形象与健康：男性气质认知对感染艾滋病毒的非裔美国男男性行为者和双性恋男性性风险行为的影响
Image versus Health: The Role of Perceptions of Masculinity on Sexual Risk Behaviors among HIV-Positive African American Men who have Sex with Men and Women.
作者信息
Kisler Kimberly A, Williams John K
机构信息
Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, CA, USA.
出版信息
J AIDS Clin Res. 2012 Jun 3;Suppl 1(8). doi: 10.4172/2155-6113.s1-008.
BACKGROUND
HIV prevention has rarely explored the impact of childhood sexual abuse (CSA) across health domains among African American men who have sex with men and women (MSMW). Early sexual experiences may influence perceptions of gender roles, sexual identity, and risks for HIV/AIDS. The attribute of masculinity is commonly associated with strength and success. However, a legacy of racism and oppression may pose challenges for African American men in achieving gender-based milestones. Instead, proxies for success may include masculinity constructs with hypersexual posturing and prowess that contradict sexual health messages.
METHODS
Two groups, each meeting twice for 90-minutes, of HIV-positive African American MSMW participated in discussions focusing on masculinity and sexual experiences. Participants were bisexual HIV-positive African American men who engaged in unprotected sex and had histories of CSA. Discussions were recorded, transcribed, and analyzed using consensual qualitative research and a constant comparison qualitative method.
RESULTS
Participant mean age was 40.5 years (n=16). Majority had a high school education (69%), half were unemployed, and almost two-thirds earned less than $20,000 annually. Three themes, each with two subthemes, emerged that described the sociocultural context for engaging in high-risk sexual behaviors, and included: 1) the importance of inhabiting a "traditional" masculine gender role with: a) general and b) sexual masculine traits; 2) the influence of conceptions of masculinity on sexual identity with the associations: a) between being gay and being effeminate and b) between being gay and being HIV-positive, and; 3) CSA experiences with: a) appraisal of CSA and b) early sexual experiences as rites of passage.
CONCLUSION
Attempts to be masculine may contribute to high-risk sexual behaviors. Research needs to explore how early sexual experiences shape perceptions of masculinity and masculinity's influence on receiving health messages for African American MSMW who may prioritize a specific image over sexual risk reduction.
背景
在与男性和女性发生性行为的非裔美国人群体（MSMW）中，艾滋病病毒（HIV）预防工作很少探讨童年性虐待（CSA）对其各个健康领域的影响。早期性经历可能会影响对性别角色、性身份以及感染HIV/艾滋病风险的认知。男子气概这一特质通常与力量和成功相关联。然而，种族主义和压迫的遗留问题可能给非裔美国男性实现基于性别的发展阶段目标带来挑战。相反，成功的替代指标可能包括带有过度性姿态和能力的男子气概建构，这与性健康信息相矛盾。
方法
两组HIV阳性的非裔美国MSMW群体，每组进行两次时长90分钟的讨论，讨论聚焦于男子气概和性经历。参与者为双性恋HIV阳性非裔美国男性，他们有过无保护性行为且有CSA病史。讨论进行录音、转录，并采用共识定性研究和持续比较定性方法进行分析。
结果
参与者的平均年龄为40.5岁（n = 16）。大多数人拥有高中学历（69%），一半人失业，近三分之二的人年收入低于2万美元。出现了三个主题，每个主题有两个子主题，描述了参与高风险性行为的社会文化背景，包括：1）扮演“传统”男性性别角色的重要性，其中包括：a）一般男性特质和b）性方面的男性特质；2）男子气概观念对性身份的影响，其关联包括：a）同性恋与娘娘腔之间的关联，以及b）同性恋与HIV阳性之间的关联；3）CSA经历，包括：a）对CSA的评价，以及b）将早期性经历视为成人仪式。
结论
追求男子气概的尝试可能导致高风险性行为。研究需要探索早期性经历如何塑造对男子气概的认知，以及男子气概对接受健康信息的影响，对于那些可能将特定形象置于降低性风险之上的非裔美国MSMW群体而言。
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