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A second common sexual script, similar to the first, describes the roles and expectations that accompany being a top or bottom. Seventeen 17 of the friend pairs discussed these roles and how they related to social interactions and status.
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Participants revealed that they were often asked to define their preferred sexual position regardless of the type of venue i. A consensus among the participants was that sexual position designation was significant and that only individuals who identified as versatile could have sex with anyone — tops could only be with bottoms, and vice versa.
However, while roles were fixed in the present, they did sometimes change over time. Several participants who identified as bottoms provided a financial incentive for their preference, such as receiving gifts for having sex with tops.
The financial basis for being a bottom can be explained, in part, by socioeconomic disadvantage among many participants, and the complex interplay between education, employment, and culture in relation to sexual decision-making. Only one priority participant had a college degree and, as noted in Table 1 , only nine were employed on a full-time basis. From the community presentation of our results, we gained further insight into this phenomenon.
Therefore, while bottoms often socialised with each other in groups, tops were more likely to socialise with their heterosexual friends and to be isolated from the Black gay community. The power differential between bottoms and tops was presented in terms of the sexual dominance and status of the older partner. However, the age-power dynamic could also operate in reverse. Clear sub-scripts for social preference and esteem for tops segued into the next theme. In one dyad, Paul priority participant and Patrick friend , who both maintain online dating profiles in which they present themselves as women, declared that trade men are the ones most likely to show interest in them, as opposed to men who are openly gay.
Trade men's sexual power and status within the gay Black community were offset by the interviewees' concerns about their putative bridging role in the HIV epidemic. When asked about how public health programmes could educate young Black men who have sex with men about HIV prevention, Hunter priority participant pointed out that trade men's activities should be addressed as a public health priority:.
These [prevention programmes] are biased against gay people, because like I said, we are catching these things from trade [men]. But trades are not going to come to no gay centre, so they [programmes] need to go where they are, not just be for gay people. In sum, a sexual script in which trade men were viewed as risky centred on their power to exert control over sexual decision-making while avoiding condom use, a problem that prevention programmes could address.
More surprising was the belief about trade men being risky precisely because they had sex with women, a perception aligned to young Black men who have sex with men's certainty that closeted men have women partners.
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These attributions were likened to the gendered power dynamics of heterosexual relationships. Projections of blame for lack of condom use were therefore deeply gendered and were attributed to denigrated femininity in heterosexual or gay relationships, further stigmatising the bottoms. The power relations that were identified in this study help to explain the dynamics of HIV risk among young Black men who have sex with men in the Deep South.
This dialectic had two purposes: dispensing with social niceties in order to get to the business of hooking up, and reinforcing a social order in which tops dictated the terms because of their superordinate status. The lack of self-empowerment among young Black men who have sex with men in relation to condom use with trade men, who were considered to be desirable, elusive, and a source of financial support, helps to explain the alarmingly high HIV rates among such men in the USA Rosenberg et al.
Being a bottom in such encounters raises the risk of HIV by a factor of 13 compared to someone who engages in penetrative sex without a condom CDC a. Sexual mores among young Black men who have sex with men were shaped and influenced by the African American community at large.
Homophobia is especially pronounced in the US Deep South, where Black church leaders strongly oppose homosexuality on biblical grounds Cleek , and where the participants self-identified as bisexual for privacy's sake. The second point relates to living in the racially divided South.
One explanation for this division is that the scripts are a natural extension of fixed gender norms in the Black community more broadly, which Fields et al. Social class differences added another layer of difference for young Black men of limited means who actively seek trade men as a source of financial support. The paradox of the non-gay-identified trade man is that his exalted role among the participants was offset by fears of acquiring HIV from them.
This perception deserves clarification in terms of actual risk factors among behaviourally bisexual Black men. As Ford et al. In fact, some authors have suggested that the literature's appropriation of the term has served further to pathologies Black men's sexuality as overly aggressive or extreme Saleh and Operario Rather than these drivers being viewed as risky because of the element of sexual exchange, we found that young Black men who have sex with men ascribed their vulnerability to dominant partners who called the shots and whose everyday lives were less knowable or controlled by gay sexual norms, scripts, or reputation.
For this reason, the participants believed that it would be productive to engage behaviourally bisexual men for HIV prevention efforts. This fatalism may result from the homophobia and social exclusion reported here, as well as structural barriers such as unemployment and unstable housing that prevent young Black men who have sex with men from becoming financially independent Hicks In terms of the parallels between Black men who have sex with men and Black women's experience of HIV risk as proposed at the beginning of this article see Underwood's [] history of such parallels , we found that culturally-informed sexual scripts define both genders, although being the receptive partner is clearly riskier for Black men.
For instance, the financial arrangements that we have identified among young Black men who have sex with men mirror Black women's exposure to HIV risk in low-income settings. In both cases, male partners are often older, wealthier, and exercise gendered power, not only through unilateral decisions about condom use and concurrency but also through expectations of gift giving, child support, and other incentives Lichtenstein Interestingly, Masvawure et al.
Even in this transactional context, the men's identity was constructed through a femme-phobic lens. With reference to the USA, Fields et al. There are some limitations that are noteworthy. First, the data were based on self-report and therefore, bias is possible—although having two parties in dyadic interviews could act as a validity check.
This article has identified gender norms, behavioural risks, and cultural scripts for sex that fuel the HIV epidemic among young Black men who have sex with men in a US Deep South locale. The financial and status elements of these arrangements are a barrier to traditional prevention methods such as condoms, and call for adjunctive prophylaxis such as PrEP or PEP that have been likened to birth control options for women because they do not require negotiation with a partner Mutchler et al. In parallel to self-empowerment strategies for women, these methods offer a path to independent decision-making without a dominant partner's knowledge or permission.
However, the US South is notable for the lack of access to biomedical methods for HIV prevention compared to other regions Rosenberg et al Elopre et al. The findings of this article identify the urgent need for alternatives to condom use in order to stem the hyperendemicity of HIV infection in this vulnerable population, including new scripts and strategies for risk reduction that would bring the Deep South into line with the life-saving interventions that are available in many areas of the United States and the globe.
Our finding that young Black men who have sex with men feel vulnerable in transactional relationships could be used to promote such methods, thus providing a person-based incentive for PrEP uptake. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Read article at publisher's site DOI : To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation.
Arch Sex Behav , 47 1 , 21 Feb Signorielli N. J Adolesc Health Care , 11 1 , 01 Jan Cited by: 5 articles PMID: Coronavirus: Find the latest articles and preprints. Europe PMC requires Javascript to function effectively. Recent Activity. Recent history Saved searches.
Search articles by 'Bronwen Lichtenstein'. Lichtenstein B 1 ,. Search articles by 'Emma Sophia Kay'. Kay ES 2 ,. Search articles by 'Ian Klinger'. Klinger I 3 ,. Search articles by 'Matt G Mutchler'. Mutchler MG 3. Affiliations 1 author 1. Share this article Share with email Share with twitter Share with linkedin Share with facebook. Three main themes emerged from the study: the power dynamics of 'top' and 'bottom' sexual positions for condom use; gender stereotyping in the iconic style of the 'I Love Lucy' show of the s; and the sexual dominance of 'trade' men. Gender stereotyping was attributed to the cultural mores of Black families in the South, to the preferences of 'trade' men who exerted sexual and financial control and to internalised stigma relating to being Black, gay and marginalised.
The findings suggest that HIV prevention education for young Black men who have sex with men is misguided if gendered power dynamics are ignored, and that funded access to self-protective strategies such as pre-exposure prophylaxis and post-exposure prophylaxis could reduce HIV risk for this severely affected population.
Free full text. Cult Health Sex. Author manuscript; available in PMC Mar 1. PMID: Mutchler c. Matt G. Author information Copyright and License information Disclaimer. Copyright notice.