title: Homophobia is associated with sexual behavior that increases risk of acquiring and transmitting HIV infection among black men who have sex with men.
abstract: We investigated whether the experience of homophobic events increases the odds of engaging in unprotected anal intercourse (UAI) among black men who have sex with men (MSM) and whether social integration level buffered the association. Participants (N = 1,154) reported homophobic events experienced in the past 12 months. Social integration measures included social support, closeness with family members and friends, attachment to the black gay community, openness about sexuality within religious communities, and MSM social network size. Logistic regression analyses indicated that experiencing homophobia was associated with (1) UAI among men not previously diagnosed with HIV and (2) sexual HIV transmission risk behavior among men who knew they were HIV-infected. None of the social integration measures buffered these associations. Homophobia may promote acquisition and transmission of HIV infection among black MSM. Interventions are needed to reduce homophobia experienced by black MSM.
authors.affiliation: Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, 1600 Clifton Road MS E-37, Atlanta, GA 30333, USA. wjeffries@cdc.gov
authors.forename: William L
authors.initials: WL
authors.lastname: Jeffries
authors.forename: Gary
authors.initials: G
authors.lastname: Marks
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lauby
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Murrill
authors.forename: Gregorio A
authors.initials: GA
authors.lastname: Millett
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People / Q000523:psychology*; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D063509:Homophobia; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015143:Philadelphia / Q000453:epidemiology; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000208:ethnology / Q000523:psychology; D012747:Sexual Partners; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult; D001741:Black or African American