STUDY: Higher Young Black Gay/Bi HIV Rates Linked to Preference for "Masculine" Partners

This is fascinating. Young Black gay and bisexual men—or men who have sex with men (MSM) in public health jargon—are up to five times more likely to contract HIV than other MSM. This is despite Centers for Disease Control data that suggests they don't necessarily have more unprotected sex.

A new study by investigators at Johns Hopkins and Emory Uniiversities—which we previewed last month at the Black Diaspora MSM Conference in the Dominican Republic—offers a possible explanation. Young Black MSM have a strong preference for "dominant" "masculine" partners and perceive "masculine" men as having much less HIV risk than "feminine" men.

Jonathan Ellen, M.D., a pediatrician and teen health expert at Johns Hopkins presented the findings of their study at the 2011 Pediatric Academic Societies Annual Meeting in Denver. The study results are based on semi-structured interviews with 35 black men MSM ages 18 to 24 in NYC and upstate New York, and Atlanta.

The research noted these young black MSM select partners and judge these partners' HIV status in a specific way. The most notable findings include an overwhelming preference for masculine partners, accepting masculine partners as dominant in the sex act and leaving to them decisions about condom use, perceiving masculine men as low risk for HIV and feminine men as high risk. The researchers say this dynamic of preferring masculine men, while also equating masculinity with lower HIV risk helps explain why young black MSM contract HIV more often than their counterparts from other races.

"There may be no difference in HIV prevalence between masculine-looking and feminine-looking men, but because black MSM perceive masculine men as lower risk, their sexual encounters with such men may make HIV infection more likely," said Dr. Ellen.

The study is entitled "Young Black Males’ Conflict between Masculinity and Homosexuality: Implications for HIV Risk." The researchers include Dr. David J. Malebranche of the Emory University School of Medicine. The sample is not large but it provides some qualitative and empirical findings that confirms what many in the Black LGBT community have suspected all along: Black gay men have a have very strong cultural and sexual preference for aggressve "masculine"  men. More in weeks to come on R20 and an interview with the study authors.

A recent Centers for Disease Control study of more than 8,100 MSM found almost one in three Black MSM are HIV positive, compared to only 16 percent of white gay/ and bisexual men. The numbers were even higher in some cities. Black poz MSM were least likely to be aware of their status—59 percent unaware vs.  26 percent for white MSM. The numbers for younger Black MSM are even more startling: 71 percent were unaware of their infection.

Some Background:
HIV a Rite of Passage for Young Black Gay Men?
1 in 3 Black Gay Men HIV Positive; 60% Unaware
"Alarming" HIV Rates Young Blk Gay Men in Miss.
CDC: 42% Black Gay Men in Milwaukee are HIV+
What PrEP Could Mean for Black Gay Men
Yolo Akili:"Are You the Kind of Man You Want?" HIV "Epidemic" Among Black Gay Chicago Men
CDC: Young Black Gays Hit Hardest by HIV Infections

Comments

[The other guy]

I can totally see this. But those of us who are a little longer in the tooth know damn well that these "masculine" dudes are the first ones to put their behinds in the air for somebody, often with no protection. DC is the capital of the butch bottoms who swear they are better because they can play the masculinity card. I am glad this study was done. Very interesting.

[Derrick from Philly]

"...leaving to them decisions about condom use, perceiving masculine men as low risk for HIV..."

No, no, no, no. Nobody ever told these young "children" such sh.t. TRADE is NOT immune to HIV. Bad mistake.

[The other guy]

I have even heard young guys say that that's why they deal with married men or men who have girlfriends - because they think they are not as great a risk. If anything, the opposite is true. Many of the gay men I know who've caught something serious got it from a man who was bi-sexual (and masculine) and dealing with women. Scary stuff.

[Antonio]

The other guy is exactly right. I was about to say the same thing. I think what is even scarier I was talking to this young dude here in DC and he was like every gay guy is going to get HIV anyway, so he is not worried about it. I just hope a vaccine or a cure comes about in a few years, people are afraid to get tested, will not use protection....sigh

[Blah]

All I got to say is let the man tell the truth (the man being Rod 2.0). I have a very active sex life and the shit I see is insane. Lets not even start by addressing the sex shops with the gloryholes where lots of black men have unprotected sex. Or The Den where tons of black men come together "on the low" and fuck each others brains out. While I see condoms all around I almost NEVER see condom wrappers. There is a perception that if you are masculine and have "swag" that are you less of a risk. But I think what ppl don't realize is that THERE IS STILL A RISK. Masculine/Feminine HIV is HIV. Why after all these years it seems that only us BLACK MEN can't get with the program on honest, responsibility or ACCOUNTABILITY. There is definitely a chip missing in some black men & women brain when it comes to PROTECTING ourselves. Forget the other person. How about just protecting yourself? This article is truly fascinating.

[Chitown Kev]

"But those of us who are a little longer in the tooth know damn well that these "masculine" dudes are the first ones to put their behinds in the air for somebody..."

QFT, lol, I was just having this discussion with someone last night

[Osiris]

Prefering masculine partners has nothing to do with it. The answer isn't complicated: it's just plain old ignorance/stupidity. Leave at it that.

[YRREJ DRAINREB]

THE MEDIA IS ALWAYS TRYING TO PINPOINT A SPECIFIC RACE, AGE, CULTURE, SOCIETY, PREFERENCE ETC AS THE LEADING CAUSE OF THIS DREADFUL EPIDEMIC! NEXT THING YOU KNOW THEY WILL BE SAYING PEOPLE THAT EAT AT SUCH AND SUCH RESTAURANTS ARE AT A GREATER RISK! WHEN THE SIMPLE FACT IS THAT EVERYONE IS AT RISK! THESE TYPE OF MESSAGES LEAVE THE IGNORANT/NAIVE INDIVIDUALS TO BELIEVE THAT IF THEY ARE NOT INCLUDED IN THIS CATEGORY THEN THEY AREN'T REALLY AT RISK! NO THATS NOT WHAT THE MESSAGE SAYS BUT THATS HOW THEY TAKE IT! WE NEED TO CONCENTRATE ON THE PICTURE AS A WHOLE NOT JUST THE FLAWS IN IT!

[uptown125th]

I've run into a few guys who refuse to put a condom on. I'm like dude don't you value your life? I know I value mines too much to let you put me at risk of getting HIV. I think many of "us" don't believe it can happen to us, but your wrong HIV/AIDS has no face, race, age, height, weight, etc..

That's why I'm celibate until I'm in another relationship. This stuff is scary and people are carrying it from one person to the other.

No one is immune from this disease...wrap it up!

[Distant Lover]

You would think after 30 years of HIV that people would wake up to the fact that it doesn't make a difference how he looks, if he has a penis, he could be HIV positive.
Putting on a condom takes less than a few seconds but could add years to your life. I have seen two of my closest friends die from ARC and I wish that these youngbloods nowadays would act like they have some sense and wrap it up.

[Jarron]

I think it has little to do with masculinity. White gay guys are just as obsessed with "straight-acting" and "masculine" guys as anyone else.

I think the way black people, gay/straight/bi/whatever, deal with sexuality is the problem.It is not just a gay thing. Look how many more black teen girls are pregnant. Black parents need to have a different attitude about talking to their kids about sex. THey are raising too many ignorant young people.

[chris w]

@Distant Lover. I really like the way you phrased it: "Putting on a condom takes less than a few seconds but could add years to your life." Thanks for that.

[Chi]

Just a reminder...this study has an N of 35. So any conclusions that come from it are not to be inferred to the greater community. I'm glad someone is asking questions to this population but it's WAY TOO SOON to be making conclusions based on a sample of 35 Black men from two locations only. It's not generalizable to all Black MSM, just to the ones who they asked the questions of. But then that gets lost in translation some how.

[Eric]

also @ Jarron, that's blatantly racist. whenever you start making a general statement about any group, you're stereotyping. Blaming "black parents" about talking to their kids about sex is ignorant. Teen pregnancy is on the rise across the board, MTV has even jumped on the bandwagon with a tv show about it. So let's not start blaming a community for a worldwide problem, and perhaps you should think about educating yourself before you start spewing your ignorance in a forum that was meant to be about trying to understand a phenomena and not try to tear a group of people down.

[Colin]

I sooo don't get the science here, and wonder whether the media is running with this 'cause it's about the pathology of Black masculinity.

I know it's clever to say “even though young black MSM have unprotected sex just as often as others, they may be having unprotected sex in riskier ways with partners whose HIV status they often miscalculate”. But what does that mean?

The large scale studies show that Black MSM do NOT engage in riskier behaviours for HIV than White MSM. So even if you can extrapolate from these 35 guys that Black MSM in general assume masculine guys are less likely to have HIV, this only makes a difference in HIV prevalence if a) masculine guys are in fact MORE likely to have HIV, which the Jonathan Ellen quote in the Hopkins release seems to discredit; or b) they are having more unsafe sex than White guys with these primarily masculine guys they think are safer, which we know they aren’t.

Help me!

[Distant Lover]

@ Chris W.
You are very much welcomed!

[Will]

What I don't understand is, how are masculine men perceived as low risk for having HIV? If anything, the risk is higher with the potential "perception" that dominant, masculine men are more likely to be on the DL --> more likely to have unprotected sex ---> more likely to have HIV. [sidebar: Those numbers at the end are STAGGERING!!! OMG]

I will never understand why in 2011 gay black men, especially in a community where almost 1 in 3 men have HIV, just don't protect themselves. SMH.

[William]

I don't think the issue is a preference for "masculine" men. I think the issue is simply people not protecting themselves because they assume that a certain person doesn't have HIV. Much like everyone else here, I'm confused as to what the actual science is behind this.

[Former COGIC]

Chi, Collin, William, etc:

Any paper with Dr. David Malebranche's name on it should be taken seriously. IMHO you're parsing what is obviously a very small sample size and meant to be more qualitative than empirical.

The larger issue = "Young Black gay and bisexual men—or men who have sex with men (MSM) in public health jargon—are up to five times more likely to contract HIV than other MSM."

And = "Up to 71 percent were unaware of their infection."

Blacks make up only 12% of the US population but more than 50% of HIV infections. Black teen pregnancy rates are sky high. And black gay men are Number One (with a bullet) in terms of HIV rates. WHY? Obviously there is something in our culture that encourages women and gay men to listen to a man who says I WILL NOT use a condom or to NOT to use condoms themselves.

And yes, many black gay men do (mistakenly) believe DL men, masculine men or tops are less likely to be HIV positive, so we are deluding ourselves trying to pretend otherwise. Masculinity and hyper masculinity are valuable sexual commodities in the 'hood gayborhood and suburbs, more so if you are black.

Several of you are repeatedly questioning the "science" or methodology for this one study but the CDC's excellent data is irrefutable. So why are Black and Black MSM HIV rates so high? And why are younger Black MSM rates soaring year after year? And why do the vast majority of HIV positive Black msm NOT know their status? We aren't using condoms and we aren't testing ourselves later. Why?

If you have an answer, speak up. Otherwise, I'll accept any research or any suggestions that tries to answer the question. My take: Folks are just upset with the CDC data that repeatedly shows black gay men are most likely to become HIV positive. No, it doesn't make our community look "good." But I'd rather get to the bottom of this and see how we can address what is obviously an extremely serious problem.

[Colin]

Nothing's obvious to me, Former COGIC. Black people conducted much of the CDC research. And what we're not listening to, years after a US government agency said so, is that they did NOT find that we are using condoms any less than those of other races. We are still eager to assign blame for Black MSM HIV rates. I'm looking to understand what's really going on. I know and respect David, but that doesn't mean I can't question him. I'm tired of us putting preachers and doctors on pedestals...if you ask me, the answer to HIV rates might lie somewhere there.

[Kevin Perez]

"I'm tired of us putting preachers and doctors on pedestals...if you ask me, the answer to HIV rates might lie somewhere there."

The irony in your poste, as it's the former that seems to get more attention, while the later is often ignored (religious beliefs dominate over facts, apparently)

[Robert Folan-Johnson]

At CROI 2011, the CDC's George Gillet revealed something similar. His study examined two hotbeds of the epidemic, Black and Latino men seeking sex with men. The study revealed participants sought partners within their own ethnicity or race, mistakenly believing doing so lessened the risk of exposure to HIV. The study also revealed that as members of high risk groups the men did not receive HIV testing through their regular care providers.