title: Gender role conflict among African American men who have sex with men and women: associations with mental health and sexual risk and disclosure behaviors.
abstract: OBJECTIVE
  We investigated whether high gender role conflict (GRC; internal conflict with traditional gender-role stereotypes and an individual's perceived need to comply with these roles) is associated with psychological distress and HIV-related risk behaviors in a sample of African American men who have sex with men and women (MSMW).
  
  
  METHODS
  We analyzed baseline data collected from questionnaires completed by 400 MSMW participating in the Men of African American Legacy Empowering Self project in Los Angeles, California, in 2007 to 2010 for associations between participants' GRC and experiences of poor mental health and HIV risk outcomes.
  
  
  RESULTS
  MSMW who reported higher levels of GRC than other participants also reported more psychological distress, lower self-esteem, greater internalized homophobia, less HIV knowledge, lower risk reduction skills, less disclosure of same-sex behaviors to others, and more unprotected vaginal or anal intercourse with female partners.
  
  
  CONCLUSIONS
  Future research should consider how high GRC affects African American MSMW's lives and identify specific approaches to help alleviate the psychological distress and other negative behavioral outcomes associated with internal conflict caused by rigid gender role socialization.
authors.affiliation: HIV Epidemiology Program, Los Angeles County Department of Public Health, Los Angeles, CA 90005, USA. tbingham@ph.lacounty.gov
authors.forename: Trista A
authors.initials: TA
authors.lastname: Bingham
authors.forename: Nina T
authors.initials: NT
authors.lastname: Harawa
authors.forename: John K
authors.initials: JK
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001727:Bisexuality / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005260:Female; D005783:Gender Identity; D006678:HIV; D015658:HIV Infections / Q000517:prevention & control; D006801:Humans; D015141:Los Angeles; D008297:Male; D001523:Mental Disorders / Q000208:ethnology*; D008875:Middle Aged; D012725:Sexual Behavior / Q000208:ethnology*; D013315:Stress, Psychological / Q000208:ethnology*; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D055815:Young Adult