African American men could be putting their health at risk by avoiding disease screening, in the belief that the results might threaten their masculinity. Because they prove their masculinity through their sexuality and sexual performance, seeking medical advice including HIV/AIDS testing goes against their notion of masculinity.
Waverly Duck, a Post Doctoral Associate from the Department of Sociology at Yale University in the US, argues that current leading theories of gender and masculinity and health behavior models are not relevant enough to African American men and their distinctive notion of masculinity. His results are published online in Springer's Journal of African American Studies.
Duck studied how African American men conceptualize masculinity and how it relates to their health behaviors. Through a combination of focus groups and in-depth interviews, he asked African American men about their own understanding of their gender identity and examined how that identity, as well as how it is achieved and maintained, relates to their health.
The study found that being sexually active is an important component of African American men's notion of masculinity. Two-thirds of the participants described masculinity based on patriarchy, heterosexuality, subordination of others, economic security and physical dominance - also known as hegemonic masculinity - as the standard. However, when they are economically marginalized, sexuality and sexual performance become the means by which they prove their masculinity. Health seeking behaviors, including going to the doctor and HIV/AIDS testing, go against their notion of masculinity by potentially interfering with the freedom of their sexual activities. However, they considered it acceptable to get screened for health conditions they perceived as curable, if the cure allowed them to resume normal sexual relations.
Dr. Waverly Duck's work challenges conventional approaches to black masculinity and attempts to lay the foundation for a more nuanced way of looking at it. He argues that a new health behavior model for Black men should be developed - one that explores the link between their history and how it affects health promoting and health avoidance behaviors.
He concludes: "If men use avoiding going to the doctor to exhibit masculinity, then new strategies of health intervention should be promoted to this population. Voluntary health screening procedures for conditions such as prostate cancer, heart disease and HIV/AIDS tests should be available and conducted in hospital emergency rooms, settings where African American men frequently have contact with the medical profession."
More information: Duck W (2009). Black male sexual politics: avoidance of HIV/AIDS testing as a masculine health practice. Journal of African American Studies DOI 10.1007/s12111-009-9097-2