Professional Psychotherapy &
Sven Schild, PhD
IDENTITY DEVELOPMENT RACIAL AND SEXUAL IDENTITY DEVELOPMENT AND
ATTITUDES TOWARD HIV/AIDS
Disproportionately high HIV and AIDS incidence rates for African Americans have been reported nationwide (CDC, 1990; Flora, MDMH, 2000; Wolitski, Valdiserri, Denning, & Levine, 2001; Wright, 1993). HIV infection and the resulting AIDS disease are the leading causes of death among Black men between the ages of twenty-five and forty-four and the second leading cause of death among Black women in the United States (Boykin, 1997). In 1999, the AIDS incidence rates among Black men who have sex with other men (MSM) were five times higher than for White MSM (Wolitski et al., 2001).
In a ten-year review of the literature pertaining to gay, lesbian, and bisexual issues, Soto (1997) discovered that less than five-percent of the journal articles reviewed focused primarily on race or ethnicity. Even less research has been conducted that explores the interaction between racial and sexual identity development. Scarcer yet are studies that examine issues related to HIV/AIDS among racial/ethnic minorities. For example, in a literature review examining 40 articles in 28 journals covering the period from 1988-1993 on lesbians and gays of color and HIV/AIDS, Kuszelewics and Lloyd (1995) noted a paucity of research addressing both race and HIV/AIDS adequately. Although further studies on HIV/AIDS and race have been conducted since 1993, Black gay men are still a difficult population to locate in the current research literature. This is particularly disconcerting, given the disproportionately high rates of HIV/AIDS observed among African Americans. Not surprisingly, there has been a call for research that explores issues concerning HIV/AIDS among African Americans (e.g., Kuszelewics & Lloyd, 1995), and particularly among gay African Americans (e.g., Hawkeswood, 1996). Heeding this call, the present study examined the relationships among attitudes toward HIV/AIDS, and racial and sexual identity development among Black men who have sex with other men.
Specifically, this study explored the relationships between fear of AIDS (as measured by the Attitudes Towards AIDS Scale; ATAS) and racial and sexual identity development (as measured by the Racial Identity Attitude Scale-B; RIAS-B and the Gay and Lesbian Identity Attitude Scale; GLIAS, respectively) among a sample of 35 Black men who were at least 18 years old (M = 33, SD = 7.87) and whose sexual orientation was toward other men. Participants were recruited from a midwestern metropolitan area and from the Internet. In addition to the measures of interest, participants also completed a socio-demographic questionnaire. It was hypothesized that internalization of one’s gay male identity (as measured by the GLIAS) would be positively correlated with holding accepting attitudes towards HIV/AIDS (as measured by the ATAS). A second hypothesis was that internalization of one’s racial identity (as measured by the RIAS) would be positively correlated with holding more accepting attitudes towards HIV/AIDS (as measured by the ATAS).
The first hypothesis predicted a negative correlation between Pre-Encounter attitudes on the GLIAS and ATAS scores and a positive correlation between Internalization attitudes on the GLIAS and ATAS scores. As predicted, results revealed a significant negative correlation between Pre-Encounter and ATAS scores (r(35) = -.34, p < .05) and a significant positive correlation between Internalization and ATAS scores (r(35) = .44, p <.01). The second hypothesis predicted a negative correlation between Pre-Encounter attitudes on the RIAS-B and ATAS scores and a positive correlation between Internalization attitudes on the RIAS-B and ATAS scores. Results did not support these predictions. However, scores on the Encounter subscale of the RIAS-B were negatively correlated with ATAS scores (r(35) = -.37, p <.05), suggesting that those in the Encounter stage of racial identity development tended to hold less accepting attitudes toward AIDS. There were no significant relationships among ATAS scores and the socio-demographic variables included in the study (e.g., age, income level, education level, religious involvement). Post-hoc analyses revealed positive correlations between (1) RIAS-B Pre-Encounter and GLIAS Pre-Encounter scores (r(35) = .41, p <.05), (2) RIAS-B Pre-Encounter and GLIAS Encounter scores (r(35) = .37, p <.05), and (3) RIAS-B Immersion/Emersion and GLIAS Encounter scores (r(35) = .41, p <.05).
Findings are consistent with racial identity theory, which suggests that those in the Encounter stage of racial identity development are likely to struggle with a mixture of feelings, such as confusion, anxiety, depression, and anger (Helms, 1990). For instance, fear regarding AIDS might be an additional factor with which individuals struggle during this stage. As suggested by Helms (1990), attitudes during the Encounter stage can be related to one’s reference-group orientation. This might explain seemingly contradictory findings in which those in the Encounter stage of sexual identity development tended to hold more accepting attitudes toward AIDS, whereas those in the Encounter stage of racial identity development tended to hold less accepting attitudes toward AIDS. Perhaps those who hold the gay community as their primary reference group, as compared to those who hold the Black community as their primary reference group, are more likely to hold more accepting attitudes towards AIDS. The positive correlations found between Pre-Encounter scores on the RIAS-B and the GLIAS suggest a parallel developmental process at the beginning of racial and sexual identity development, such that those who initially embrace the assumptions of the dominant U.S. culture might tend to favor heterosexuality and Whiteness. However, when triggered by some internal or external event in the Encounter stage, racial and sexual development might begin to occur independently and at different rates from one another.
Results of the study should be considered when designing HIV/AIDS prevention programs. For instance, more effective interventions might be designed via considering the racial and sexual identity development of members of the target audience. These and related implications are discussed in further detail. Limitations of the study and suggestions for future research are also presented.