clash between internal sexual identity and external expectations at a critical developmental stage age,” Fields said. “This clash creates loneliness and low self-esteem and appears to drive these boys and men to risky behaviors, sexual and otherwise.”

Continued efforts by participants to hide their sexuality led to chronic anxiety and fear of being found out. Further, those who hid their sexuality were more likely to avoid HIV-preventive messages and services. The loss of familial and social support was another reported reason for hiding sexuality.

“It’s a true catch-22 for these youngsters,” Fields said. “On one hand, they are dealing with the chronic anxiety of hiding their homosexuality, but on the other hand, they face the prospect of becoming social pariahs if they come out as gay or bisexual.”

Disclosure: See the study for a full list of researchers’ financial disclosures.