Men's Sexual Risk Factors for HIV Infection: Racial Differences in Behavior, Knowledge, and Self-Perception
Tewksbury, Richard, Moore, Darin K., The Journal of Men's Studies
HIV transmission most often results from individually-induced activities. Previous research into HIV transmission has identified both high-risk groups and high-risk behaviors. This research identifies differences between white and African-American men and their participation in HIV-risk behaviors, HIV-related knowledge, and self-perceived likelihood for HIV infection. Findings show a contradiction between reported HIV-risk behaviors and self-perceived risk of contracting HIV for all male participants. Furthermore, racial differences are significantly related to both the type and number of sexual partners, participation in and frequency of condom use for various sexual activities, and levels of self-perceived knowledge of HIV/AIDS. These findings and implications on current and future HIV prevention/ intervention efforts are discussed.
HIV/AIDS has continued to grow as a deadly epidemic since its identification in 1981. Additionally, HIV/AIDS remains an epidemic in which transmission of the virus is usually centered around an individually induced behavior. Almost complete responsibility is assigned to the individual who engages in activities that either lead to one's own infection or the infection of another with the virus. It is this focus on individual behaviors--especially sexual behaviors--that has stood at the center of nearly all HIV prevention and intervention efforts.
The American experience with HIV shows very distinct, albeit dynamic, patterns regarding who experiences HIV disease. Since its initial identification, HIV has been overwhelmingly associated with men, typically gay and bisexual men. Additionally, this is a disease that has hit hardest among young adults. By the late 1980s, popular images of persons with HIV began to include persons of color, largely in response to growing recognition of HIV transmission via injection drug use. In the 1990s, the rates of transmission attributed to heterosexual sex and injection drug use have been growing steadily, but still lag far behind male-male sexual transmission. However, despite these developments, it was not until 1996 that the number of African Americans with positive HIV test results surpassed that of whites (Centers for Disease Control and Prevention, 1997). These trends in the American HIV experience strongly suggest that underlying patterns of behaviors (especially sexual behaviors) are significant influences on the epidemiology of the epidemic. It is the intent of this research to add to the literature on sexual behaviors as HIV risk factors by examining the sexual behaviors of men in a medium sized, upper-South city, focusing on differences between white and African-American men.
When considering where to focus HIV prevention efforts, researchers and health educators alike have identified high-risk groups as men between the ages of 25 and 35, not married, and African American (Lemp et al., 1994; McQuillan et al., 1994; Smith, 1991). Unfortunately, and thereby presumably contributing to continued transmissions of HIV, many members of these at-risk groups are not aware of their HIV-seropositive status (Brunswick et al., 1993), while those who are aware may refuse (for whatever reason) to obtain medical treatment (Lemp et al., 1994). Further, the vast majority of members in these high-risk groups do not perceive themselves as likely to contract the virus (Brunswick et al., 1993).
Research focusing on high-risk behaviors and their relation to HIV-seroprevalence have found various activities associated with contracting the virus. For example, marijuana use, injection drug use, same-gender sex, receptive anal intercourse, sex with multiple, and anonymous, partners, and even engaging in sexual relations with persons from California have been noted as prominent HIV-risk activities (Brunswick et al., 1993; McCusker et al. 1988; McQuillan et al., 1994). Additionally, it has been found that heavy drinking, moderate to heavy drug use, and younger age are significantly related to HIV seroconversion, as well as to other HIV-risk behaviors including the failure to use condoms during sexual activities (Penkower, Dew, Kingsley, Becker, Satz, Schaerf, & Sheridan, 1991). …