Homophobia, self-esteem, and risk for HIV among African American men who have sex with men.

Qualitative data from individual interviews with 18-29 year old African American men, who have sex with men (n = 76) were used to examine the relationship of negative attitudes toward homosexuality, self-esteem, and risk for HIV. Respondents perceived members of their communities as holding negative attitudes toward homosexuality, and many thought the African American community was less accepting of homosexuality than the white community. There was evidence that these negative attitudes are internalized by some of the young African American men themselves. Respondents mentioned several ways that negative attitudes toward homosexuality could lead to lower self-esteem and psychological distress in young gay and bisexual men. In addition, respondents articulated several mechanisms by which low self-esteem and psychological distress might be associated with sexual behaviors that put one at risk for HIV. We concluded that addressing and changing society's negative views of homosexuality are important components of a comprehensive approach to reducing the transmission of HIV, especially among young people in communities of color.