Sex and gender at work, in bed, and on the street

Homophobia and the heightened HIV risk for black gay men

November 17, 2010 - 10:30 AM
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Homophobia contributes to D.C. AIDS problem (Photo: Associated Press)

In the District of Columbia, 26 percent of black men who have sex with men are HIV positive, compared to 8 percent of white men and 7 percent of Latino men who have sex with men. A new study hopes to explain that alarming divide.

Why are black gay and bisexual men at such a heightened risk of infection in D.C.? According to the study's findings, the high infection rates can't be attributed to risky sex. But widespread stigma against that sex may be to blame.

According to the study, conducted by researchers in the George Washington University School of Public Health and Health Services and the District of Columbia Department of Health, black men who have sex with men "reported fewer sexual risks than non-black" men. Of men who have sex with men in D.C., "black men had fewer male sex partners than non-black, fewer had ever engaged in intentional unprotected anal sex, and more used condoms at last anal sex," the study concluded.

The study suggested instead that HIV rates among black men who have sex with men are a result of  "nontraditional sexual risk factors": "Despite significantly higher HIV/AIDS rates, black MSM in DC Black men were less likely to have health insurance, have been tested for HIV, and disclose MSM status to health care providers," the study found. Black men were more likely to experience "barriers to disclosing MSM status and HIV testing"—barriers that could be attributed to social factors like poverty and homophobia.

A University of Washington study released this year addresses the contributions of homophobia to the epidemic. According to the study, attitudes toward homosexuality in the United States have improved markedly since the 1970s. In 1973, 71 percent of whites described homosexuality as "always wrong"; in 2008, only about half of respondents would say the same thing. But attitudes among blacks have not changed: In 2008, 72 percent of black people continued to consider homosexuality  "always wrong."

The impact of this stigma on HIV transmission becomes clear when men who have sex with men are asked to sound off on homosexuality. In the study, 27 percent of white men who had "reported same-sex sexual behavior" said that homosexuality was "always wrong." Among black men who have sex with men, that figure doubles. Fifty-seven percent of black gay men think that being gay is always wrong.

Holding "unfavorable attitudes toward homosexuality" while engaging in same-sex behavior directly contributes to the low HIV testing rate among black men. According to the study, men with negative attitudes "were about half as likely as those with more favorable attitudes to report ever having been tested for HIV." The longer these men wait to learn their status, the more likely they are to transmit HIV to others. And because men are likely to choose sex partners within their own race, race-based partner selection "further magnifies the population-level impact of what might otherwise be relatively small differences in behavior," the study says.

Homophobia can be a real health hazard to all LGBT people, regardless of race. These new figures point to a particularly disturbing corner of that stigma. As anti-gay organizations like the National Organization for Marriage target the black community in their efforts to keep homosexuality stigmatized, black men are dying.

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