Associations Between Internalized Homophobia and Sexual Risk Behaviors Among Young Black Men Who Have Sex With Men

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Abstract

Objective

To assess internalized homophobia (IH) and its relationship to sexual risk behaviors and prevalence of sexually transmitted infection (STIs) in a clinic-based sample of young black men who have sex with men (YBMSM).

Methods

Six hundred YBMSM completed a self-interview and provided specimens for testing. A 7-item scale assessed IH, and 19 sexual risk behaviors were assessed.

Results

In adjusted models, compared with men with less IH, those with greater IH were more likely to report: any condomless anal receptive sex (P = 0.01) and sex with women (P < 0.001). Alternatively, men with greater IH were less likely to: discuss acquired immune deficiency syndrome prevention with sex partners (P = 0.009), disclose their same sex sexual behavior to providers (P = 0.01), be tested for human immunodeficiency virus in the past 12 months (P = 0.04), report condomless oral sex (P = 0.049), and test RPR positive (P = 0.01).

Conclusions

With some exceptions, IH among YBMSM attending STI clinics may influence their sexual risk behaviors; however, STI prevalence was not associated with this construct.

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