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.