Masculinity values and sexual risk behavior among black bisexual men

Background: Factors affecting sexual risk behaviors among bisexual men may be different from those previously documented for gay men. We examined the relationship between traditional masculinity values, internalized homonegativity and sexual behavior in a sample of 159 Black men who reported male and female partners in the past 12 months. Methods: Black bisexual men who reported multiple partners and unprotected sex were recruited using respondent driven sampling for an intervention trial. Data reported are from the baseline ACASI interview conducted before randomization to treatment groups. Masculinity values were measured by a 4 point Likert scale of 13 items (MEAN=2.058/SD=.420), with good reliability (Alpha=.854) where higher scores indicate more traditional masculine ideals. Internalized homonegativity values were measured by an 8 item 4 point Likert scale (MEAN=2.1/SD=.490), with good reliability (Alpha=.776). Results: Men with more traditional masculine ideals were more likely to have more unprotected sex. Masculinity scale scores positively related with incidence of unprotected sex with any partners (p=.002) and female partners (p=.002), controlling for age and education in a multiple regression analysis. This relationship was not significant for unprotected sex with male partners. Although internalized homonegativity positively related to masculinity, it did not have an independent effect on unprotected sex. Conclusions: Bisexual men may require different messages than gay men regarding sexual behaviors and activities. People working with bisexual men should be aware of pre-existing masculinity ideals when developing interventions. Realigning traditional masculine ideals with more positive behaviors may be an effective strategy to decrease sexual risk among this population.