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. Author manuscript; available in PMC: 2017 Jan 1.
Published in final edited form as: Psychol Men Masc. 2015 Jun 29;17(1):42–53. doi: 10.1037/a0039455

Adherence to Traditionally Masculine Norms and Condom-Related Beliefs: Emphasis on African American and Hispanic Men

Wilson Vincent 1,*, Derrick M Gordon 2, Christina Campbell 3, Nadia L Ward 2, Tashuna Albritton 4, Trace Kershaw 4
PMCID: PMC4779342  NIHMSID: NIHMS696409  PMID: 26957949

Abstract

Although studies have shown that adherence to traditional masculine norms (i.e., Status, Toughness, Antifemininity) affect men’s attitudes toward sexual health, there is little research on how men’s adherence to these norms affect them in the context of heterosexual, dyadic relationships. Among 296 young pregnant couples, we investigated the extent to which adherence to traditional masculine norms affected male and female partners’ own condom-related beliefs (i.e., condom self-efficacy, positive condom attitudes) and that of their partners. We tested an interdependence model using a dyadic-analytic approach to path analysis. We also tested for differences across gender and race-ethnicity (i.e., African American, Hispanic). Results showed that adherence to the Antifemininity and Toughness masculine norms predicted negative condom-related beliefs, whereas, overall, adherence to the Status norm predicted positive condom-related beliefs. Men’s and women’s adherence to traditional norms about masculinity were associated with their partner’s condom self-efficacy, and moderated associations based on gender and race-ethnicity were detected. In contrast, each dyad member’s traditional masculine norms were not associated with his or her partner’s positive condom attitudes. Taken together, findings indicated that the roles of traditional masculinity and condom-related beliefs in sexual health should be addressed within the context of relationships and associations between masculine norms and condom-related beliefs are not uniformly negative.

Keywords: masculinity, male role norms, masculine norms, HIV, condoms, couples

Men account for 74% of all HIV cases among young adults under 26, and heterosexual sex remains the most common form of transmission among women (Centers for Disease Control and Prevention [CDC], 2009; Higgins, Hoffman, & Dworkin, 2010). The risks are greater for African Americans and Hispanics than Whites and greater for persons living in poverty than those who are not (CDC, 2009, Prejean et al., 2011; Swartzendruber et al., 2013). Due to the well-documented biological and social vulnerability of women to HIV and other sexual risks, interventions have focused on women in heterosexual dyads (Dworkin, Fullilove, & Peacock, 2009; Gupta, 2001; Higgins et al., 2010). Nonetheless, there are an insufficient number of studies to address men in these dyads (Dworkin et al., 2009; Higgins et al., 2010).

Adherence to traditionally masculine norms may help to explain sexual risk among men and the implications of these beliefs on sexual risk in the context of their relationships. Men who adhere to traditionally masculine norms tend to report less consistent condom use and believe that a woman’s pregnancy validates a man’s masculinity (Pleck, Sonenstein, & Ku, 1993; Santana, Raj, Decker, La Marche, & Silverman, 2006). These men also endorse more negative attitudes toward condom use than men who adhere less to traditionally masculine norms (Pleck et al., 1993; Santana et al., 2006). These traditional norms are particularly significant for adolescent and young-adult men and their female partners who observe and practice gender norms while growing up, often to their detriment (Kerrigan et al., 2007; Santana et al., 2006). However, adherence to traditional beliefs about masculinity is not uniformly negative (Shearer, Hosterman, Gillen, & Lefkowitz, 2005).

Adherence to Traditional Masculine Norms, Condom-Related Beliefs, and Sexual Risk

Masculinity is a multifaceted construct that can be understood in multiple ways (Connell & Messerschmidt, 2005). Thompson and Pleck (1986) empirically validated a multidimensional conceptualization of masculine ideology. Results indicated that men varied based on three distinct, masculine norms: (a) Status, which reflects the belief that man must gain the respect of others; (b) Toughness, which reflects the expectation that men are physically tough and willing to be aggressive; and (c) Antifemininity, which reflects the belief that men should not engage in stereotypically feminine activities. Such traditionally masculine norms are often hypothesized to be associated with sexual-risk behavior across racial and ethnic groups, including (a) deemphasizing danger (e.g., sexually transmitted infection [STI], unplanned pregnancy) while emphasizing one’s own toughness; (b) negative attitudes toward health-enhancing behaviors, such as condom use; (c) an adversarial stance toward women in relationships (e.g., Bowleg, Lucas, & Tschann, 2004; Noar & Morokoff, 2002; Shearer et al., 2005).

However, adherence to traditionally masculine norms may have positive, negative, or null effects on health-related behaviors (Addis & Mahalik, 2003; Mankowski & Maton, 2010). In a sample of 220 undergraduate students, Shearer and colleagues (2005) found that adherence to the Status masculine norm was linked to lower incidence of sexual-risk behavior and more positive attitudes toward condoms among men and women. In contrast, adherence to the Antifemininity masculine norm was positively, significantly associated with sexual-risk behavior. Shearer and associates (2005) concluded that adherence to the Status masculine norm was associated with positive condom-related beliefs because the Status masculine norm measure emphasized men’s responsibility, rationality, and authority. Noar and Morokoff (2002) found that endorsement of the Toughness and Antifemininity masculine norms were significantly correlated with earlier onset of sexual-risk behavior, whereas the Status masculine norm was not. In sum, endorsement of various traditionally masculine norms may differentially increase or decrease sexual risk.

Race-Ethnicity and Gender as Moderators

Although traditional masculinity may exclude certain groups of individuals (e.g., Blacks, women, homosexuals) while privileging White men (Connell & Messerschmidt, 2005; Wade, 2008), anyone is subject to it regardless of their social status (Iwamoto, Cheng, Lee, Takamatsu, & Gordon, 2011; Iwamoto et al., 2012). This is important for some men of color, who, because of their social status, may be unable to “fully” attain ideals of traditional masculinity, yet are still subject to it. For example, among socioeconomically marginalized men, strong adherence to traditionally masculine norms related to toughness and an emphasis on sexual prowess are bolstered by the male partners’ perceived inability to attain the gender role of an economic provider (Kerrigan et al., 2007). Indeed, adherence to traditionally masculine norms has real-world implications: adherence to these norms is linked to health outcomes—regardless of race, ethnicity, or socioeconomic status (Gordon, et al., 2013; Iwamoto et al., 2012; Murphy, Gordon, Sherrod, Dancy, & Kershaw, 2013).

Existing studies may provide clues as to how culturally specific manifestations of traditional masculinity may play a role in health outcomes of men of color in the context of heterosexual relationships. Although studies have used Thompson and Pleck’s (1986) tripartite construct of masculinity with racially and ethnically diverse samples (Pleck et al., 1993; Thompson & Pleck, 1986), other culturally specific models have been used to examine the associations between traditional masculinity and sexual health among African American men and Hispanic men, respectively, in heterosexual relationships. For example, among some African American men, cool pose (Majors & Billson, 1992; Wade & Rochlen, 2013) may be understood as a “ritualized form of masculinity that entails behaviors, scripts, physical posturing, readiness to physically fight and violently defend and protect, impression management based on toughness, and carefully crafted performances that deliver a [singular] message: pride, strength, and control” (Majors & Billson, 1992, p. 4; Wade & Rochlen, p. 2). Studies suggest that the hypermasculinity characterized by the cool pose construct may be a means of coping with gendered racism faced by African American men, who may experience more overt or aggressive acts of racial discrimination and harassment than African American women (Wade & Rochlen, 2013). This may provide some indications as to how traditionally masculine norms from the dominant culture (e.g., Toughness; Pleck et al., 1993; Thompson & Pleck, 1986) may be expressed and may influence sexual health. For example, the cool pose is linked to the devaluing of condom readiness through social pressures that emphasize hypermasculinity in the form of promiscuity over intimacy and monogamy (Bowleg, 2004; Bowleg et al., 2011; Corneille, Tademy, Reid, Belgrave, & Nasim, 2008).

Further, as reflected by studies of Thompson and Pleck’s (1986) conceptualization of the Status masculine norm, the impact of expressions of masculinity among African American men is not consistently negative. For example, John Henryism, which reflects a strong disposition to cope actively with both psychological and environmental stressors, has been associated with positive outcomes (e.g., efficacious mental and physical vigor, singular determination to succeed, and firm commitment to hard work; James, 1994; Majors & Billson, 1992; Merritt, Bennett, Williams, Sollers, & Thayer, 2004).

Whereas the research literature sought to identify how masculinity is expressed or attained among African American men within the dominant cultural ideals of masculinity in the U.S., the literature on Hispanic men has focused on two culturally specific constructs among Hispanic men of various nationalities: machismo and caballerismo. The first, machismo, reflects cultural ideals of men’s power, aggressive attitudes, vulgarity, hypersexuality, toughness, etc.; the second, caballerismo, represents cultural ideals of men’s honor, integrity, fairness, cooperation, respect for elders, importance of family, etc. (Arciniega, Anderson, Tovar-Blank, & Tracey, 2008; Galvan, Bogart, Wagner, Klein, & Chen, 2014; Ojeda, Rosales, & Good, 2008). Typically, machismo is framed as a risk factor, and caballerismo is framed as a protective factor (Arciniega et al., 2008; Ojeda & Piña-Watson, 2014). For example, caballerismo has been found to be associated with indicators of self-efficacy, such as higher active coping (Ojeda & Liang, 2014) and higher self-esteem (Ojeda & Piña-Watson, 2014). Given these results, beliefs in traditionally masculine norms may have implications for health-related beliefs and sexual risk within heterosexual, dyadic relationships. Additional research is needed on how beliefs about traditional masculinity among heterosexual men may affect their own and their partners’ health-related beliefs, and whether these results vary across social ascribed cultural groups.

Recognizing that these culturally specific conceptualizations of masculinity (e.g., John Henryism, caballerismo) are clearly appropriate for within-group studies of racial- and ethnic-minority men and their partners, mainstream American constructions of masculinity may also be useful for making worthwhile comparisons between racial- and ethnic-minority groups in the United States (Abreu, Goodyear, Campos, & Newcomb, 2000; Murphy et al., 2013; Wade & Rochlen, 2013). Such study may allow for an examination of how dominant constructions of masculinity are adhered to and influence the health of racially and ethnically diverse men. For example, studies have found that adherence to the Toughness masculine norm was negatively associated with interpersonal competencies among White men but not African American men. Further, the Status masculine norm was positively associated with interpersonal competencies among African American men but negatively associated with interpersonal competencies among White men (Lease et al., 2010). Although levels of acculturation to norms of the dominant culture in the United States may differ between and within various racial and ethnic groups and individuals, these persons are still exposed to conventional cultural beliefs that may overlap with notions of traditional masculinity in the U.S. (Abreu et al., 2000). The effects of these men’s beliefs, their partners’ beliefs, as well as differences by race or ethnicity may help to clarify the association between adherence to traditionally masculine norms among men whose socioeconomic status and position may place them at increased sexual risk (e.g., HIV, other STIs, unplanned pregnancy).

As a caveat, xtant scholars (e.g., Lee, Mountain, & Koenig, 2001; Osborne & Feit, 1992; Williams, 1994) have highlighted that social constructs such as race and gender are generally not well-defined and may be proxies for other factors (e.g., effects of stigma towards social groups, socioeconomic status or position). As such, the reader is cautioned not to attribute any associations directly to participants’ race, ethnicity, or gender.

The Present Study

The present study aimed to address the gaps in the literature regarding the role of traditionally masculine norms in the sexual health-related beliefs of men and women in the context of intimate relationships. The focus was on heterosexual populations at greatest risk of HIV in the U.S. Specifically, African Americans and Hispanics are at greater risk of STIs than other racial and ethnic groups. Further, the rate of new HIV infections is twice as high among African American men compared to both Hispanic men and African American women. The rate of new HIV infection among African American women is twice that of Hispanic women (CDC, 2013). Given these differences along categories of race-ethnicity and gender, the present sample consists of African American and Hispanic men as well as their female partners or co-parents. Our original intention was to include non-Hispanic White men and men of other raices and their partners or co-parents in the analyses. However, we were unable to include them due to small subsample sizes and, thus, insufficient statistical power.

This study used a dyadic, interdependence model, which accounts for the influence that each member of a couple has on him- or herself and each other. The present study examined how adherence to traditionally masculine norms might affect endorsement of condom-related beliefs among young adults within heterosexual dyads who are most at risk. Differences between African American and Hispanic men and their female partners were explored.

  • Research Question 1: Men’s and women’s adherence to Antifemininity and Toughness masculine norms will be inversely associated with their own and their partners’ condom-use self-efficacy and positive condom attitudes, whereas adherence to the Status masculine norm will be positively associated with these condom-related beliefs. Specifically, does participants’ adherence to traditionally masculine norms affect their own as well as their partner’s condom-related beliefs?

  • Research Question 2: Are any of these associations moderated by gender?

  • Research Question 3: Are any of these associations moderated by race-ethnicity?

Method

Study Sample and Procedures

Baseline data from a longitudinal study of pregnant and postpartum adolescent females and their male partners were used for the present study. Between July, 2007, and February, 2011, 296 couples (592 total participants) were recruited from obstetrics and gynecology clinics in four university-affiliated hospitals in Connecticut. Prospective participants were screened by research staff. If eligible, research staff explained the study to participants in detail and answered any questions. If the baby’s father was not present at the time of screening, research staff asked for permission to contact their partner to explain the study. Research staff provided informational materials to female participants for their partners and asked them to explain the study to their partners. Inclusion criteria were as follows: (a) the female partner was pregnant in the second or third trimester of pregnancy at time of the baseline interview, (b) women were aged 14 to 21 years and men were at least 14 years old at time of the interview, (c) both members of the couple reported being in a romantic relationship with each other, (d) both reported being the biological parents of the unborn infant, (e) both agreed to participate in the study, and (f) both were fluent in English or Spanish. Given that this was a longitudinal study, we used an initial run-in period (i.e., a procedure in which participants were not enrolled when initially contacted but, instead, given a period of two or more weeks to ensure they are reachable as part of the larger, longitudinal study) as part of eligibility criteria where participants were deemed ineligible if they could not be re-contacted after screening and before their estimated due date.

Research staff obtained written informed consent at baseline. The members of each couple separately completed structured interviews via audio computer assisted self-interviews (ACASI; participants did not have access to partners’ ACASI data) at the same time in private areas at our research offices or in clinic space provided by participating clinics. Participation was voluntary and confidential, and did not affect the provision of health care or social services. All procedures were approved by the Yale University Human Investigation Committee and by institutional review boards at study clinics. Participants were compensated $25 for their effort.

Of 413 eligible couples, 296 (72.2%) couples enrolled in the study. Those who agreed to participate were of greater gestational age (p = .03). Participation did not vary by any other pre-screened demographic characteristic (ps > .05). Data reported are from the baseline assessments of all participants.

Measures

Demographics

Participants completed measures of race, ethnicity, and household income. Household income includes participants’ personal income and/or parental income if they received monetary support from their parents.

Condom attitudes (CA)

Attitudes toward condom use were measured using twelve items adapted from the UCLA multidimensional condom attitude scale (Helweg-Larsen & Collins, 1994). Sample items include “Condoms are an effective method of birth control,” “Condoms ruin the sex act,” and “Condoms are uncomfortable for both partners.” Participants responded using a 7-point scale ranging from 1 = strongly disagree to 7 = strongly agree. Higher scores represented more positive attitudes towards condoms. Cronbach’s alpha coefficients for the scale scores were α = .70 for men and α = .73 for women.

Condom self-efficacy (CSE)

Self-efficacy in regard to condom use was measured by a 17 item adaptation of the condom self-efficacy scale (Brafford & Beck, 1991). Sample items include “I feel confident in my ability to put a condom on myself or my partner,” and “I feel confident in my ability to discuss condom usage with any partner I might have.” Participants responded using a 5-point scale ranging from 1 = strongly agree to 5 = strongly disagree. Higher scores indicated more condom self-efficacy. Cronbach’s alpha coefficients were α = .89 for men and α = .90 for women.

Male Role Norms Scale (Thompson & Pleck, 1986)

This 26-item, Likert-type inventory assessed adherence to three dimensions of traditional, masculine ideology, or, more specifically, norms (i.e., male role norms): Antifemininity (e.g., “It bothers me when a man does something that I consider ‘feminine’”), Status (e.g., “A man must stand on his own two feet and never depend on other people to help him do things”), and Toughness (e.g., “A good motto for a man would be ‘When the going gets tough, the tough get going’”). Participants were asked to rate each item on a scale from 1 (strongly disagree) to 7 (strongly agree), with higher scores reflecting endorsement of more traditional gender norms. Internal consistency coefficients for these subscales range between .74 and .81 in standardization samples (Thompson & Pleck, 1986). In the present sample, the reliability coefficients Antifemininity, Status, and Toughness subscales were .64, .90, .74, respectively, for men and.70, .87, .70, respectively, for women.

Spanish translation of measures

The Spanish-translated measures of the outcome variables, positive condom attitudes and condom-use self-efficacy, have been validated in similar populations (Kershaw, Arnold, Gordon, Magriples, & Niccolai, 2012; Milan et al., 2006), although the measures of adherence to masculine norms have not been validated in similar populations. Nonetheless, all questionnaire items were translated by a native Spanish speaker and then back-translated by a separate native Spanish speaker. Additionally, all of our participants spoke English. However, a handful (seven out of 592) preferred to take the survey in Spanish. Given the small number of participants who elected to complete questionnaires in Spanish instead of English, we could not make meaningful comparisons between participants who completed the questionnaires in Spanish and those who completed them in English.

Data Analysis

Frequencies and means were conducted to describe the sample. To assess differences by gender and race-ethnicity in adherence to masculine norms (i.e., Antifemininity, Status, Toughness), condom self-efficacy, condom attitudes, we conducted a series of paired t-tests for continuous variables. For categorical demographic variables, we used McNemar’s test.

Path analysis was used to assess the fit of the data to an actor-partner interdependence model (APIM) of the influence of adherence to masculine norms on condom-related beliefs. In contrast to alternative statistical procedures, path analysis permits simultaneous examination of relations among multiple “predictor” and criterion variables for both male and female partners in each dyad. A detailed description on how to conduct APIM analyses using structural equation modeling programs has been previously outlined (see Kenny, Kashy, & Cook, 2006) and served as the guide for our analysis plan. Actor associations refer to whether a person’s score on a predictor variable is related to the person’s own outcome (e.g., a woman’s adherence to the Toughness masculine norm relates to her own condom self-efficacy). Partner associations refer to whether the person’s partner’s score on the predictor variable is related to that person’s outcome (e.g., the male partner’s adherence to the Toughness masculine norm is related to the woman’s condom self-efficacy). Path analysis allows for both actor and partner associations to be simultaneously represented as theoretically causal paths in the model and to be estimated as a regression coefficient (see Figures 1 and 2 as examples). However, actual causality cannot be determined from cross-sectional data.

Figure 1.

Figure 1

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N = 252. *p < .05. **p < .01. ***p < .001. Structural paths in an actor-partner interdependence model depicting direct associations of male and female partners’ adherence to the traditionally masculine norms of Status, Toughness, and Antifemininity with male and female partners’ condom self-efficacy. Covariances between “predictor,” or exogenous, variables, were estimated, but not included in the figure to facilitate presentation. For this figure, parameter estimates are standardized.

Figure 2.

Figure 2

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N = 252. _p < .10. *p < .05. **p < .01. ***p < .001. Structural paths in an actor-partner interdependence model depicting direct associations of male and female partners’ adherence to the traditionally masculine norms of Status, Toughness, and Antifemininity with male and female partners’ condom self-efficacy. Covariances between “predictor,” or exogenous, variables, were estimated, but not included in the figure to facilitate presentation. For this figure, parameter estimates are standardized estimates.

In order to determine whether actor and partner associations of masculine norms were moderated by gender of the partner and the race or ethnicity of the male partner, we conducted pairwise comparisons such that regression coefficients of respective actor and partner associations were statistically tested using the chi square difference test for differences between genders. Additionally, to test for differences by race or ethnicity of the male partner, we used a multiple group model and tested for differences in regression coefficients of each actor and partner associations across racial and ethnic groups of the male partners. There were not sufficient numbers of White men and men of other races or ethnicities for their inclusion. The total number of White and other men who were not African American or Hispanic was 44, which is not sufficient to yield stable parameter estimates. In contrast, there were 144 African American men and 108 Hispanic men. Given the exploratory nature of this study, and the fact that tests of moderation in path models are often underpowered at α = .05 or even α < .20 (Selvin, 2004), multiplicity control (e.g., Bonferroni) was not used in the present study. Some quantitative methodologists have recommended as high as α = .25 for the purposes of model building and power-related issues in various types of path models, such a logistic regression models (Bursac, Gauss, Williams, & Hosmer, 2008; Hosmer & Lemeshow, 2000; Hosmer, Lemeshow, & Sturdivant, 2013). In the present study, we chose a conservative approach of using .05.

Results

Descriptive Statistics

Demographics of participants are shown in Table 1. Participants were predominantly African American (44.1%) or Hispanic (38.0%), whereas only 13.7% were White and 4.2% identified as another race or ethnicity. Based on Cohen’s κ, both members of each couple were significantly more likely to be of the same race than of differing races, χ2 (8, N = 296) = 206.69, κ = .56, p = < .001. The mean (with standard deviation in parentheses) age of women was 18.98 (1.34), and the average age of men was 21.65 (3.72). Only 26 couples (8.8%) in the sample were married, and the average household income across individual participants was $15,471 ($18,870). Differences between couples and between men and women by race and ethnicity of the male partner (as conducted in primary analyses) are presented in Table 1. The mean gestation age at the time of the interview was 29.05 (5.25) weeks.

Table 1.

Patient Characteristics by Gender, Race-Ethnicity

Characteristic African American p Hispanic p White p Other p
Male (n=144) Female (n=144) Male (n=108) Female (n=108) Male (n=31) Female (n=31) Male (n=13) Female (n=13)
Current Age M (SD) 21.48 (4.11)a 18.79 (1.57)A .000 20.91 (3.70)a 18.50 (1.76) A .000 22.50 (3.92) 19.03 (1.45) .000 19.69 (2.29) 18.85 (1.07) .094
Household income ($) M (SD) 18,318 (25,786)a 13,052 (14,193) A .022 14,107 (12,688)a 12,616 (17,551) A .003 27,633 (24,633) 19,983 (14,321) .136 13,577 (14,143) 11,500 (12,627) .611
Race-Ethnicity N (%) --- --- --- .001
 African American 144 (100.0) 102 (70.8) --- --- 11 (10.2) --- --- 0 (0.0) --- --- 4 (30.8) ---
 Hispanic --- 27 (18.8) --- 108 (100.0) 82 (75.9) --- --- 4 (12.9) --- --- 4 (30.8) ---
 White --- 7 (4.9) --- --- 14 (13.0) --- 31 (100.0) 26 (83.9) --- --- 3 (23.1) ---
 Other --- 8 (5.6) --- --- 1 (0.9) --- --- 1 (3.2) --- 13 (100.0) 2 (15.4) ---
Reported any sexual or physical violence or threats from partner N (%) 60 (41.7)a 28 (19.4)A .000 34 (31.5)a 13 (12.0) A .001 13 (41.9) 7 (22.6) .070 6 (46.2) 2 (15.4) .219
Adherence to traditional male role norms
 Antifemininity 22.81 (6.18)a 19.17 (6.44) A .000 20.45 (7.01)b 17.79 (5.78) A .001 20.83 (7.58) 17.10 (5.72) .035 15.69 (4.21) 19.08 (6.44) .121
 Status 60.29 (11.04)a 57.08 (11.16) A .027 58.94 (14.28)a 54.78 (11.94) A .017 57.33 (9.96) 53.10 (10.08) .040 56.38 (17.21) 49.32 (8.28) .321
 Toughness 35.89 (8.33)a 28.69 (7.60) A .000 33.22 (9.30)b 27.42 (7.23) A .000 32.17 (9.11) 25.35 (6.03) .000 33.31 (9.34) 23.62 (8.96) .004
Condom self-efficacy 4.01 (0.58)a 4.16 (0.59) A .025 3.81 (0.74)b 3.93 (0.63)B .194 4.07 (0.63) 3.94 (0.64) .392 3.97 (0.72) 4.02 (0.49) .856
Positive condom attitudes 43.27 (8.27)a 45.60 (8.54) A .020 42.45 (9.54)a 44.17 (8.22) A .162 42.13 (9.62) 41.65 (9.59) .792 40.00 (8.60) 44.85 (7.60) .150
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Note. N = 296 couples. Differences between male and female partners by race-ethnicity of the male partner based on study variables were tested using paired samples t-tests for continuous variables. Cohen’s κ measure of agreement was used for the categorical race-ethnicity variable across couples Chi-square tests were used for intimate partner violence within couples (McNemar’s test) and between couples. Any comparisons between White and “other” men and their female partners must be interpreted with caution, as there was insufficient power to test these differences. Percentages may not add to 100.0 due to rounding. Significant p-values are in bold font.

Men and women in the sample did not differ in their endorsement of the Status masculine norm. However, female and male partners differed in their reports of adherence to the Antifemininity and Toughness masculine norms. Specifically, male partners reported greater adherence to the Antifemininity norm and to the Toughness masculine norm than their female partners. Additionally, female and male partners did not differ significantly in the extent to which they endorsed condom self-efficacy and positive attitudes toward condom use (see Table 1). Table 2 displays the zero-order correlations between variables in the model.

Table 2.

Correlation matrix of all variables included in dyadic models and race and ethnicity

1 2 3 4 5 6 7 8 9 10
1. Antifemininity (male) 1
2. Antifemininity (female) .14* 1
3. Status (male) .23** −.08 1
4. Status (female) .05 −.04 .00 1
5. Toughness (male) .49** .07 .53** .00 1
6. Toughness (female) .14* .44** −.03 .32** .13* 1
7. Race: AA (male) .20** .12* .08 .14* .16** .14* 1
8. Race: AA (female) .07 .14* .01 .15* .07 .11 .62** 1
9. Ethnicity: L/H (male) −.11 −.08 −.02 −.05 −.10 −.02 −.74** −.46** 1
10. Ethnicity: L/H (female) −.07 −.11 −.02 −.07 −.07 −.11 −.41** −.65** .56** 1
1 2 3 4 5 6 7 8 9 10
11. Household income (male) .01 −.05 .08 .11 −.01 .02 .04 −.03 −.12* .04
12. Household income (female) .05 −.01 .03 .02 .04 −.05 −.03 −.10 −.04 .05
13. IPV by partner (male) −.04 .02 .02 .01 .07 −.02 .07 .08 −.10 −.01
14. IPV by partner (female) .04 .10 .06 .01 .06 .15* .07 −.01 −.10 .00
15. CSE (male) −.19** −.14* .28** .12 .01 −.11 .10 .01 −.16** −.02
16. CSE (female) .02 −.28** −.03 .24** .05 −.20** .18** .18** −.15* −.12*
17. CA (male) −.24** −.14* −.01 .023 −.28** −.15** .06 .06 −.02 .01
18. CA (female) .03 −.29** −.01 .11 −.04 −.19** .11 .12 −.04 .00
11 12 13 14 15 16 17 18
11. Household income (male) 1
12. Household income (female) .20** 1
13. IPV by partner (male) −.03 −.01 1
14. IPV by partner (female) .06 .10 .18** 1
15. CSE (male) .17** .10 .07 −.01 1
16. CSE (female) .09 −.02 −.02 −.05 .12 1
17. CA (male) .09 −.01 .05 −.03 .40** .09 1
18. CA (female) .03 −.05 −.03 .02 .00 .44** .09 1
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Note. N = 296 couples. Race: AA = Race with African American as referent group (coded as 1). Ethnicity: H/L = Ethnicity with Hispanic as referent group. IPV = sexual or physical violence or threats by partner, as reported by the participant (yes coded as 1). CSE = condom self-efficacy. CA = positive condom attitudes.

*

p < .05.

**

p < .01.

Condom Self-Efficacy

A dyadic model of the associations of adherence to three traditionally masculine norms with condom self-efficacy was tested (Figure 1). The model fit the data well, χ2 (6, N = 296) = 5.05, p = .54, CFI = 1.00, TLI = 1.00, RMSEA = .00, 90% CI [.00, .07]. The model accounted for 19.8% of variance in men’s condom self-efficacy and 19.1% of variance in women’s condom-self-efficacy.

Antifemininity

Both men’s (b = −0.02., SE = 0.006, p <.001) and women’s (b = −0.018, SE = 0.006, p = .003) adherence to the Antifemininity masculine norm showed significant, negative actor associations, such that men’s and women’s higher scores on adherence to the Antifemininity masculine norm were associated with lower scores on their own condom self-efficacy. However, there were no partner associations of adherence to the Antifemininity masculine norm, indicating that men’s and women’s adherence to the Antifemininity masculine norm were not related to their partners’ condom self-efficacy.

Status

Both men’s (b = 0.018, SE = 0.003, p < .001) and women’s (b = 0.017, SE = 0.003, p < .001) adherence to the Status masculine norm showed significant, positive actor associations, indicating that men’s and women’s higher scores on adherence to the Status masculine norm were associated with lower scores on their own condom self-efficacy. In addition, there was a significant, negative partner association of men’s adherence to the Status masculine norm (b = −0.007, SE = 0.003, p = .02), indicating that men’s higher scores on the Status masculine norm were associated with women’s lower scores on condom self-efficacy. Conversely, there was a significant, positive partner association of women’s adherence to the Status masculine norms (b = 0.009, SE = 0.003, p = .01), such that women’s higher scores on adherence to the Status masculine norm were associated with higher scores on these men’s condom self-efficacy.

Toughness

There was a significant, negative actor association of women’s adherence to the Toughness masculine norm (b = −0.021, SE = 0.005, p < .001) and a significant positive partner association of men’s adherence to the Toughness masculine norm (b = 0.011, SE = 0.005, p = .03). Specifically, women’s higher scores on adherence to the Toughness masculine norm were associated with lower scores on their own condom self-efficacy. However, their male partners’ higher scores on their own adherence to the Toughness masculine norm were associated with higher scores on women’s condom self-efficacy. There was no significant actor or partner association of adherence to the Toughness masculine norm with men’s condom self-efficacy, suggesting that adherence to the Toughness masculine norm was not associated with men’s condom self-efficacy.

Moderation: Gender and Racial/Ethnic Differences

Several associations were moderated by gender of the participant and race of the male partner. Pairwise comparisons revealed gender differences in actor and partner associations. Men and women differed on partner associations of adherence to the Status masculine norm on condom self-efficacy, Δχ2 (1) = 11.42, p = .001. The positive association of women’s adherence to the Status masculine norm with men’s condom self-efficacy (b = 0.009, SE = 0.003, p .01) was significantly different from the negative association of men’s adherence to the Status masculine norm with women’s condom self-efficacy (b = −0.007, SE = 0.003, p .02). Further, men and women differed significantly on both actor associations, Δχ2 (1) = 5.44, p = .02, and partner associations, Δχ2 [1] = 6.61, p = .01, of adherence to the Toughness masculine norm on condom self-efficacy. The associations of women’s adherence to the Toughness masculine norm with their own condom self-efficacy (b = −0.021, SE = 0.005, p <.001) and their male partners’ condom self-efficacy (b = −0.009, SE = 0.006, p = .13) was significantly different from the associations of men’s adherence to the Toughness masculine norm with their own condom self-efficacy (b = −0.004, SE = 0.005, p = .47) and their female partners’ condom self-efficacy (b = 0.011, SE = 0.005, p = .03).

A multiple-group moderation analysis was conducted to determine whether any actor or partner associations differed across African American and Hispanic men and their female partners. A multiple-group model with African American men and their female partners in one group and Hispanic men and their female partners in another group fit the data adequately, χ2 (12, N = 252) = 10.35, p = .59, CFI = 1.00, TLI = 1.00, RMSEA = .00, [90% CI: .00, .06]. However, only one association was moderated by race or ethnicity of the male partner. The association of men’s adherence to the Status masculine norm with their own condom self-efficacy was significantly different between Hispanic men (b = 0.025, SE = 0.005, p < .001) and African American men (b = 0.009, SE = 0.005, p =.068), Δχ2 (1) = 4.86, p = .03.

Positive Condom Attitudes

A dyadic model of the associations of adherence to three traditionally masculine norms with condom attitudes was also tested (Figure 2). The model fit the data well, χ2 (6, N = 296) = 2.68, p = .85, CFI = 1.00, TLI = 1.00, RMSEA = .00, 90% CI [.00, .04]. The model accounted for 13.5% of variance in men’s positive condom attitudes and 12.7% of variance in women’s positive condom attitudes. Although there were significant actor associations, there were no significant partner associations. This suggested that men’s and women’s scores on adherence to the three masculine norms influenced their own, but not their partners’, scores on positive condom attitudes.

Antifemininity

Women’s adherence to the Antifemininity masculine norm showed a significant, negative actor association (b = −0.307, SE = 0.088, p < .001), such that higher scores on adherence to the Antifemininity masculine norm were associated with lower scores on their own positive condom attitudes. The negative actor association of men’s adherence to the Antifemininity masculine norm approached significance at α = .05 (b = −0.159, SE = 0.083, p = .06), suggesting a trend toward men’s higher scores on adherence to the Antifemininity masculine norm being associated with lower scores on their own positive condom attitudes.

Status

Men’s (b = 0.107, SE = 0.046, p = .02) and women’s (b = 0.105, SE = 0.045, p = .02) adherence to the Status masculine norm showed significant, positive actor associations, such that men’s and women’s higher scores on adherence to the Status masculine norm were associated with higher scores on their own positive condom attitudes.

Toughness

Men’s (b = −0.276, SE = 0.072, p < .001) and women’s (b = −0.183, SE = 0.076, p = .02) adherence to the Toughness masculine norm showed significant, positive actor associations, such that men’s and women’s higher scores on adherence to the Toughness masculine norm were associated with higher scores on their own positive condom attitudes.

Moderation: Gender and Racial/Ethnic Differences

No associations differed by gender of the participant. However, there was one association that was moderated by race or ethnicity of the male partner. A multiple group model based on (a) African American men and their female partners and (b) Hispanic men and their female partners fit the data adequately, χ2 (12, N = 252) = 11.89, p = .45, CFI = 1.00, TLI = 1.00, RMSEA = .00, 90% CI [.00, .06]. The association of women’s adherence to the Toughness masculine norm on their own condom attitudes was significantly different between women who were paired with African American men (b = −0.333, SE = 0.104, p = .001) and women who were paired with Hispanic men (b = 0.095, SE = 0.139, p = .49), Δχ2 (1) = 5.96, p = .02.

Discussion

Using a sample of young, expectant, couples, this is the first study to show that beliefs in traditionally masculine norms (i.e., Antifemininity, Status, Toughness) may be linked not only to men’s and women’s respective condom-related beliefs, but to their partners’ condom related beliefs in their heterosexual dyads. These results extend prior research indicating that adherence to traditionally masculine norms differentially affects men’s condom-related beliefs (Addis & Mahalik, 2003; Mankowski & Maton, 2010; Noar & Morokoff, 2002; Shearer et al., 2005) by finding similar associations in the context of heterosexual, dyadic relationships.

Specifically, when actor associations of adherence to traditionally masculine norms with condom self-efficacy and positive condom attitudes were significant, they were positive for adherence to the Status masculine norm and negative for adherence to the Antifemininity and Toughness masculine norms. These findings make sense in light of prior research indicating that both dominant constructions of masculinity (e.g., Antifemininity, Toughness, Status) and culturally specific constructions of masculinity (e.g., machismo, caballerismo, cool pose, John Henryism) may differentially affect health outcomes (Arciniega et al., 2008; James, 1994; Merritt et al., 2004; Ojeda & Piña-Watson, 2014). As suggested by prior literature and the present findings, some facets of masculinity have positive influences on critical health-related outcomes, behaviors, and attendant beliefs, such as Status, caballerismo, and John Henryism (Arciniega et al., 2008; Gordon, et al., 2013; James, 1994; Merritt et al., 2004; Noar & Morokoff, 2002; Ojeda et al., 2008; Shearer et al., 2005). The positive association of the Status masculine norm with condom-related beliefs may reflect the importance of values such as responsibility and rationality for both men and women when these beliefs influence their own behavior. It may be important to emphasize the positive aspects of these beliefs, as opposed to only highlighting the negative ones.

Partner Gender and Cross-Partner Associations

The negative relation of adherence to the Toughness masculine norm with one’s own and one’s partner’s condom self-efficacy was larger for women than for men. Among the present sample, women’s adherences to ideals of toughness (e.g., that men should be aggressive and rugged) may have had more of a deleterious link with their own self-efficacy and their male partners’ condom self-efficacy than the men’s adherence to ideals of toughness. These findings indicate the importance of women’s beliefs about what a man should be like and the possible influence of their beliefs in the context of heterosexual relationships. It may be that women’s own belief in the Toughness masculine norm in this lower-SES sample may indicate an endorsement of Toughness as a way for their male partners to maintain a sense of masculinity or perhaps for them to view their male partners as masculine within traditional, social hierarchies with the United States (Bowleg et al., 2011; Gordon, et al., 2013; Wade & Rochlen, 2013). However, this possible attempt at uplifting men’s sense of masculinity may be adversely associated with a sense of self-agency regarding condom use.

There were significant cross-partner associations such that the condom self-efficacy of individuals in these dyads was indirectly related, at least to some extent, to their partner’s adherence to traditionally masculine norms. Specifically, women’s adherence to the Status masculine norm was linked to men’s higher condom-use self-efficacy. In contrast, men’s adherence to the Status masculine norm was linked to women’s lower condom-use self-efficacy. Moderation analyses confirmed that the difference was statistically significant. To the extent that men in these populations are denied status or expectation of status within a culture of traditional masculinity in the United States (Bowleg et al., 2011; Gordon, et al., 2013; Iwamoto et al., 2011; Iwamoto et al., 2012; Murphy et al., 2013; Wade & Rochlen, 2013), both partners may have felt that it was important to maintain a semblance of status for male partners, as indicated in a prior qualitative study (Bowleg et al., 2004). This could have led to deference to men, thus reducing women’s sense of agency. These findings unexpectedly contradicted previous studies suggesting a positive role of the Status masculine norm (Noar & Morokoff, 2002; Shearer, et al., 2005). Further study is needed to clarify these divergent associations.

Paradoxically, in opposition to prior literature (Noar & Morokoff, 2002; Sheerer, et al., 2005), men’s toughness beliefs were associated with greater condom self-efficacy in their female partners. As such, male partners who believe that men should be tough and perhaps reckless may have partners who feel a greater need to protect their own sexual health and to communicate the need for the use of a condom. Also, we controlled for experience of intimate partner violence, so women may feel safer or more compelled to protect themselves if IPV is not apparent in their relationships with “tough” men. Although further research is needed, this link may be associated with a sense of greater necessity or urgency about being able to introduce condoms if they are with men who believe that men should tough, aggressive, and willing to flirt with danger (Bowleg, 2004; Bowleg et al., 2004; Noar & Morokoff, 2002; Pleck et al., 1993).

An important finding in this study is that, although there were significant partner associations with condom self-efficacy in the overall sample, there were no significant partner associations with positive condom attitudes. To our knowledge, these results are unique to our study. These findings suggest that the traditionally masculine norms of men and women in these dyads may be linked to their partners’ sense of being able to use or communicate about condoms, but not linked to their partners’ underlying attitudes about condoms. Specifically, core beliefs may not change, but the ability to act on core beliefs in the face of a partner’s beliefs or attitudes may be compromised (or enhanced). Additional research is needed into ways of improving self-efficacy about condom use in the context of relationships.

Male Partner Race-Ethnicity

African American men and their partners differed from Hispanic men and their partners in the influence of men’s adherence to the Status masculine norm on their own condom self-efficacy. The positive association was significantly different and appeared to be greater among Hispanic men than among African American men. This may be the result of cultural differences in the adherence to, influence of, and access to various aspects of masculinity (Abreu et al., 2000). It is possible that, even within traditional masculinity and social hierarchies of the United States, culturally specific constructs such as caballerismo (Abreu et al., 2000; Arciniega et al., 2008) in Hispanic cultures and links to nations of origin may provide a means by which Hispanic men benefit directly from the Status masculine norm. Further research is needed to confirm.

In regard to positive condom attitudes, none of the associations were moderated by gender alone in the single-group model. However, one association was moderated by the male partner’s race in multiple-racial/ethnic-group model. The deleterious association of women’s adherence to the Toughness masculine norm with their own positive condom attitudes was moderated such that it was robust among women who were partnered with African American men but not significant among women who were partnered with Hispanic men. There may be cultural factors linked to these findings, at least for women who are with African American men, and such associations merit further study. For example, the manner in which hypermasculinity or cool pose is expressed may be particularly deleterious on African American men’s female partners’ attitudes towards condom use to the degree that they believe that men should indeed be hypermasculine, risk-taking, and tough. These are qualities that tend to be prevalent among lower-SES black men and their peers (Wade & Rochlen, 2013). In contrast, positive aspects of status-oriented John Henryism typically benefit African Americans of higher socioeconomic status (Merritt et al., 2004), excluding most African American men in the present sample.

In sum, these moderation analyses suggest that gender and racial/ethnic differences may depend on whether one is examining (a) partners’ beliefs that they can enact behaviors that enhance sexual health versus (b) their general attitudes toward sexual-health-enhancing behaviors regardless of whether they think they can enact these behaviors. Further, we must continue to address the unique experiences of each person in the context of the couple and of each couple in the context of their respective cultures.

Strengths and Limitations

This study had a number of strengths. Few, if any, studies have used an interdependence framework to examine the association of traditionally masculine norms with men’s and women’s beliefs about sexual health in the context of heterosexual relationships. Further, this study adds to the literature showing that beliefs regarding traditional masculinity may linked to both men’s and women’s health. This study also took into account possible gender and racial/ethnic differences that may speak to the ways in which these relationship dynamics may differ based on gender- and racial/ethnic socialization. Also, the use of ACASI in this study may have minimized several well-established issues related to self-report, including recall bias and demand characteristics. Additionally, the sample consisted largely of persons who are most adversely affected by the HIV epidemic among heterosexuals: young expecting couples who were predominately racial and ethnic minorities and also living in relatively poor urban areas (Ickovics, Niccolai, Lewis, Kershaw, & Ethier, 2003; Meade & Ickovics, 2005).

Although this study has a number of strengths, it also has some limitations. For example, the cross-sectional nature of the study precludes definitive inferences regarding causal or temporal relations among the variables. Although ACASI was used to minimize bias, the data for this study were obtained via self-report. In regard to the use of race and ethnicity in this study, aforementioned scholars (e.g., Lee, Mountain, & Koenig, 2001; Osborne & Feit, 1992; Williams, 1994) have cautioned against arbitrary categorization of race in research and highlighted that race is generally not a well-defined construct. Given the focus of this study on beliefs about traditional masculinity among men and how these beliefs influence heterosexual dyads, we did not conduct separate analyses based on the racial and ethnic identities of women in the study. Nonetheless, the majority of dyads were the same of the same race and ethnicity. Also, we did not examine condom use. Although condom-related beliefs and adherence to traditionally masculine norms have been empirically linked to actual condom use (Shearer et al., 2005; Sheeran et al., 1999), other constructs (e.g., behavioral intentions) may be stronger predictors of condom use (Albarracin, Johnson, Fishbein, & Muellerleile, 2001; Turchik & Gidycz, 2012). Finally, there was insufficient power to examine the relatively few White men and men of other races and their partners in the sample.

Implications

This research represents an effort to understand HIV prevention among MSW, recognizing the critical role of beliefs about masculinity and their association with health. Given that HIV prevention for MSW generally receives little attention (Bowleg et al., 2004; Coley, 2001; Coley & Morris, 2002; Kershaw et al., 2012; Logan, Cole, & Leukefeld, 2002), the current study advances efforts to understand the underlying mechanisms of increased sexual risk among some MSW. This is particularly important for those who are members of groups at increased risk of HIV infection, including African Americans and Hispanics, people living in impoverished urban areas, and expectant adolescents. Appealing to participants’ existing values (e.g., Status, caballerismo, John Henryism), without assuming that these groups have monolithically harmful beliefs, may be helpful. Although further research is merited, the findings of this study indicate that HIV prevention programs that ignore MSW or gender or that target individuals at the expense of the relationship context may miss opportunities to address prevention needs while reaching more people in their relational contexts. (For examples of pertinent reviews and empirical studies, see Exner et al., 2003; Jewkes & Morrell, 2010; Wu, et al., 2014).

Conclusion

The associations found in this study provide a necessary step in understanding how rigid adherence to traditionally masculine beliefs might affect the health of both men and their partners in the context of heterosexual relationships. As young men and women navigate challenges they face (e.g., social-minority status, poverty), their risk for unplanned pregnancy and HIV/STIs increases. Cultural factors, such as adherence to beliefs about traditional masculinity play a role for men and women across race and ethnicity. These beliefs may be modified, but some aspects of these beliefs may be less harmful than others. Indeed, some dimensions of traditional masculinity may be associated with positive outcomes. We must not take a one-size-fits-all approach to individual- or relationship-based interventions, and we must challenge ourselves to be creative by addressing or incorporating traditional, gender-related beliefs.

Acknowledgments

This research was supported by Grants 1R01MH075685 (Title: “HIV/STD Risk among Young Expectant Fathers: Relationship Attachment and Transition”; P.I.: Trace Kershaw), 5P30MH062294-0A1 (Title: “Center for Interdisciplinary Research on AIDS”; P.I.: Paul Cleary), and T32MH020031 (Title: “Interdisciplinary HIV Training grant”; PI: Trace Kershaw) from the National Institute of Mental Health. In addition, support was provided by Grant T32DA019426 (Title: “Research Training Program in Substance Abuse Prevention”; PI: Jacob Tebes).

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