Masculinity and HIV risk among homeless men in Los Angeles.

Abstract

HIV continues to be a serious public health problem for men who have sex with women (MSW), especially homeless MSW. Although consideration of gender has improved HIV prevention interventions, most of the research and intervention development has targeted how women’s HIV risk is affected by gender roles. The effect of gender roles on MSW has received relatively little attention. Previous studies have shown mixed results when investigating the association between internalization of masculine gender roles and HIV risk. These studies use a variety of scales that measure individual internalization of different aspects of masculinity. However, this ignores the dynamic and culturally constructed nature of gender roles. The current study uses cultural consensus analysis (CCA) to test for the existence of culturally agreed upon masculinity and gender role beliefs among homeless MSW in Los Angeles, as well as the relationship between these beliefs and HIV-related behaviors and attitudes. Interviews included 30 qualitative and 305 structured interviews with homeless MSW in Los Angeles’s Skid Row area. Analysis identified culturally relevant aspects of masculinity not represented by existing masculinity scales, primarily related to barriers to relationships with women. Behaviors, attitudes, and knowledge related to HIV were significantly associated with men’s level of agreement with the group about masculinity. The findings are discussed in light of implications for MSW HIV intervention development.

Cultural Identity Among Urban American Indian/Alaska Native Youth: Implications for Alcohol and Drug Use

“…This research is combines a CBPR approach with a clinical trial to assess the effectiveness of blending culture with current evidence-based approaches. We suggest that future research take a mixed methods approach to exploring AI/AN identity and its relationship with AOD use, including both cultural consensus and social network approaches (Bang, Medin, & Atran, 2007; Kennedy, et al, 2013). Testing for patterns of agreement with cultural beliefs (cultural consensus) combined with social network interviews could yield additional insights and precision regarding how cultural identity and other factors combine to affect AOD use among AI/AN youth.…”

Masculinity and HIV: Dimensions of Masculine Norms that Contribute to Men’s HIV-Related Sexual Behaviors

“…Numerous studies have documented the relationship between norms of masculinity and HIV-related sexual behaviors in settings across the globe (8–27). These studies use a variety of measures (e.g.…”

Condoms and Contexts: Profiles of Sexual Risk and Safety Among Young Heterosexually Active Men

“…Heterosexual men’s behavior is important to controlling the epidemic of STIs and HIV for heterosexual women as well as for men themselves, but until recently, research on heterosexual risk reduction has focused more on women (Bowleg et al, 2013; Edwards, Barber & Dziurawiec, 2013; Exner, Gardos, Seal & Ehrhardt, 1999; Higgins, Hoffman & Dworkin, 2010; Kennedy et al, 2013; Phillips & Pirkle, 2011). While this is partly because disease transmission is more efficient from men to women than vice versa (Haverkost & Quinn, 1995), this state of affairs also parallels tendencies to emphasize the vulnerability of women (Dworkin, 2005) and to place responsibility for protection on them (Campbell, 1995).…”

“…Research on the sexual risk of men who have sex with women has increased in the 21 st century (e.g., Bowleg et al, 2013; French & Holland, 2013; Kennedy et al, 2013; Kershaw, Arnold, Gordon, Magriples, & Niccolai, 2012; Oparanozie, Sales, DiClemente & Braxton, 2012; O’Sullivan, Hoffman, Harrison & Dolezal, 2006; Walsh, Senn, Scott-Sheldon, Vanable, & Carey, 2012). Factors such as masculinity norms and heterosexual scripts influence men’s sexual behavior in ways that may increase risk both for them and their female partners (Santana, Raj, Decker, LaMarche & Silverman, 2006; Wade, 2008), and men differ in the extent to which their behavior conforms to these scripts (Masters, Casey, Wells & Morrison, 2013).…”