Race-Based Sexual Stereotypes and HIV Risk in Young Men Who Have Sex with Men

Background: Men who have sex with men (MSM) account for more than half of new HIV infections each year, and Black MSM between the ages of 13-29 experience the highest HIV incidence rates. Black MSM have not been found to engage in more HIV risk behaviors, and it has been proposed that patterns of racial in-group and out-group sexual partnering may be contributing to their disproportionate risk.  Emerging evidence further suggests that race-based sexual stereotypes may be driving these patterns of sexual partnering, but little is known about how these stereotypes influence sexual risk behavior.

Methods: Participants were 262 young MSM (YMSM) from an ongoing longitudinal study designed to analyze predictors of HIV risk and seroconversion in YMSM. Data for these analyses were taken from 3 waves of data collection (18-month reporting window), with 85.2% and 81.2% retention at 6- and 12-month follow-up waves, respectively. At each time point, participants were asked to report on their 3 most recent sexual relationships during the past 6 months, resulting in 9 possible partnerships per participant. Participants also reported endorsement of race-based sexual stereotypes (i.e., perceived masculinity and femininity during sexual behavior) for Black, White and Latino sexual partners. All analyses were conducted with Hierarchical Linear Modeling.

Results: Across the three largest racial groups represented in this study (Black, White and Latino), YMSM were significantly more likely to report preferring to have sex with members of their own racial group than members of other groups, and YMSM were significantly more likely to have sexual partners of their same race during the 18-month assessment period. In terms of sexual risk behavior, analyses found significant interactions between race-based sexual stereotypes and sexual partner’s race in predicting likelihood of condom use with partners.  For example, participants who endorsed more masculine sexual stereotypes for Black partners were more likely to have unprotected sex with their Black partners compared to those who did not endorse these stereotypes (ERR = 1.48, p < .05).

Conclusions: Emerging evidence suggests that the elevated HIV incidence in MSM may be explained by patterns of racial in-group and out-group sexual partnering. Our findings support the assertion that YMSM are more likely to have same-race sexual partners than partners of other racial groups. What’s more, race-based sexual stereotypes appear to influence decisions about condom use in both same- and cross-race sexual partnerships, and these patterns of sexual risk behavior may drive infections into the smaller networks of YMSM of color. Implications of these findings for public health messaging and intervention will be discussed.