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.
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