Examining the relationships between religiosity, spirituality, internalized homonegativity, and condom use among African-American men who have sex with men

Although disproportionate HIV infection rates among African-American men who have sex with men (AAMSM) have been well-documented, less is known about reasons for the disparity.  The Sexual Health in Faith Traditions (SHIFT) Study evaluated the relationships between religiosity, spirituality, internalized homonegativity, and frequency of condom use among a sample of 348 AAMSM living in the Deep South region of the United States.  Participants completed a self-administered, paper-and-pencil survey.  The Internalized Homonegativity Inventory (IHNI) was used to measure internalized homonegativity, the Religious Commitment Inventory-10 (RCI-10) to assess religiosity, and the Daily Spiritual Experiences Scale (DSES) to measure spirituality.  Structural equation modeling was used to determine relationships between religiosity, spirituality, internalized homonegativity, and frequency of condom use for both insertive and receptive anal intercourse in the last 3 months.  The mean age of participants was 28.24, and more than 20% were living with HIV.  Almost half of respondents reported using condoms “Every time” they engaged in insertive (48.3%) or receptive (45.1%) anal intercourse.  Structural equation models found that religiosity was positively associated with personal & moral homonegativity and negatively associated with gay affirmation, while spirituality was negatively associated with personal & moral homonegativity and positively associated with gay affirmation.  There were no significant direct relationships between religiosity and condom use or spirituality and condom use; however, there were significant indirect relationships using the dimensions of internalized homonegativity as mediators.  These findings suggest that religiosity and spirituality have the potential to influence AAMSM’s feelings toward their sexuality and engagement in safer sex behaviors.