Gender role conflict, Black racial identity and sexual risk behavior among Black men who have sex with men (MSM)

Background: Black men who have sex with men (MSM) are disproportionately impacted by HIV/AIDS. Gender role conflict and racial identification may influence sexual behavior in this population.

Methods: Black MSM (N=480) were recruited in Atlanta, Georgia between May and September, 2006. Participants completed a 75-item survey with demographics, the Gender Role Conflict Scale (GRCS), the Multidimensional Inventory of Black Identity (MIBI), and questions on sexual behavior in the past year.

Results: Forty-three percent of the sample (232/480) reported any unprotected anal intercourse (UAI) with other men, while 6% (29/480) reported unprotected vaginal intercourse (UVI) and 4.4% (21/480) UAI with women, respectively. Multivariable analysis showed significant associations between UAI with other men and 1) self perception of high likelihood of getting HIV (p<.0001); 2) recruitment from Black Gay Pride (p=.0139) or club/street venues (p=.0097); and 3) reporting greater than 7 male sexual partners (p=.0044). High GRCS and MIBI scores did not predict UAI with other men, but did predict unprotected sex with women (p=.0079, p=.00371, respectively) among the subsample of participants who reported having sex with women (N=68).

Conclusions: High rates of UAI persist among Black MSM. High perception of risk may reflect increased social awareness of risky behaviors, while targeting certain sexual/social networks and reducing numbers of sexual partners may be important components of future HIV prevention interventions for Black MSM. Gender role conflict and Black racial identification, while not significantly associated with UAI with other men, may have implications for Black men with their female sexual partners.