“And that is a good question. What does it take to be a man? What is a real man?”: Learning about gender role norms and sexual risk from the voices of Black heterosexual men

Background: Theories abound about Black heterosexual men's gender role norms and HIV risk, but empirical evidence is rare. This focus group study provides a culturally grounded understanding of Black heterosexual men's gender role norms and implications for HIV sexual risk. Methods: We conducted 6 focus groups with 41 Black heterosexual men recruited from randomly selected venue sites in Philadelphia, PA. The sample ranged in age from 19 to 51 (M = 33.68, SD = 8.42). Twenty-two men (55%) had annual incomes above the median income level of $20,500; 18 men (48%) had incomes below it. All but one man identified as heterosexual. We analyzed the data via coding and analytical memos. Results: Respondents expressed gender role norms such as: (1) negative attitudes towards Black gay and bisexual men, particularly those perceived to be on the “down low”; (2) varying norms about concurrent sex partners; (3) being “aggressive” about caring for families; (4) being community-oriented; (5) being spiritual or religious; and (6) the need for respect. Men expressed heterogeneous norms. For example, although many endorsed the concurrent sex partner norm, many others did not, citing their concerns about HIV infection. Conclusions: Our findings illustrate the complexity and heterogeneity of Black heterosexual men's gender role norms and highlight how structural factors in the U.S. such as unemployment and incarceration shape gender role norms. Our results underscore the importance of a culturally grounded understanding of gender role norms and how it can inform HIV prevention messages and interventions for urban Black heterosexual men.