November 12, 2002
Many theories have been put forth to explain why African American men who self-identify as heterosexual and have sex with men are at a particularly high risk for HIV. One hypothesis suggests that heterosexual African American men are not reached by the prevention messages directed at gay and bisexual communities. Another postulates that, unlike gay and bisexual men, heterosexual men do not normally circulate in social networks that reinforce sexual norms of risk reduction. Furthermore, many African American men who identify themselves as heterosexual and have sex with men are not comfortable with homosexuality or its perceived reception in the African American community. Evidence suggests that self-homophobia is linked with high-risk behavior among men who have sex with men.
Researchers found increased odds for HIV infection were associated with a decreasing age at first sexual experience and a history of injection drug use. They caution that the percentage of heterosexually identified men reporting anal sex with other men in this study is likely to be an underestimate due to the subjects' underreporting. Low condom use among this cohort could mean that self-identified heterosexual men do not consider themselves at risk for HIV infection and thus do not heed public messages about the importance of condom use.
Female partners of the men in the study are at risk for HIV transmission, given that the men in the study reported a high frequency of unprotected anal sex with women. Moreover, female partners may not know about the men's risk behavior or HIV status.
Journal of Acquired Immune Deficiency Syndromes
11.1.02; Vol. 31: 354-360; Amy Rock Wohl, Denise F. Johnson, Sharon Lu, Wilbert Jordan, Gildon Beall, Judith Currier, Paul A. Simon