Skip to main content
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2003 Sep;95(9):846–852.

Overlooked role of African-American males' hypermasculinity in the epidemic of unintended pregnancies and HIV/AIDS cases with young African-American women.

William A Wolfe 1
PMCID: PMC2594477  PMID: 14527052

Abstract

This article looks at multiple lines of converging evidence relevant to the 72% unintended pregnancy rate, and recently emerged heterosexually-based HIV/AIDS epidemic with young African-American women. Evidence recently reveals a convergence of these epidemics, in a vulnerable subpopulation segment of African-American women. Overlooked, as a unique contributing factor in these epidemics is the hypermasculine behaviors of African-American males. Among the risky behaviors linked with this hypermasculinity are a greater tendency with African-American males to have more multiple sexual partners, and a stronger aversion to condom use than other male ethnic groups. As a contributing factor in these epidemics, African-American males' hypermasculinity has several implications for intervention strategies to reduce the epidemics, which are discussed.

Full text

PDF
846

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abma J., Driscoll A., Moore K. Young women's degree of control over first intercourse: an exploratory analysis. Fam Plann Perspect. 1998 Jan-Feb;30(1):12–18. [PubMed] [Google Scholar]
  2. Aral S. O., Hughes J. P., Stoner B., Whittington W., Handsfield H. H., Anderson R. M., Holmes K. K. Sexual mixing patterns in the spread of gonococcal and chlamydial infections. Am J Public Health. 1999 Jun;89(6):825–833. doi: 10.2105/ajph.89.6.825. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Binson D., Dolcini M. M., Pollack L. M., Catania J. A. Data from the National AIDS Behavioral Surveys. IV. Multiple sexual partners among young adults in high-risk cities. Fam Plann Perspect. 1993 Nov-Dec;25(6):268–272. [PubMed] [Google Scholar]
  4. Centers for Disease Control (CDC) Number of sex partners and potential risk of sexual exposure to human immunodeficiency virus. MMWR Morb Mortal Wkly Rep. 1988 Sep 23;37(37):565–568. [PubMed] [Google Scholar]
  5. Chirgwin K. D., Feldman J., Dehovitz J. A., Minkoff H., Landesman S. H. Incidence and risk factors for heterosexually acquired HIV in an inner-city cohort of women: temporal association with pregnancy. J Acquir Immune Defic Syndr Hum Retrovirol. 1999 Mar 1;20(3):295–299. doi: 10.1097/00042560-199903010-00013. [DOI] [PubMed] [Google Scholar]
  6. DiClemente R. J., Lodico M., Grinstead O. A., Harper G., Rickman R. L., Evans P. E., Coates T. J. African-American adolescents residing in high-risk urban environments do use condoms: correlates and predictors of condom use among adolescents in public housing developments. Pediatrics. 1996 Aug;98(2 Pt 1):269–278. [PubMed] [Google Scholar]
  7. DiIorio C., Dudley W. N., Kelly M., Soet J. E., Mbwara J., Sharpe Potter J. Social cognitive correlates of sexual experience and condom use among 13- through 15-year-old adolescents. J Adolesc Health. 2001 Sep;29(3):208–216. doi: 10.1016/s1054-139x(00)00200-7. [DOI] [PubMed] [Google Scholar]
  8. Dicks B. A. African American women and AIDS: a public health/social work challenge. Soc Work Health Care. 1994;19(3-4):123–143. doi: 10.1300/J010v19n03_07. [DOI] [PubMed] [Google Scholar]
  9. Dolcini M. M., Catania J. A., Coates T. J., Stall R., Hudes E. S., Gagnon J. H., Pollack L. M. Demographic characteristics of heterosexuals with multiple partners: the National AIDS Behavioral Surveys. Fam Plann Perspect. 1993 Sep-Oct;25(5):208–214. [PubMed] [Google Scholar]
  10. Durbin M., DiClemente R. J., Siegel D., Krasnovsky F., Lazarus N., Camacho T. Factors associated with multiple sex partners among junior high school students. J Adolesc Health. 1993 May;14(3):202–207. doi: 10.1016/1054-139x(93)90006-b. [DOI] [PubMed] [Google Scholar]
  11. Ford K., Norris A. E. Sexually transmitted diseases: experience and risk factors among urban, low income, African American and Hispanic youth. Ethn Health. 1996 May;1(2):175–184. doi: 10.1080/13557858.1996.9961785. [DOI] [PubMed] [Google Scholar]
  12. Fox L. J., Williamson N. E., Cates W., Jr, Dallabetta G. Improving reproductive health: integrating STD and contraceptive services. J Am Med Womens Assoc. 1995 May-Aug;50(3-4):129–136. [PubMed] [Google Scholar]
  13. Fuller Crystal M., Vlahov David, Ompad Danielle C., Shah Nina, Arria Amelia, Strathdee Steffanie A. High-risk behaviors associated with transition from illicit non-injection to injection drug use among adolescent and young adult drug users: a case-control study. Drug Alcohol Depend. 2002 Apr 1;66(2):189–198. doi: 10.1016/s0376-8716(01)00200-9. [DOI] [PubMed] [Google Scholar]
  14. Guinan M. E., Hardy A. Epidemiology of AIDS in women in the United States. 1981 through 1986. JAMA. 1987 Apr 17;257(15):2039–2042. [PubMed] [Google Scholar]
  15. Haverkos H. W., Turner J. F., Jr, Moolchan E. T., Cadet J. L. Relative rates of AIDS among racial/ethnic groups by exposure categories. J Natl Med Assoc. 1999 Jan;91(1):17–24. [PMC free article] [PubMed] [Google Scholar]
  16. Henshaw S. K. Unintended pregnancy in the United States. Fam Plann Perspect. 1998 Jan-Feb;30(1):24-9, 46. [PubMed] [Google Scholar]
  17. Ho Eleanor M., Brown JoAnn, Graves William, Lindsay Michael K. Maternal death at an inner-city hospital, 1949-2000. Am J Obstet Gynecol. 2002 Nov;187(5):1213–1216. doi: 10.1067/mob.2002.127136. [DOI] [PubMed] [Google Scholar]
  18. Jemmott J. B., 3rd, Jemmott L. S., Fong G. T., McCaffree K. Reducing HIV risk-associated sexual behavior among African American adolescents: testing the generality of intervention effects. Am J Community Psychol. 1999 Apr;27(2):161–187. doi: 10.1007/BF02503158. [DOI] [PubMed] [Google Scholar]
  19. Jemmott J. B., 3rd, Jemmott L. S., Fong G. T. Reductions in HIV risk-associated sexual behaviors among black male adolescents: effects of an AIDS prevention intervention. Am J Public Health. 1992 Mar;82(3):372–377. doi: 10.2105/ajph.82.3.372. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Johnson E. H., Jackson L. A., Hinkle Y., Gilbert D., Hoopwood T., Lollis C. M., Willis C., Gant L. What is the significance of black-white differences in risky sexual behavior? J Natl Med Assoc. 1994 Oct;86(10):745–759. [PMC free article] [PubMed] [Google Scholar]
  21. Kalichman S. C., Rompa D., Coley B. Lack of positive outcomes from a cognitive-behavioral HIV and AIDS prevention intervention for inner-city men: lessons from a controlled pilot study. AIDS Educ Prev. 1997 Aug;9(4):299–313. [PubMed] [Google Scholar]
  22. Kelly J. A., Kalichman S. C. Increased attention to human sexuality can improve HIV-AIDS prevention efforts: key research issues and directions. J Consult Clin Psychol. 1995 Dec;63(6):907–918. doi: 10.1037//0022-006x.63.6.907. [DOI] [PubMed] [Google Scholar]
  23. Kirby D., Barth R. P., Leland N., Fetro J. V. Reducing the risk: impact of a new curriculum on sexual risk-taking. Fam Plann Perspect. 1991 Nov-Dec;23(6):253–263. [PubMed] [Google Scholar]
  24. Landry D. J., Forrest J. D. How old are U.S. fathers? Fam Plann Perspect. 1995 Jul-Aug;27(4):159-61, 165. [PubMed] [Google Scholar]
  25. Landry D. J., Forrest J. D. How old are U.S. fathers? Fam Plann Perspect. 1995 Jul-Aug;27(4):159-61, 165. [PubMed] [Google Scholar]
  26. Laumann E. O., Youm Y. Racial/ethnic group differences in the prevalence of sexually transmitted diseases in the United States: a network explanation. Sex Transm Dis. 1999 May;26(5):250–261. doi: 10.1097/00007435-199905000-00003. [DOI] [PubMed] [Google Scholar]
  27. Leigh B. C., Temple M. T., Trocki K. F. The sexual behavior of US adults: results from a national survey. Am J Public Health. 1993 Oct;83(10):1400–1408. doi: 10.2105/ajph.83.10.1400. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Lindberg L. D., Sonenstein F. L., Ku L., Martinez G. Age differences between minors who give birth and their adult partners. Fam Plann Perspect. 1997 Mar-Apr;29(2):61–66. [PubMed] [Google Scholar]
  29. Maxwell A. E., Bastani R., Warda U. S. Condom use in young blacks and Hispanics in public STD clinics. Sex Transm Dis. 1999 Sep;26(8):463–471. doi: 10.1097/00007435-199909000-00008. [DOI] [PubMed] [Google Scholar]
  30. Miller K. S., Clark L. F., Moore J. S. Sexual initiation with older male partners and subsequent HIV risk behavior among female adolescents. Fam Plann Perspect. 1997 Sep-Oct;29(5):212–214. [PubMed] [Google Scholar]
  31. Miniño Arialdi M., Arias Elizabeth, Kochanek Kenneth D., Murphy Sherry L., Smith Betty L. Deaths: final data for 2000. Natl Vital Stat Rep. 2002 Sep 16;50(15):1–119. [PubMed] [Google Scholar]
  32. Oliver W. Sexual conquest and patterns of black-on-black violence: a structural-cultural perspective. Violence Vict. 1989 Winter;4(4):257–273. [PubMed] [Google Scholar]
  33. Osemene N. I., Essien E. J., Egbunike I. G. HIV/AIDS behind bars: an avenue for culturally sensitive interventions. J Natl Med Assoc. 2001 Dec;93(12):481–486. [PMC free article] [PubMed] [Google Scholar]
  34. Overby K. J., Kegeles S. M. The impact of AIDS on an urban population of high-risk female minority adolescents: implications for intervention. J Adolesc Health. 1994 May;15(3):216–227. doi: 10.1016/1054-139x(94)90507-x. [DOI] [PubMed] [Google Scholar]
  35. Pallin Daniel J., Sundaram Vandana, Laraque Fabienne, Berenson Louise, Schomberg David R. Active surveillance of maternal mortality in New York City. Am J Public Health. 2002 Aug;92(8):1319–1322. doi: 10.2105/ajph.92.8.1319. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Peterson J. L., Catania J. A., Dolcini M. M., Faigeles B. Data from the National AIDS Behavioral Surveys. III. Multiple sexual partners among blacks in high-risk cities. Fam Plann Perspect. 1993 Nov-Dec;25(6):263–267. [PubMed] [Google Scholar]
  37. Polit D. F., Kahn J. R. Early subsequent pregnancy among economically disadvantaged teenage mothers. Am J Public Health. 1986 Feb;76(2):167–171. doi: 10.2105/ajph.76.2.167. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Rosenberg P. S. Scope of the AIDS epidemic in the United States. Science. 1995 Nov 24;270(5240):1372–1375. doi: 10.1126/science.270.5240.1372. [DOI] [PubMed] [Google Scholar]
  39. Santelli J. S., Brener N. D., Lowry R., Bhatt A., Zabin L. S. Multiple sexual partners among U.S. adolescents and young adults. Fam Plann Perspect. 1998 Nov-Dec;30(6):271–275. [PubMed] [Google Scholar]
  40. Seidman S. N., Rieder R. O. A review of sexual behavior in the United States. Am J Psychiatry. 1994 Mar;151(3):330–341. doi: 10.1176/ajp.151.3.330. [DOI] [PubMed] [Google Scholar]
  41. Sikkema K. J., Koob J. J., Cargill V. C., Kelly J. A., Desiderato L. L., Roffman R. A., Norman A. D., Shabazz M., Copeland C., Winett R. A. Levels and predictors of HIV risk behavior among women in low-income public housing developments. Public Health Rep. 1995 Nov-Dec;110(6):707–713. [PMC free article] [PubMed] [Google Scholar]
  42. Sonenstein F. L., Ku L., Lindberg L. D., Turner C. F., Pleck J. H. Changes in sexual behavior and condom use among teenaged males: 1988 to 1995. Am J Public Health. 1998 Jun;88(6):956–959. doi: 10.2105/ajph.88.6.956. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. St Lawrence J. S., Brasfield T. L., Jefferson K. W., Alleyne E., O'Bannon R. E., 3rd, Shirley A. Cognitive-behavioral intervention to reduce African American adolescents' risk for HIV infection. J Consult Clin Psychol. 1995 Apr;63(2):221–237. doi: 10.1037//0022-006x.63.2.221. [DOI] [PubMed] [Google Scholar]
  44. Stein Z. Family planning, sexually transmitted diseases, and the prevention of AIDS--divided we fail? Am J Public Health. 1996 Jun;86(6):783–784. doi: 10.2105/ajph.86.6.783. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Vadies E., Hale D. Attitudes of adolescent males toward abortion, contraception, and sexuality. Soc Work Health Care. 1977 Winter;3(2):169–174. doi: 10.1300/j010v03n02_05. [DOI] [PubMed] [Google Scholar]
  46. Vass J. S., Gold S. R. Effects of feedback on emotion in hypermasculine males. Violence Vict. 1995 Fall;10(3):217–226. [PubMed] [Google Scholar]
  47. Walter H. J., Vaughan R. D., Ragin D. F., Cohall A. T., Kasen S., Fullilove R. E. Prevalence and correlates of AIDS-risk behaviors among urban minority high school students. Prev Med. 1993 Nov;22(6):813–824. doi: 10.1006/pmed.1993.1074. [DOI] [PubMed] [Google Scholar]
  48. Warren C. W., Santelli J. S., Everett S. A., Kann L., Collins J. L., Cassell C., Morris L., Kolbe L. J. Sexual behavior among U.S. high school students, 1990-1995. Fam Plann Perspect. 1998 Jul-Aug;30(4):170-2, 200. [PubMed] [Google Scholar]
  49. Wingood G. M., DiClemente R. J. Rape among African American women: sexual, psychological, and social correlates predisposing survivors to risk of STD/HIV. J Womens Health. 1998 Feb;7(1):77–84. doi: 10.1089/jwh.1998.7.77. [DOI] [PubMed] [Google Scholar]
  50. Wingood G. M., DiClemente R. J. The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. Am J Public Health. 1997 Jun;87(6):1016–1018. doi: 10.2105/ajph.87.6.1016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Wolitski R. J., Valdiserri R. O., Denning P. H., Levine W. C. Are we headed for a resurgence of the HIV epidemic among men who have sex with men? Am J Public Health. 2001 Jun;91(6):883–888. doi: 10.2105/ajph.91.6.883. [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. Zabin L. S., Huggins G. R., Emerson M. R., Cullins V. E. Partner effects on a woman's intention to conceive: 'not with this partner'. Fam Plann Perspect. 2000 Jan-Feb;32(1):39–45. [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES