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Abstract #156927
Slides (pdf) or HandoutManuela V. Costa, MPH1, Seth Welles, ScD, PhD2, Anita Raj, PhD3, Elizabeth A. Reed, PhD4, and C. Robert Horsburgh, MD1. (1) Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, T3E, Boston, MA 02118, (2) Department of Epidemiology and Biostatistics, Drexel University School of Public Health, 1505 Race Street, Office 613, Philadelphia, PA 19102, (215) 762-4953, slw58@drexel.edu, (3) Department of Social & Behavioral Sciences, Boston University School of Public Health, 715 Albany St., T2W, Boston, MA 02118, (4) Harvard School of Public Health, 677 Huntington Ave, Kresge 705, Boston, MA 02115
Background: We report findings of internalized homophobia among men who have sex with men (MSM) and non-MSM in a sample of Black/African-American men attending five Boston healthcare clinics.
Methods: We recruited 703 Black/African-American men aged 18-65 years who reported more than one sex partner in the past year. Black/African-American men were surveyed on demographics, homonegative attitudes, and behaviors. Men were classified into 3 groups: MSM with reported male sex partners, MSM who denied male sex partners but reported homosexual behaviors, and non-MSM. A seven item homonegativity scale was created and summed, with higher scores representing increased homonegativity.
Results: 18.2% of our sample (128/703) were behaviorally homosexual. The majority of participants were of low income (53% earning <$5,000), unemployed (62%), and homeless (76%). When quartile cut-offs were used for homonegativity scores, MSM who denied male sex partners (n=56) had much higher (p=0.0005) homonegativity scores than MSM who reported male sex partners (n=72) or non-MSM (n=575). MSM who acknowledged (adjOR = 5.3, 95%CI=2.4-11.6) or denied male partners (adjOR = 3.7, 95%CI=1.36-10.1) were more likely to report HIV infection than non-MSM. Similarly, MSM who acknowledged (adjOR = 3.1, 95%CI=1.8-5.1) and or denied male sex partners (adjOR = 1.6, 95%CI=0.9-2.9) were more likely to report lifetime STIs.
Conclusions: Our findings suggest that denial of MSM identity is associated with sharply higher homonegativity. This group remains at higher risks for HIV and STIs compared with non-MSM. In assessing HIV/STI risk among non-MSM, clinicians should identify strongly homonegative attitudes as potentially indicating MSM behaviors.
Learning Objectives: At the conclusion of this session, the participant (learner) will be able to
- Understand sexual behavior and sexual orientation among adult B/AA men who are MSM and non-MSM
- Evaluate the continuum of sexual orientation and its implications for understanding and identifying high risk sexual behaviors
- Discuss the effects of internalized homophobia among our sample of A/BB men
- Identify and prioritize more efficient STD and behavioral interventions that capture not just sexual orientation (such as being gay or bisexual) but those who are MSM.
Keywords: Risk Behavior, Homophobia
Presenting author's disclosure statement:
Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.
The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA