Black men who have sex with men (BMSM) account for one quarter of new HIV infections in the United States each year. Yet surprisingly, BMSM are no more likely to engage in HIV-risk behaviors than non-BMSM. This suggests that factors other than sexual behavior contribute to higher HIV-infection rates. Examples of such factors include stress due to minority status, psychological vulnerabilities like depression and anxiety, and high levels of homophobia in Black communities.

Subgroups of BMSM also have sex with women (BMSMW) and may face even more specific challenges and health disparities. Black men who only have sex with men (BMSMO) were compared with BMSMW in a recently published article co-authored by members of CBAM. Researchers assessed differences in substance use, mental health and social characteristics between BMSMO and BMSMW across six US cities to assess factors particular to each group.

Compared to BMSMO, drug use was significantly higher in BMSMW, except for methamphetamine use. More BMSMW reported higher levels of depressive symptoms, lower social support levels, and higher scores of internalized homophobia. These characteristics may be associated with barriers to attaining treatment or engaging in healthier behaviors to prevent infection, thereby raising the risk of HIV infection significantly for BMSMW.

To read the full study, click here.

Dyer, T.P., Regan, R., Wilton, L., Harawa, N.T., Ou, S.S., Wang, L., Shoptaw, S. Differences in substance use, psychosocial characteristics and HIV-related sexual risk behavior between black men who have sex with men only (BMSMO) and black men who have sex with men and women (BMSMW) in six US cities. Journal of Urban Health. 2013 Jul 30 (Epub ahead of print) PMCID: PMC in progress


CBAM is a multidisciplinary center that seeks to advance the prevention and treatment of chronic illnesses, especially in communities with health disparities. As part of the UCLA Department of Family Medicine, CBAM works at the intersection of academia and community with a focus on treating addictions and preventing the spread of HIV.

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