African Americans face the most severe burden of HIV among other racial and ethnic groups in the United States. Despite representing only 14% of the US population in 2009, African Americans accounted for 44% of all new HIV infections in that year (Center for Disease Control, 2011). While the overall incidence of HIV in the US did not change significantly from 2006-2009, there was a 21% increase in people 13-29 years of age and a 34% increase in men who have sex with men. Among the 13-29 age groups, only MSM experienced an increase, and among MSM aged 13-29, there was a significantly greater increase among African American MSM. Overall, there was a 48% increase in African-American men who have sex with men (Prejean, Song, Hernandex, Ziebell, Green & Walker, 2011).
Furthermore, in 2009, 57% of the 11,200 new HIV infections among women occurred in African American women and the vast majority (80%) of the new cases were due to heterosexual transmission (Prejean, et al., 2011). Research has suggested that there are some African-American men who do not self-identify as gay or bisexual, but do in fact have sex with both men and women (Millet, Malebranche, Mason & Spikes, 2005). This phenomenon may be one explanation for the increased rates of HIV transmission to African- American women (Millet,et al., 2005). Black men appear more likely to be behaviorally bisexual than men of other racial groups (Montgomery, Mokotoff, Gentry & Blair, 2003). However, despite attention to this phenomenon of African American males, there is no empirical evidence that this is uniquely African American or responsible for increased HIV infection among African Americans (Millet, et al., 2005; Bond, Wheeler, Millett, LaPollo, Carson & Liau, 2009).
Male African-American college students are at particularly high risk for HIV infection. Between 2000 and 2003, 11% of men ages 18-30 years who were newly infected were enrolled in college at the time of their diagnosis, and 87% of those college students were African American (Hightow, MacDonald, Pilcher, Kaplan, Foust, Nguyen & Leone, 2005). An examination of HIV transmission among men ages 18-30 years in North Carolina found that 15% of the men reported sexual contact with both men and women in the year prior to their diagnosis. Bisexual men were more likely than men who exclusively had sex with men to be African American and enrolled in college (Hightow, Leone, MacDonald, McCoy, Sampson & Kaplan, 2006).
Although all men and women, regardless of sexual orientation, race and ethnicity have a process for sexual identity, this study focuses on African Americans because they are disproportionately affected by the disease and it is essential to implement culturally appropriate interventions to address this disparity. It is important to understand African American men's sexuality and views of homosexuality in order to implement the best strategies that will assist them in protecting themselves and their partners. Therefore, a first step in addressing the spread of HIV in African American college students is to gain insight into African American male sexuality and sexual identity development. Such information could shed light on the factors that drive sexual risk behaviors among young, college-aged African-American men. Research on the sexual experiences of African-American men, however, has typically focused primarily on their behaviors; little work has been done to understand how these men develop their sexual identities (Wyatt, Williams & Myers, 2008). Furthermore, most of the work on the sexuality of African-American men has ignored heterogeneity, developmental change, and the context in which sexual behaviors occur (Lewis & Kertzner, 2002).
Finally, little research has been done with African-American college men despite the importance of understanding the context of their sexual behaviors (Hightow, et al., 2006).
To gain insight into the role that sexual identity may play in the lives of African-American men, we interviewed African-American male college students in a historically Black college and university (HBCU) located in the central Piedmont region of North Carolina in one of the largest cities in the state. Specifically, we explored the language, meaning and dimensions of sexual identity and factors influencing the sexual identity development process. The study had two goals: 1) to assess men's ideas about gender, sexuality, and sexual behavior, and 2) to identify ways in which an understanding of sexual identity development might inform appropriate and effective sexual health interventions.
This exploratory study used a qualitative design to investigate the sexual identity development of African-American college men. We conducted semi-structured interviews with African-American male college students to solicit information about their experiences, attitudes, and beliefs about sexual identity development and sexual activity. The interviews took place during November 2010. The undergraduate population at this HBCU is 89% African-American and 46% male.
Thirty-one African-American male undergraduate students participated in one-on-one interviews. Participants were recruited through fliers, texting, and Twitter communications sent by recruiting assistants as well as by word of mouth. To be eligible, participants had to 1) be enrolled in the university as a part-time or full-time student; 2) self-identify as a black and/or African-American male; 3) be between the ages of 18 and 25; 4) be conversant in English; and 5) be able to provide consent. Participants received a $40 gift card for their participation in the study.
Given the study's focus on participants' subjective experiences and views of sexual behaviors, a qualitative method was chosen. A qualitative approach explores individual experiences by using dialogue and emergent themes that delve beneath...