Effects of Gender Role Expectations on the Health of Black Heterosexual Men: A Lesson in Intersectionality translation missing: zh.hyrax.visibility.files_restricted.text

DeSousa Williams, Nancy Silva (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/6w924c650?locale=zh


Although Black men contract HIV through heterosexual sex more than white men, they are often ignored in the realm of HIV prevention. Studies have shown that masculinity and the construction of manhood among Black heterosexual men (BHM) impact health decisions and sexual behaviors have typically failed to examine the mechanisms through which racialized gender role expectations affect men's beliefs and behaviors to subsequently impact health.

Answering the call for more research on theories of the role of gender in HIV prevention interventions among BHM, this dissertation uses an intersectional lens to examine how racialized gender role expectations affect BHM's sexual and mental health. We undertook a mixed methods study examining relationships between gender role strain (GRS), depression, racism experiences, age, and socioeconomic status (SES) on sexual scripts and subsequent sexual behaviors using both a structural equation model (SEM) (N=379) and qualitative research methods (N=26) in a diverse group of BHM.

Gender role expectations, experiences of GRS, and sexual scripts all differed by age, SES, and other salient identities. In the SEM, GRS was associated with sexual concurrency, depression, and racial discrimination, yet did not have an association with SES. However, the qualitative data illuminated differences such as men of higher SES feeling more pressure to combat negative racial stereotypes and men of lower SES experiencing more pressure to "prove one's manhood" through violence. Other salient gender role expectations consisted of providing for family and emotional restriction, both of which had racial components to how they were expressed. Older BHM experienced less GRS, were less likely to be influenced by peers in sexual scripts, or engage in high risk sexual behaviors.

Taken together, findings emphasize the need to explore the mental and sexual health of BHM through an intersectional lens. Researchers and practitioners working with BHM must not only address the effects of racism and gender role expectations on their health, but also identify how other salient identities, such as age and SES, and intersect with dominant systems of oppression and privilege in the lived experiences of BHM. Intersectionality is essential when creating culturally appropriate interventions for this population.

Table of Contents

Chapter 1. Literature Review

Introduction 2 BHM Risk for HIV and Other STIs 5 Limitations of Current Research 16 Black Men's Masculinity 19 Conceptual Model and Theoretical Frameworks 27 Significance and Aims of Research 38 References 46

Chapter 2. Intersectional Analysis of Gender Role Stress on Sexual

Behaviors of Black Heterosexual Men: A Structural Equation Model

Introduction 73 Method 78 Results 83 Discussion 86 References 100

Chapter 3. "You Have to Be a Superhero because There Are So Many Villains:" An Intersectional exploration of gender role strain among Black Heterosexual Men

Introduction 112 Method 117 Results 123 Discussion 145 References 154

Chapter 4: Gendered Sexual Scripts of Black Heterosexual Men

Introduction 167 Method 172 Results 176 Discussion 195 References 201

Chapter 5: Conclusion

Main Findings 212 Evaluation of the Dissertation Research 222 Implications for Research and Practice 227 Conclusion 235 References 240 Table of Tables 2.1. Sample Characteristics 92 2.2.

Correlation Coefficients of Observed Indicator Variables

93 2.3

Parameter Estimates and Significance Levels for Final Model

94 3.1 Participant Characteristics 153 4.1 Participant Characteristics 200 Table of Figures 1.1 Conceptual Models 42 2.1 Conceptual Model of Structural Equation 96 2.2

Measurement Model of Latent Variables of Socioeconomic Status

97 2.3 Structural Equation of Hypothesized Model 98 2.4 Structural Equation of Modified Model 99 5.1 Conceptual Model 236

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