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Journal of Urban Health : Bulletin of the New York Academy of Medicine logoLink to Journal of Urban Health : Bulletin of the New York Academy of Medicine
. 2005 Mar;82(Suppl 1):i26–i34. doi: 10.1093/jurban/jti021

Sexual diversity among black men who have sex with men in an inner-city community

Maureen Miller 1,✉, Malin Serner 1, Meghan Wagner 1
PMCID: PMC3456163  PMID: 15738323

Abstract

Dramatic increases in HIV-incidence rates have been documented for Black men who have sex with men (MSM). Moreover, MSM has become a more visible HIV-transmission route in the Black community, in part due to public interest in the “down low” (i.e., “straight” men who also have sex with men). Interviews were conducted with 21 Black MSM in central Brooklyn, New York City, in efforts to understand the diversity of MSM experience in a low income, high HIV-prevalence community. Two thirds of the men identified as either heterosexual (43%) or bisexual (24%) and 15 (71%) MSM reported recent sex with women. Conformity to masculine social role expectations made it difficult to identify sex partners in the community; therefore, men relied on private sex clubs and the Internet. The findings suggest that stigma surrounding both HIV and homosexuality may effectively insure that nonheterosexual preferences and practices remain hidden in the Black community. A focus on sexual orientation and bisexuality has obscured the issue of race in the HIV/AIDS epidemic among Black MSM. In the long term, public health promotion and HIV prevention will require greater tolerance and acceptance of sexual diversity in the Black community.

Keywords: Black MSM, Drug use, HIV, Sexual risk

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References

  • 1.Harawa N, Greenland S, Bingham T, et al. Associations of race/ethnicity with HIV prevalence and HIV-related behaviors among young men who have sex with men in 7 urban centers in the United States. J Acquir Immune Defic Syndr. 2004;35:526–536. doi: 10.1097/00126334-200404150-00011. [DOI] [PubMed] [Google Scholar]
  • 2.HIV/AIDS Surveillance Report 2003. Atlanta, GA: Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention; 2003. U.S. HIV and AIDS cases reported through December 2001; pp. 1–48. [Google Scholar]
  • 3.Wolitski RJ, Halkitis PN, Parsons JT, Gomez CA. Awareness and use of untested barrier methods by HIV-seropositive gay and bisexual men. AIDS Educ Prev. 2001;13:291–301. doi: 10.1521/aeap.13.4.291.21430. [DOI] [PubMed] [Google Scholar]
  • 4.Centers for Disease Control and Prevention Increases in HIV diagnoses — 29 states, 1999–2002. MMWR Morb Mortal Wkly Rep. 2003;52:1145–1148. [PubMed] [Google Scholar]
  • 5.Centers for Disease Control and Prevention. HIV/AIDS Among African Americans 2003.
  • 6.Centers for Disease Control and Prevention Update: Trends AIDS Incidence-United States, 1996. 1997;46:861–867. [Google Scholar]
  • 7.Mays VM, Cochran SD, Zamudio A. HIV prevention research: are we meeting the needs of African American men who have sex with men? J Black Psychol. 2004;30:78–105. doi: 10.1177/0095798403260265. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Easterbrook PJ, Chmiel JS, Hoover DR, et al. Radial and ethnic differences in human immunodeficiency virus type 1 (HIV-1) seroprevalence among homosexual and bisexual men. The Multicenter AIDS Cohort Study. Am J Epidemiol. 1993;138:415–429. doi: 10.1093/oxfordjournals.aje.a116874. [DOI] [PubMed] [Google Scholar]
  • 9.Kennamer JD, Honnold J, Bradford J, Hendricks M. Differences in disclosure of sexuality among African American and White gay/bisexual men: implications for HIV/AIDS prevention. AIDS Educ Prev. 2000;12:519–531. [PubMed] [Google Scholar]
  • 10.Centers for Disease Control and Prevention HIV/STD risk in young men who have sex with men who do not disclose their sexual orientation — six U.S. Cities, 1994–2000. MMWR Morb Mortal Wkly Rep. 2003;52:81–85. [PubMed] [Google Scholar]
  • 11.Laumann EO, Gagnon JH, Michael RT, Michaels S. The Social Organization of Sexuality. Sexual Practices in the United States. Chicago, IL: University of Chicago Press; 1994. [Google Scholar]
  • 12.Brooks R, Rotheram-Borus MJ, Bing EG, Ayala G, Henry CL. HIV and AIDS among men of color who have sex with men and men of color who have sex with men and women: an epidemiological profile. AIDS Educ Prev. 2003;15:1–6. doi: 10.1521/aeap.15.1.5.1.23607. [DOI] [PubMed] [Google Scholar]
  • 13.Montgomery JP, Mokotoff ED, Gentry AC, Blair JM. The extent of bisexual behaviour in HIV-infected men and implications for transmission to their female sex partners. AIDS Care. 2003;15:829–837. doi: 10.1080/09540120310001618676. [DOI] [PubMed] [Google Scholar]
  • 14.Heckman TG, Kelly JA, Sikkema KJ, et al. Differences in HIV risk characteristics between bisexual and exclusively gay men. AIDS Educ Prev. 1995;7:504–512. [PubMed] [Google Scholar]
  • 15.Denizet-Lewis B. Double lives on the down low. The New York Times. August 3, 2003.
  • 16.Villarosa L. AIDS fears grow for Black Women. The New York Times. April 5, 2004.
  • 17.Strauss AL. Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Newbury Park, CA: Sage Publications; 1990. [Google Scholar]
  • 18.Strauss AL. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Thousand Oaks, CA: Sage Publications; 1998. [Google Scholar]
  • 19.Battle J, Cohen C, Warren D, Fergerson G, Audam S. Say It Loud. I’m Black and I’m Proud. New York, NY: The Policy Institute on the National Gay and Lesbian Task Force; 2002. [Google Scholar]
  • 20.Herek G, Capitanio J. Black heterosexuals attitudes toward Lesbians and gay men in the United States. J Sex Res. 1995;32:95–105. doi: 10.1080/00224499509551780. [DOI] [Google Scholar]
  • 21.Lewis G. Black-White differences in attitudes toward homosexuality and gay rights. Public Opin Q. 2003;67:59–78. doi: 10.1086/346009. [DOI] [Google Scholar]
  • 22.Stokes JP, Peterson JL. Homophobia, self-esteem, and risk for HIV among African American men who have sex with men. AIDS Educ Prev. 1998;10:278–292. [PubMed] [Google Scholar]
  • 23.Peterson JL, Coates TJ, Catania J, et al. Evaluation of an HIV risk reduction intervention among African-American homosexual and bisexual men. AIDS. 1996;10:319–325. doi: 10.1097/00002030-199603000-00011. [DOI] [PubMed] [Google Scholar]
  • 24.Kraft JM, Beeker C, Stokes JP, Peterson JL. Finding the “community” in community-level HIV/AIDS interventions: formative research with young African American men who have sex with men. Health Educ Behav. 2000;27:430–441. doi: 10.1177/109019810002700406. [DOI] [PubMed] [Google Scholar]
  • 25.Malebranche DJ. Black men who have sex with men, and the HIV epidemic: next steps for public health. Am J Public Health. 2003;93:862–865. doi: 10.2105/ajph.93.6.862. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Soc Sci Med. 2003;57:13–24. doi: 10.1016/S0277-9536(02)00304-0. [DOI] [PubMed] [Google Scholar]
  • 27.Wolfe WA. Overlooked role of African-American males’ hypermasculinity in the epidemic of unintended pregnancies and HIV/AIDS cases with young African-American women. J Natl Med Assoc. 2003;95:846–852. [PMC free article] [PubMed] [Google Scholar]
  • 28.Bull SS, McFarlane M, Rietmeijer C. HIV and sexually transmitted infection risk behaviors among men seeking sex with men on-line. Am J Public Health. 2001;91:988–989. doi: 10.2105/AJPH.91.6.988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29.Centers for Disease Control and Prevention Internet use and early Syphilis infection among men who have sex with men — San Francisco, California, 1999–2003. MMWR Morb Mortal Wkly Rep. 2003;52:1229–1232. [PubMed] [Google Scholar]
  • 30.McFarlane M, Bull SS, Rietmeijer CA. The Internet as a newly emerging risk environment for sexually transmitted diseases. JAMA. 2000;284:443–446. doi: 10.1001/jama.284.4.443. [DOI] [PubMed] [Google Scholar]
  • 31.Toomey KE, Rothenberg RB. Sex and cyberspace-virtual networks leading to high-risk sex. JAMA. 2000;284:485–487. doi: 10.1001/jama.284.4.485. [DOI] [PubMed] [Google Scholar]
  • 32.Carballo-Dieguez A, Stein Z, Saez H, Dolezal C, Nieves-Rosa L, Diaz F. Frequent use of lubricants for anal sex among men who have sex with men: the HIV prevention potential of a microbicidal gel. Am J Public Health. 2000;90:1117–1121. doi: 10.2105/ajph.90.7.1117. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 33.Baron S, Poast J, Nguyen D, Cloyd MW. Practical prevention of vaginal and rectal transmission of HIV by adapting the oral defense: use of commercial lubricants. AIDS Res Hum Retroviruses. 2001;17:997–1002. doi: 10.1089/088922201300343672. [DOI] [PubMed] [Google Scholar]
  • 34.Gollub EL, French P, Latka M, Rogers C, Stein Z. Achieving safer sex with choice: studying a women’s sexual risk reduction hierarchy in an STD clinic. J Womens Health Gend Based Med. 2001;10:771–783. doi: 10.1089/15246090152636532. [DOI] [PubMed] [Google Scholar]
  • 35.Rogow D, Horowitz S.Withdrawal: a review of the literature and an agenda for research Stud Fam Plann 199526140–153.7570764 [Google Scholar]
  • 36.Hawkeswood W. One of the Children: Gay Black Men in Harlem. Berkeley, CA: University of California Press; 1996. [Google Scholar]
  • 37.Heckathorn D. Respondent driven sampling: a new approach to the study of hidden populations. Soc Probl. 1997;44:174–199. [Google Scholar]
  • 38.Thompson SK, Seber GAF. Adaptive Sampling. New York, NY: Wiley; 1996. [Google Scholar]

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