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

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.