Recorded presentation

David Joseph Malebranche, MD, MPH, Division of General Medicine, Emory University, 49 Jesse Hill Jr. Drive, Atlanta, GA 30303, (404) 778-1630, dmalebr@emory.edu and Lawrence Bryant, MPH, Behavioral Sciences and Health Education Department, Emory University, 1518 Clifton Road, Atlanta, GA 30322.

Background: HIV is disproportionately impacting the black community. Media fascination has surrounded the so-called “Down Low” black man as the reason why HIV rates are so high, but little is known about how issues of black masculinity and sexual identity influence the sexual behaviors of this population. Methods: Qualitative one-on-one interviews with 29 black men who have sex with men (BMSM) in Atlanta, Georgia on familial experiences, black male role models, masculinity, sexual identity and sexual behaviors. A brief demographic questionnaire was also completed. Results: Almost half (45%) of the men felt that being black was more important than their sexual identity; Sixty-six percent (19/29) felt spirituality was the most important part of their manhood; Forty-one percent (12/29) felt homosexuality was a sin; and 21% said they would change their attraction to men if they could. Relevant themes included maternal influence, the paucity of black male role models, racial and sexual discrimination, child sexual abuse, gender role conflict, levels of black masculinity and “gay” as a negative term. Conclusions: The results of this study emphasize the importance of the individual social context for BMSM at risk for contracting HIV, instead of emphasizing risk groups like "Down low." Socialized black masculine expectations influence BMSM familial and community upbringing, spiritual beliefs, sexual identities, sexual networks and sexual behaviors. These findings illustrate the need for future HIV prevention initiatives for BMSM focusing on risk behaviors, not risk groups, while redefining and facilitating masculine empowerment as a means to increase condom usage and decreased sexual risk-taking.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Discuss the realities and misconceptions regarding the relationship between "Down Low" black men and the HIV epidemic.
• Describe the social constructs of black masculinity and "gay" identity and their influences on black men who have sex with men.
• Define the term "gender role conflict" and it's impact on the sexual behaviors of black men who have sex with men.
• Identify the specific social contextual factors influencing the lives of black men who have sex with men.
• Develop innovative strategies for future HIV prevention efforts among black men who have sex with men.

Keywords: African American, HIV Risk Behavior

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation