Urban Low-Income African American Men, HIV/AIDS, and Gender Identity Author(s): Tony L.

Whitehead Source: Medical Anthropology Quarterly, New Series, Vol. 11, No. 4 (Dec., 1997), pp. 411-447 Published by: Blackwell Publishing on behalf of the American Anthropological Association Stable URL: http://www.jstor.org/stable/649531 Accessed: 29/01/2010 19:19
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ARTICLES

TONY L. WHITEHEAD

Of Anthropology Department UniversityOf Maryland

Urban Low-Income African American Men, HIV/AIDS, and Gender Identity

In a 1993 Human Organization article, Jerome Wright called for more research on African American male sexual behavior and the risk for HIV infection. The present article is a response to that call. Wright pointed out a well-known fact of HIVAIDSprevention programs: such programs have not been very successful in reaching low-income African American males. The present article suggests that perhaps the key to better understanding sex-related health-risk behavior is to conduct more systematic research on gender identity, and the historical and sociocultural origins of such identities. I argue that if we are truly interested in developing effective HIV/AIDS programs targeting low-income African American males, then the sociocultural "meanings" that this population attaches to AIDS-related phenomena must be understood in the broader contexts ofAmerican constructs of masculinity, and in the real and perceived experiences of black men in America. Data from several ethnographic and qualitative research projects carried out among low-income African American male and female residents of Baltimore, other parts of Maryland, and Washington, D.C. are used in support of my primary arguments. [HIV/AIDS,

African American Males, Gender Constructs, Sociocultural Meaning, PlantationAmerica]

n the United States, ethnic minority groups, particularlyAfrican Americans in morbidityand mortalityfrom the (and Hispanics) sufferdisproportionately humanimmunodeficiency virusand the acquiredimmunodeficiency syndrome (HIV/AIDS).Between June 1981 and October1995, 501,310 cases of AIDS were
MedicalAnthropologyQuarterly11(4):411-447. Copyright? 1997 AmericanAnthropological Association.

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reportedto the U.S. Centers for Disease Control and Prevention (CDC), and to have died (CDC 1995).Thirty-four 311,381 (62%)werereported percentof these 12 percent of the U.S. population (CDC 1995; Wright 1993). Among newly diagnosedcases, 38 percentare AfricanAmericans.In areasheavily populatedby AfricanAmericans,the prevalenceamong blacks is even higher.For example, in Washington,D.C., where AfricanAmericanscomprise66 percentof the population, 81.1 percentof AIDS cases in 1993 were amongAfricanAmericans.This was a jumpfrom62.8 percentof its AIDS cases in 1988. In actualnumbers,we saw an increasein AIDS cases amongAfricanAmericansin theDistrictfrom 362 cases to 975 cases, an increaseof 169 percentin just 5 years.In additionto greaterincidence and prevalencerates,it has also been documentedthatAfricanAmericanssurvive for a shorterperiod than whites, after having been diagnosed with AIDS (CDC 1986; Duh 1991). The disparitybetween blacks and whites is even greateramong the female population, amongwomen of child bearingage, andamong youth.Alparticularly though African American women make up only 13 percent of the U.S. female population,they representan astounding53 percentof all AIDS cases among females. While AIDS presently ranks among the top ten causes of death for all Americanwomen in theirchildbearingyears,it is one of the top five killers of AfricanAmericanwomen. In New York City, where 84 percentof the adultfemale AIDS cases are black or Hispanic,AIDS is now the numberone killer of women betweenthe ages of 25 and 34. While the problemof HIV disease amongAfricanAmericanwomen andchildrenis a cause for alarm,thereis also a need to give more attentionto the AIDSrelatedproblemsof African Americanmen. The evidence shows that a primary methodof contracting HIV/AIDS for AfricanAmericanwomen is throughsexual with male relationships partnerswho are injection drug users (IDUs) (Wright 1993). In the winter 1993 issue of Human Organization,JeromeWrightpointed out that even though the role played by African Americanmen in the spreadof HIV diseasein theircommunitiesis a significantone, thereis still surprisingly very little research on this population.Wrightcites the workof Schilling andcolleagues (1989) who found thatthe problemis exacerbated by the fact thatIDUs who have begun to engage in saferdrugbehaviors(e.g., less sharingof needles) continueto practiceunsafesexual behavior.Also, AfricanAmericanmale IDUs are also more likely to have multipleIDU female partners,accordingto Freucht,Stephens,and Roman(1990, cited in Wright1993). Because of these relationships between drug use andsexualbehavior,Wrightpoints out thatfor the IDU segmentof the African Americancommunity,"AIDSis often a disease of the whole family, fathers,mothers and theiroffspring"(1993:43). Factorsrelatedto poverty,culturaldifferences,differentialaccess to care,and distrustof the formalhealthcare system, combinedwith otherfactors,aremaking the challengeof AIDS a difficult one, particularly with regardto AfricanAmericans andotherethnicminorities.The purposeof the presentarticleis to contribute to ourunderstanding of the perceptionof HIV disease,the riskbehaviorsfor transmitting the disease, and the sociocultural contexts for transmissionamong lowincome, inner-cityAfricanAmericans.'The articlereportson a numberof qualitative researchstudiescarriedout with personsof these demographiccharacteristics
cases were among African Americans, although this ethnic group makes up only

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between 1989 and 1992 in Baltimore,otherMarylandlocations,and Washington, D.C. The findings from these studies are then discussed in broaderhistoricaland socioculturalcontexts and processes as explorationsinto why AfricanAmericans sufferdisproportionately from this illness. Research Methods The findingsin this articlearebased on qualitativedatacollected by members of the Cultural Systems Analysis Group(CuSAG),an appliedresearchand technical assistanceunit of the Department of Anthropologyat the Universityof Maryland, College Park(UMCP). Between the fall of 1989 (the year CuSAG was initiated) and the spring of 1992, CuSAG was involved in eight AIDS-related qualitativeresearchand technicalassistanceprojectsin Baltimore,otherMaryland locations, and Washington,D.C. Throughopen-ended,group, and ethnographic interviews,and full neighborhoodethnographies,we interviewedmore than 600 men and women in these studies.Because this articlefocuses more on the families and social marginality of black men, most of the datafor this articlecame fromour interviewswith the more than350 males thatwe have interviewed. The ages of the males we interviewedrangedfrom 10 to 49 years, with most falling between 14 and 29 years. They were recruitedwith the assistanceof researchassistantswho residedin the study neighborhoods, from community-based organizations,health departmentsand other public agencies, STD and pediatric clinics, and throughnetwork"snowball"techniques.Because methodsof recruitmentvariedandwere nonrandom, and interviewingmethodsvaried,the interpretations provided here are only exploratory,raising issues that require more systematic research.The readeris also warned against generalizing to all African Americans,or to all low-income African Americans,or to all AfricanAmericans or low-income AfricanAmericansresiding in BaltimoreandWashington,D.C. Masculine Gender Identity: Homosexuals, Gays, "Real Men," and Safe Sex While HIV/AIDS in the United States is no longer viewed as primarilya "gay"disease, there is an ongoing problem with developing effectiveprevention programstargetingblack men who have sex with other men (MSWMs).2When HIV was firstdiagnosedduringthe 1980s, the disease was overwhelminglyassociated withhomosexualmen, and numerouspreventionprograms emergedtargeting this population.These programs,which emphasized"safe sex" practicessuch as the use of condoms and single partnersexual relationships, have had some impact on changingthe risk behaviorsof white middle-classhomosexualmen. They have had little if any impact,however,on AfricanAmericanmen involved in homosexual activities(men who identify themselves as homosexuals,as well as those who do not identify themselves as such, but periodically have sex with other men) (Bowser 1994). Moreover,as Hawkeswood(1993) foundin his study of 156 uninfected black gay men, almost all (98%) of the sample believed that AIDS was mainly a gay men's illness. At the same time, one thirdof the men thoughtthat it was a disease peculiarto "white"gay males. These findings corroborate those of Wright(1993) thathomosexualAfricanAmericanmen use the wordgay as a label for white homosexuals,but not for themselves. Wright's(1993) principalthesis is

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thatthe presentcategorizationof men as heterosexual,bisexual, andgay or homosexual is inadequatefor assessing the sexual behaviorsof AfricanAmericanmen who put themselves, theirpartners, and theirchildrenat risk for HIV disease. His alternativeis a more useful categorization of (1) men whose sexual activities are men who are homosexualand occasionally totally homosexual;(2) predominantly men whose sexual activities are heterosexualbut heterosexual;(3) predominantly men whose sexual activities are bisexual, that is, occasionally homosexual; (4) and homosexual and men whose sexual activitiesareexheterosexual; (5) equally heterosexual (with females). clusively Categories 3 and 4 include complicatedattitudinaland behavioralpatterns thatput such men andtheirpartners at risk.Withinthe thirdgroup,homosexualencountersserve usually to meet sexualand sometimeseconomic needs;but the selfidentityof these men is often heterosexual.This genderidentity,Wrightsuggests, is sustainedby: (1) maintaining with women;and (2) in homosexualrelationships sexual encounters,being the passive partnerin oral sex and the active partnerin anal sex. Wrightfound that therewere men in category 4 (bisexuals)for whom maintaining heterosexualrelationshipsmade them "feel complete,"or protectedthem from the stigma of being viewed as being exclusively homosexual. Moreover, Wrightfoundmen in categories3 and4 who sharedthe common belief thatas long in analsex andpassive in oralsex, the "inserter" as they were the activepartners (of 3they would not contractHIV. At the same time, the penis) andnot the "insertee," The problemof HIV transmissuch males seldom use condomswith eitherpartner. sion is exacerbated, accordingto Wright,becausethese men rejecthealthcareprogramsthatfocus on homosexualsor homosexuality. Thereis a particular of males thatcuts acrossWright'sthirdand subcategory
fourth categories: the male who self-identifies as heterosexual, but engages in homosexual activities in exchange for money, drugs, or other commercial goods or

services. There are at least two ways thatsuch activitiesput networksof people at in unprotected risk for HIV transmission.The first is their frequentparticipation homosexual activities with numerouspartners.Peterson and colleagues (1992) found in their study of 250 randomlyselected homosexual and bisexual men that men who were low income andhad been paid for sex were less likely to use conwith publiclydisclosing doms. They also found thatmen who were uncomfortable anal intercourse. theirhomosexualitywere more likely to practiceunprotected The second problemis relatedto the fact thatsome of these males vigorously pursueheterosexualrelationshipsto maintaintheir identity as "realmen"and not in commercial "fags."In his study,Wright(1993) found thatmen who participate homosexualactivities will frequentlynot use condomsbecause, they say, theirclients or theirfemale partners don't wantthemto. They also statethatif they initiate the latterwill thinkthey have been the use of condoms with theirfemale partners, "fooling around"(having sex with other women). Bisexual males who engage in HIV themcommercialhomosexual activitiesarethus at greatrisk for contracting selves as well as for being conduitsfor the transmissionof the virus betweenheterosexualand homosexualpopulations.4

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Constructs of Sociocultural Meaning: What's Wrong with Condoms? Anotherproblemwith healthprogramsthatadvocatethe use of condoms for preventingtransmissionof HIV is that merely increasingone's knowledge often does not necessarilylead to behavioralchange. A plethoraof evidence now exists thatincreasedknowledgealone rarelydoes lead to such change.CuSAG studiesin Baltimore(Whitehead1990a, 1990b, 1992b, 1993, and 1996) have consistentlyrevealed thateven though a study populationmay have a very high level of knowledge abouthow to preventthe spreadof HIV throughthe use of condoms, condoms are still seldom used. The 270 men (98 percent African Americans) interviewedby CuSAG in BaltimoreandD.C. voiced a rangeof reasonsfor dislik"condomscut off my ing condoms:"condomsare irritatingand uncomfortable"; "condomsbreakeasily ... circulation"; "theymakeyou lose [sexual]momentum"; if you do some seriousstroking,man, themthingsyou know, they pop";"theytake away thatgood sexy feeling"; and "I just don't like them,"and "I just don't use them!" Thesefindingsarenot new. Since the early 1960s, male oppositionto condom use has been broadly documentedcross-culturallyin scores of national family planningknowledge, attitudes,and practice(KAP) surveys and elsewhere. Since the mid-1980s, AIDS preventionstudieshave contributed to this knowledgebase. Yet the condom is still broadly advocated as the primarymode of HIV/AIDS prevention.Moreover,family planningand HIV preventionprogramsin various partsof the world initiatedcondomcampaignstargetingwomen. Little attentionis being given, however, to the impact of such a strategyon conjugal and broader social relationships. CuSAG found in the Baltimore and other Marylandsites that a numberof use condoms. Theirrelucwomen were also reluctantto have their male partners tancewas basedon theirneed or desireto maintaintheirongoing relationships, and the fearthatmen would leave thembecauseof the strongmale dislike for condoms. Womenin the CuSAG studiespointedout thatwomenhave to be carefulaboutinitiating condom use in their sexual practices because some men associate such practiceswith a woman being "sexually loose." Moreover,as CuSAG found in associatedwith disease preBaltimore,because condoms have been traditionally vention, they are also associatedwith women who are "dirty"or diseased. Thus, condoms are used with "outside"women who "you don't know who they have been lying with,"but not with one's primarymate.If a man's mate initiatesthe discussion of condoms, she runs the risk that he will suspect that she is sleeping around.Men in Baltimorealso reportthat if they know that their "main"woman has the virus,they would eitherkick her out or leave her immediately.Thereis also the potentialfor conjugal discord when women bring up condoms. It is said that men interpret this action as an insinuationthatthey are sleeping aroundand carrydisease. ing In summary,our findings indicate that for some populationscondoms have symbolic power or sociocultural"meanings"thatmay clash with the desiredproin the CuSAG regram outcomes. For example, among some of the participants search,the publichealthmessage of using condomsto preventsexually transmitted diseases has become part of a construct for using condoms only with women thoughtto be diseased. Most of the men in our studiesdid not deny thatthey sleep

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with a numberof women. In fact, many of themboasted aboutthis as a display of masculine strength(more on masculine sexual prowess later). Yet they said they did not sleep with "dirty"or diseased women, and some said that they can tell a dirtywoman by the way she looks, smells, or carriesherself. Because of this constructof "not sleeping with dirty women,"the use of a condom is consideredunnecessary. "Freaks," Fast Women, and Negotiating Condom Use in Male-Female Relationships Our CuSAG studies have also increasedour awarenessof the need to better understand people's perceptionsof partsof the body, sex, and the dynamicsof using symbolically powerful technologies like condoms. In the precedingsection I discussedhow some of our female studyparticipants mentionedthe potentialdanif they initiatedthe use of condomsduringsexual encounters. ger to a relationship A numberof interventionprogramsnow help high-riskfemales to develop skills for negotiatingcondom use with sexual partners. The CuSAG data, however, reveal anotherpotentialproblem:a generaldistrustof men by females such thateven when they reachan agreementwith men regardingcondom use, they believe that the men will find ways of not using them.A good numberof ourfemale study parwho tricked,or attempted to trickthemby pretendticipantsspokeof male partners ing to put on a condom, but "they ain't doing nothingbut fumbling arounddown there.... and you so hot [with passion] ... you don't know what's going on." Interventionscould be designed (and probablyhave been) that encourage women to put condomson men. In fact, such a strategycould be includedin a session on sexual foreplay.Our work, as well as thatof others,suggests thatfemales have greaterinterestin sexual foreplaythanmales, and that some men may be rehandletheir ceptive to this strategybecause of theirdesireto have female partners penis. There were also some men in our study,however, who statedthat they were uncomfortablewith women who were "forward." Similarly, the CuSAG studies also suggest that such a strategymight be a problemwith females who are afraid thatjust bringingup the use of condoms, or being the one who bringsthe condom to the relationship, could threaten the survival of the relationship. For these women, the idea of handlinga male's genitaliawas out of the question.Even some who statedthey were comfortablewith bringingup the of our female participants, idea of condom use, or even providingit, said thatthey left it to the man to "putit on."To "touchthe mandown there"was a further indicationof sexualforwardness associatedwith sleeping around,or of "beingtoo schooled"sexually-perceived as somethinga woman learnsonly by sleeping around.For some of our study participants,touchinga man's genitaliawas "nasty." In conclusion, interventionprograms thatadvocatethat women put condoms on men must first assess how the program'stargetpopulationfeels about raising the issue of condom use, providingcondoms,and puttingcondoms on men. Such assessmentsshouldalso explore women's expectationsof men's reactionsto these strategies.Where possible such assessmentsshould also explore men's reactions directly.

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The "Gender Self and Barriers to Condom Use": The Role of Paternity and Sexual Functioning in Masculine Gender Identity There is a theoreticaltraditionin social psychology that a "sense of self," or sourceof socioculturalmeaning(e.g., Goffman subjectiveidentity,is an important of anthropological researchindicatesthatacross 1963; Mead 1934). An abundance cultures a central componentof one's sense of self, or self-identity, is "gender self." 5 Genderself is a culturalconstruct.It is a perceptionof self thatis strongly influencedby the culture-based notions of masculinityand femininitythatare attributedto people withina culturalsystem. of masculinegenOurresearchsuggeststhatthereare at least threeattributes to the adoptionand utilizationof condoms by der identity thatcan act as barriers men: (1) ideas aboutpaternity in constructsof adult masculinity;(2) sexual prowand (3) economiccapabiless (conquests)as evidenceof masculineattractiveness; of masculinestatusand power. ity as an attribute In most societies, biological parenthoodis an importantattributeof adult masculinity and femininity. In my own research in Jamaica two decades ago (Whitehead1976), I, like Blake (1961), found that young girls in ruralcommunities were expected to have childrenby theirmid-teens,or would be seen by others themunatas "mules."This referenceto young women as sterile animalsrendered attributes one of the most important tractiveto men becausepaternity represented of ideal adult masculinity(see Whitehead 1976, 1986, 1992a). Family planning male belief found in nuby the traditional professionalshave long been frustrated merous societies that the more children a man fathers, the more of a man he is (Castiglia 1990; Friedman1990; Van Oss Marin et al. 1993; Whitehead1976, 1992a; Wilson 1973). There were popularviews among inner-cityAfrican Americansand Jamaicans in the 1960s and 1970s that family planning programsattemptedto deny and were a form of genocide (Darityet al. 1971; Polgar black men theirpaternity 1975; Rauch 1970; Weisbord1975; Whitehead1971, 1976, 1978) or male castration, and in some cases were acts perpetuated against the will of God.6I experienced these views personally in Jamaica, where I was chastised by men and women for being childless at 33 years of age. I found it interestingthatJamaican for family planningprofessionalssaw low-income men as "sociallyirresponsible" their fertile paternity,while low-income Jamaicanmales viewed childless higherThese contrastingviews of male responsibilitywere statusmales as irresponsible. based on similar views of the paternalrole of economic responsibility.Thus for family planning professionalsit was irresponsiblefor low-income men to have "pickni(children)all over the island"becausethey could not anddid not economically provide for them. Among low-income males, however, the fatherlessstatus of a "big" (high socioeconomic status) man like me was a symbol of selfishness-evidence of not being willing to share my status and wealth (Whitehead 1976,1986,1992a). Although none of the CuSAG researchwas designed to explore whetheror not inner-cityU.S. residentsassociatedfatherlessnesswith selfishness, a similar constructcame up in one focus groupin which women talkedof theiroppositionto males using condoms."Ifeel thatwhen a man uses a condom,he is not giving all of himself to me." Such sentimentswere also similarto those expressedby Jamaican

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men talkingof using condoms so thatwomen would not "taketheir 'strength'(semen) when they gave it up in sexual encounters"(Whitehead1976, 1992a). In these cases, it appearsthatpeople considera man's semen a metaphysicalessence and the source of his strength,his soul. Similar attributesassociated with semen have been found in othercultures.7 I have long been interested in subjectiveparadigmsaboutwhat it meansto be male or female (i.e., constructsof gender) because they can provide potentially new insightsinto an arrayof social problemsthatareassociatedwith male-female relationships(e.g., decisions regardingthe adoptionof contraceptives,domestic andso violence, father-daughter incest,rape,childhoodprostitution, pornography, on [see Whiteheadand Reid 1992]). While CuSAG's work on the meanings of male body partsandfunctionsrelatedto sexualbehavioris sketchy,it does suggest the need for more focused and systematicresearchon the topic. Attributes of the Masculine Gender Self: Sexual Attractiveness and Sexual Prowess In CuSAG's researchin Marylandand Washington,D.C., and in my earlier work in Jamaica (Whitehead 1976, 1986, 1992a), I found that both men and women cited loss of male sensualpleasureas a reasonfor theiroppositionto condoms. Both men and women reported thatcondomscausedmen, in the wordsof a female Baltimore study participant,to lose that good "sexy" feeling. Another womanin Baltimoresummarized the discussionby saying thatwhen "menpull out condoms,"she knows thatthe sexual session is not going to be an enjoyableone. Such sentimentson the partof females have been used by males to supporttheir reasons for not using condoms:"womendon't like them."What these persistent findings suggest to me is thatfor some people, condomuse may be partof a larger As partof the constructof attractiveness to the opposite sex, some men may to achievinganotherideal attribute see condom use as detrimental of young adult masculinityin many societies: seductivecapabilitiesor "sexual prowess."I have in Jamaica(Whitehead1976, discussedelsewherethe significanceof this attribute 1984, 1986, 1992a) and in inner-citycommunitiesin the Baltimore-Washington urbancorridor (Whiteheadet al. 1994). I have also discussed(Whitehead1986) the I researchin Jamaicaduringthe difficulty experiencedin conductingethnographic mid-1970s because of the community's expectations that I skillfully display a certainlevel of sexual prowess, as is expected of the "big"(high in social status) men.8Discussions with colleagues doing family planningand HIV/AIDS work in a numberof Africancountrieshave also focused on the value of masculine"sexual prowess" as possibly one of the greatest contributorsto the spread of the AIDS virus. of sexual prowesshas not been the focus of Althoughthe masculineattribute much published anthropologicalor social science researchcross-culturally,we have many anecdotes of its prevalencecross-culturally, especially among young If moreresearchwere to focus on male sexual prowadultmales priorto marriage. in those societies thathave high or iness, andit is shown thatit is widely prevalent creasingrates of HIV/AIDS, it could be assumedthat this attributeis probablya contributor to the transmission of the disease. In the inner-citycommunitiesof the
gender-related construct: attractivenesslunattractiveness to the opposite sex.

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urban corridor,where the bulk of CuSAG researchhas Baltimore-Washington been carriedout, HIV/AIDS is now one of the leading causes of mortality for from those communities young adults.We have also had male study participants suggest thatthey value sexual prowessso highly thatneithermarriagenor thepossibility of catching HIVIAIDS would prevent them from displaying it. Because of

the significanceof such commentsfor possible HIV transmission,we need more systematicresearchto explore the source and breadthof this masculinetheme. Economic Capacity and "Fragmented" Masculinity in America in America is A well-documentedattribute of a male's sexual attractiveness his economic capacity.Economic capacity becomes internalized by males and is to theirdefinitionsof themselves as men, theirsense of (gender)self. A important numberof sociological studies have discussed the negative impactof job loss on the ego of American males and on family functioning. Literatureon African Americanfamily life is replete with referencesto the impactof lower socioecoon the sense of the gender nomic status, unemployment,and underemployment self of young black men.9As I will discuss in more detail in the next section, economic capacityin the United Stateshas become interwovenwith moreglobal male of sociopoliticalandsexual power to createthe constructof ideal mascuattributes linity in America. I will also discuss how American institutions socialize all Americanmales into this integrated(economic, sociopolitical,and sexual) gender self. I will thenarguehow the socializationof this sense of the genderself, andperthatpreventthe achievementof all threecomponentsof sistent contextualbarriers this constructof ideal masculinity, can contributeto a sense of a "fragmented" sense of the genderself. I will arguethatat the core of this fragmentedsense of the genderself arepersistent contextual(historicaland sociopolitical) barriersto achieving a "socially acceptable"economic status (being able to economically provide for a family). I also arguethatbecauseof the role of capitalismin Americanculturalhistory,masculine sociopoliticalstatusis highly relatedto economic status,andthata manwho is weak in economic capacityrunsthe risk of also having low sociopoliticalstatus. due to low levels of economic and Finally, I arguethat masculine fragmentation sociopolitical statusmay contributeto men's exaggerationof their sexual capacities, that is, exaggeration of their need to sexually control and/or conquer females

(Anderson 1990; Whiteheadet al. 1994). In other words, I am arguingthat"fragmented"sense of the gender self is a primarycontributor to low-income male beat greaterriskfor HIV transmishavior, which in turnputs them and theirpartners sion and otherhealthandsocial problemsassociatedwith sexual relationshipsand gender identitythanmen of highersocioeconomic status. The concept of a fragmentedmasculinityrecalls my interpretation of the Jamaicanuse of the concept of "masculinebalance"(Whitehead1986, 1992a). I was told of the importanceof males maintainingbalance between the expression of masculine "respectable" behavior(e.g., economically providingfor one's partner and their children) and masculine "reputation" (e.g., demonstrationsof sexual masculineattributes can lead prowess). Imbalancein respectableand reputational to masculineimbalance.If a man does not correcta stateof imbalance,it leads to

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an even greaterand acceleratedstateof imbalance:a sense of a loss of controland of masculinity. attributes discipline, which are two other important In the Jamaicancontext, I was trying to understand constructsof gender as they relateto masculineconjugalandfamily functioning,includingcontraceptiverelatedattitudesand behaviors.In the Maryland-Washington, D.C. context, I am at tryingto understand genderconstructsas they might put men and theirpartners risk for HIV transmission.(It would be interestingto returnto Jamaicato reexamine the concept of balanceand how it is being used to explain AIDS and the traditionalnotionthatit is a gay disease. My interestresultsfrommy researchthereduring the 1970s and 1980s, duringwhich my informants explainedwhathappensto men who allow their imbalanceto continueat an acceleratedpace, leading to the lowest state of masculine imbalanceand wickedness-homosexuality.) Some of the similaritiesin the constructsof masculinegender in the two researchsites are due to the fact thatboth researchenterpriseswere trying to understand such constructsas they are associatedwith conjugalrelationships and relatedhealthissues. But, I arguebelow, they are similarbecause of the culturaland historicalrole of formationin both societies, including the role of capitalism in gender-construct plantationslavery. Historical and Cultural Contexts of Masculine Gender Formation in America TheImpactof Plantation Society on the Formationof MasculineGender Constructsand Its Expansionas a CulturalArea Most of the themesof masculinitydiscussedin this articlearenot exclusive to AfricanAmericanmales, or to Americanmales generally;they are similarto those foundin numerousothersocieties (Whitehead1992a). Cross-culturally, ideal masculinity seems to revolve aroundconstructsof sociopolitical,sexual, and in some cases economic power.'0Male sociopoliticalpower is usually expressed in terms of social statusvis-a-vis othermen. Masculinesexual power is most often characof females to males and male control over feterizedby the social subordination male sexuality. Male control over female sexuality includes the power to determine who has sexual access to specific females, and the control of female reproductivecapacity." Masculine sexual power is maintainedthroughcultural rules and social institutionsthat regulatemarriage,dowries and bride-pricesysbetween the three types of masculine tems, and kinship. The interrelationship power noted above is highlighted by the fact that in most societies men's ecointo sexual power. nomic, social, and/orpolitical power are translated in the The formationof gender constructsin the Americas, and particularly United States,has to be understoodin termsof the developmentof capitalismand the emergence of the United States as the leader of world capitalism.Plantation contributor to the emergenceof slaveryin the WesternHemispherewas a primary capitalismbecause for the first time in humanhistory the primaryfactorsof production, land, labor, and capital were being moved from continentto continent (Williams 1994[1944]). Withinthis context,plantation society playeda significant role in the formationof New World (after Europeancontact) gender constructs. Historical,social, andeconomic dominationby the rhythmsof plantationlife gave

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rise to socioculturalconstructsthat were greatly influenced by considerationsof ethnicity(Europeanand African)and race (white and black). Plantationslavery had a powerful impacton the definition of the status and between men and women, and between blacks and whites. patternsof interaction The extremewealththatplantation slaveryaffordedto men of the planterclass provided the powerto define the sexualityof the women of theirsocioeconomicclass, and the sexuality of the female and male slaves.12 Extremewealth made possible the constructionof economic capacity as a core component in the definition of ideal masculinity.Economic power was controlledby of the ideal (white) male, and everyone was dependenton this male for his or her economic well-being. At the householdandfamily level, this constructwas expressedin termsof the importanceof men being economicallyresponsiblefor theirfamilies. Forwhite malesof Europeand America,the wealthgeneratedby plantationslavery,colonialism,and a greatercontrol over the world's resources,both economic and human,made it economic capacityas a core constructof ideal possible to maintainand strengthen from plantation-dominated economies to masculinity.The impactof the transition industrializationon an emerging globally connected economy brought greater wealth and a continuedstrengthening of the role of economic capacityin defining masculinity. The areasof the WesternHemispherewhereplantationslaverydominatedfor South America (Brazil, Surinam, centuries-including countries in northeastern and Guyana),the islands of the Caribbean,and the AmericanSouth-have been to by scholarsas "Plantation America" groupedinto a culturalareaandarereferred (Wagley 1952). Having directednumerousresearchprojectsfor CuSAG over the past 7 years, I have come to includeareasof the U.S. innercities thatarepredominantly peopled by African Americans as part of the PlantationAmerica cultural area,althoughthese locationswere neverdominatedby plantation agriculture. My observationsin the innercities of the similaritiesin social relationships, language belief systems, and realityconstructions to those found in the plantation structure, societies thatI have studiedfor years, and my experiencesgrowingup in a plantation areain the southeastern United States, led me to considerthis inclusion. The expansionof the PlantationAmericaculturalareato include nonplantation urbanareasbecomes even more plausiblewhen one considersthatthe majority of the black people who reside in the innercities of the United Statesmigrated (or their parentsmigrated)from areas in which the economic and social domination of plantationsociety had a long history.The concept of Plantation Americaas a culturalarea,however, includes more thanjust the migrationof AfricanAmericans. Culturalconstructsthat are significant to white Americansshould also be considered. For example, consider the influence of the founding fathersof this countryon the formationof the political,economic, and social institutions,andthe culturalconstruction thatareproducedandreproduced by these institutions. Many of the founding fathers were themselves plantationowners. It would be logical then to assume thatmany of the culturalconstructionsthatemergedfrom plantation society were transported into the constructionsthat are now valued in the United States, includingconstructsof race, gender,and class. Finally, the legacies of plantationsociety are still visible in urbancenterstoday. The juxtapositionof the slave and the masterclasses of plantation society can be seen in urbansettingsin both the West Indiesand the United States.Studentsof

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PlantationAmerica have long commented on the visual continuitybetween the "bighouse"and slave shantiesof plantationsociety, and the more recentmanifestationin the mansionsin the hills surrounding majorWest Indiancities thatoverlook the poverty-stricken shanties below. Visions of a similar type of structural U.S. inner-city continuitycan be seen in the racially segregated,poverty-stricken communities of Washington, D.C. and Baltimore, Maryland, which are surroundedby some of the wealthiest suburban communitiesin the nation and even the world.
Respectability and Reputation: A Paradigm for Exploring Masculine Gender Constructs in Plantation America

Buildingon the work of PeterJ. Wilson (1973), I have arguedthatideal adult and "reputation." masculinityin Americahas two majorthemes:"respectability" Attributesof masculine "respectability"include: (1) having enough economic power to provide for one's family; (2) being law abiding; (3) winning through sense of mocompetingsuccessfully;and (4) exhibiting a strongJudeo-Christian and fair of Attributes masculine themes include (1) sexual rality play. "reputation" prowess;(2) defianceof authorityand generalrowdiness;and(3) winningthrough or "outsmarting" others(see Whitehead1986, 1992a;Whiteheadet gamesmanship al. 1994). Wilson suggestedthatthe construction of masculinitywas divided along class and economic lines. He proposedthatEuropean andmiddle- andhigh-status West Indiansvalue respectability,and lower-statusWest Indiansrebel againstreIn my Jamaican research, however, I found that spectabilityby valuing reputation. West Indianmales of all classes valuedboth categoriesof masculinity(Whitehead 1992a). In my CuSAG work in the United StatesI have also arguedthatin the United States, too, males from all classes value both sets of masculine themes. In fact, themes of masculine respectabilityand reputationexist cross-culturallyand are practicedby males of differing socioculturalstatus.The themes thatWilson catearefound in othersocietiesas themesthatcontributeto sogorizesas respectability cial order (Whitehead1992a). Moreover,in most humansocieties, althoughit is potentiallydisruptiveto social order,young males are allowed to express reputational traits.Masculinematurity,however, is markedby bringingan end to such men provideeconomically andsocioculturalcontexts.For example, "respectable" for theirfamilies, arelaw abiding,and follow the rules of Allah or God. Thereare atcertaintimes, places, andpeople with whom men can express such reputational tributesas sexual prowess,rowdiness,andgamesmanship withoutconflicting with their respectablestatus. Thus there are certaintimes (e.g., days that are not reliandcertaincategories gious or sacred),certainplaces (e.g., in all-malegatherings), of women (the culturallyconstructedwhore), with whom a respectableman can express himself reputationally(e.g., see Ralston 1988). Men keep the value of these reputational expressions throughsharingtales of their exploits in all-male men who exgroups,and throughtheir supportof, and pridein, young unmarried hibit these traitsbefore settling into the respectablestatus frequentlymarkedby and the readinessto fatherchildren. marriage
expressions and channeling them into culturally defined units of time, space, style, cial order, while those that he classifies as reputational are themes that threaten so-

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In comparinggenderconstructsin the West Indies and the UnitedStates,the in the culturalhistory of the United variableof race, which has been so important States, has not been as significantin the West Indies. Many of the culturalconstructsthatarehighly influencedby class in the West Indiesare influencedby race in the United States. Wilson differentiatesbetween masculine respectabilityand and West Indian)andclass (middleand reputationin termsof ethnicity(European is made along racial upperversus lower). In the United States, this differentiation lines; thatis, white males are"expectedto be" respectableand black males are exThus, while thereare black males and white males who pected to be reputational. value both respectabilityand reputational masculine themes in the United States, culturalconstructscreatethe illusion of genderdifferencesalong raciallines. The evolution of the UnitedStates as a powerfulglobal culturalinfluenceresulted in the social and linguisticseparationof themes of masculinerespectability and reputation. This separation was necessaryin orderto maintainmeaningfulcultural boundariesfor differentiating between white and black men, and between white and black women (Collins 1996; Sacks 1979). The denial of economic, soto the productionand ciopolitical, and sexual power to blackmen has contributed of racialdifferencesin male achievementsin economic, educational, reproduction and family matters. Historically,the physicalproximitybetween white and black men, thatis, of constructedideal masculinityand its opposite (first as masters/slaves,and then as employers/employees)has tended to perpetuateand strengthenalong racial lines the differences in constructsof masculinity.In fact the production,reproduction, and strengthening of theseracialconstructsof differencesin masculinityhavebeen in the evolution of all institutionallife in mainstream Americansociperpetuated have providedwhite men with the rewardsof ety. Americaneconomic institutions capitalism,and thus assuredthem that the image of the white man as the model providerfor the family was valid. American institutionsof slavery, racism, and discriminationhave historicallydenied the black man equal access to such economic rewards. Mainstreameducational,research, and media institutionshave in mattersof the family.The soconsistentlydepictedblackmen as "irresponsible" them as "interested in cioculturallyconstructedimage of black men characterizes sex and spreadinguncared-forbabies all over the place" without providingfor them economically (see Whitehead1971, 1992a). These same institutions(education, research,media), along with the U.S. judicial institutions,have historically the image of blackmen as having naturaltendenciestowardcriminalperpetuated ity (see hooks 1992; LeMelle 1995; Thackara1979; Van Dijk 1987). Earlycolonial associations of black men with low moral characterwere supportedby religious beliefs such as the idea that slavery in a Christiancountry was good for blacks because it extractedthem from the "sinfulhabitsof Africa." At the same time, these same institutionshave consistentlycontributed to the "illusion"thatwhite men are law abidingandmorallysuperiorto blackmen (Billingsley 1968; Weatherspoon1994). White men have been constructedas hard workerswho demonstratethe "Christian work ethic";black men, in contrast,are depictedas interestedonly in gettingsomethingfor free, "conning"[cheating]others, and/or robbing them. The constructof "welfarecheats," for example, combines the reputednotions thatblack men get things for free and cheat. These illusions of difference between white and black men have been maintainedby

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historicalshifts in the meaningof words such as irresponsibleor hustler, and by the associationof such labels primarilywith black men (Whiteheadet al. 1994). The persistentinstitutionalreproduction of these constructsmakes it easy for us, who have been socializedby these institutions, to blamelow-incomeblackmen for theirown circumstances. The emergence of economic capacity as a core constructof the masculine genderself in PlantationAmericaplayed a majorrole in defining the black man's statusas a man in the wider society (sociopoliticalstatus),in his conjugalrelationto his children.Men of low economic ships (sexual status),and in his relationship capacity are not desirableas husbandsand fathersto most women (or valued by othermale protectorsof male sexuality,i.e., fathersand brothers).Also, such valued mainstreamroles of husbandand father are frequentlynot attractiveto the mostpowerless of men (Liebow 1967). In fact, legal marriage andfamily responsibility in some cases remindsthe economically,sociopolitically,and sexually powerless PlantationAmericamale of his lack of statusas a man. A male informantin Washington,D.C., for example, told me that going to jail was a sort of reprieve from his wife andeveryoneelse who frequentlyremindedhim of what a failurehe was: "At least in jail, I don't have to see it in theireyes all the time. At least here I
can feel like a man."

The Impact of the Valued Masculine Theme of Economic Capacity on Male-Female Relationships
Masculine Economic Capacity and the Attractiveness of Males as Sexual Partners

of AfricanAmericanhealth issues in both the United States As a researcher for the past 30 years, and as a black man living among African and the Caribbean Americansfor the past half century,I have often heardblack men lamenttheirinability to give their women the materialthings they desire. Some black men also complainthatthe only thing thatblack women are interestedin when in relationships is getting as much as they can (materialpossessions) out of men. I have also dismiss men who had nothing(mafrequentlyhadblack female studyparticipants terial)to offer them. At present, CuSAG is finishing a research project of inner-city African Americanadolescent(13-20 yearsof age) female clients of a sexually transmitted disease clinic. One of the strongestthemesto come out of this researchis the assowith his materialpossessions, as a sexual partner ciation of a male's attractiveness whetherhe has money to a and of late model car, luxury ownership particularly as symbolic of spendon a female. Frequentlythe ownershipof a car is interpreted of materialismor wealth have resulted a man having money. Such interpretations in some of these young women "hoppinginto cars"(literallycalled "carhopping" by some of these girls) with men that they don't know, and being compromised sexually, or even worse, raped,beaten,or murdered. In both the Jamaicanand the U.S. inner-cityresearch,female study particito men who were legally marriedto otherwomen pantsin common-lawmarriages confirmedtheirdesire to maintainthese extramarital relationshipswith statements such as: "He is a good man, andtherearenot too manyof those out here."In these

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instances"good"is definedin economic terms:"hehelps to pay the rent,buy groon the West ceries, and put clothes on my children'sbacks."I have also reported Indiancustom in which men put off marryingthe motherof some of theirchildren until they are able to own a home. Home and land ownershipare evidence of a man's economic capability,andof his abilityto providefor his wife andto give her materialthings (Whitehead1976, 1992a). It is interestingthatthe practiceof marIt suggeststhatin rying a woman laterin her life is said to make her "respectable." PlantationAmerica,a man has to be respectablein orderto make the woman respectable,andhis economic capacity is whatbringshim respect.
The Cultural Construction of the "Black Woman as Whore" in Plantation America

Categoriessimilarto those of respectabilityandreputation applyto women as well as men in PlantationAmerica. Respectablewomen are mothers,wives, and potential wives. For all of these women, their sexuality is ideally controlledby men, first by their fathers and then by their husbands. Alternatively,there are women with (sexual) reputationswho are constructedlinguistically and cogniThese arewomen with whom men can easily meet theirsexual tively as "whores." needs (andfantasies)andexpressthe reputational masculinethemeof sexualprowand crossess. These constructsof femininity also have broaderJudeo-Christian culturalcontexts. The Judeo-Christian foundationfor respectabilityand reputational attributes comas they areappliedto womenin Plantation Americais the "Madonna-Whore" plex. This paradigm,createdfor women by men, which can be found in cultures the Mediterranean andMoslem world,becamerigidlyinstitutionalized throughout in Europeduringthe Calvinist/Puritan periods (see Bastide 1968). As Europeans with them.Again,becauseof the settledthe new world,theybroughtthis paradigm power thatwhitemen of the planterclass had to constructthe sexualityof everyone on the plantation,white women became depicted as models of respectabilityand
black women became depicted as whores. These constructs were supported by the

Puritanview of sex as sinful (Worth 1990:113), and the subjectiveinterpretations of the Bible that black skin was a sign of sin (Bastide 1968:40). Thus white women-the preferred wives of white men andthe preferred mothersof white children-were cloaked in themes of respectability;sex with these women was priBlack women, by contrast,were represented as the "sexmarily for reproduction. ual temptresses"-whores (Kaljee 1990). The association of both sex and black skin with sin contributed to the idea thatblackmales andfemales werehypersexual (Thomasand Sillen 1972:103).Thus white women had to be protectedfromblack men, and black womencould be accusedof invitingthe rapethey often sufferedat the handsof white men. Black male economic powerlessness(inabilityto providefor his woman and children) and sexual powerlessness (inability to protect and control the black woman's sexuality),and the economic barriersto black women in theirefforts to provide for their children and protect themselves from the sexual advances of white men, sometimesdid result in their use of sexual strategiesto advancetheir own and their children'slives. Such tactics, however, only strengthened the constructionof the black woman as whore for both white and black men. But while

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white males may not publicly verbalize this construct,the persistenteconomic powerlessnessof low-income black men has broughtsome of them to publicly refer to black women as "Hos"(whores) and bitches.
"Hos," Dogs, and "Freaks": The Public Verbalization of Black Hypersexuality in Contemporary American Cultural Settings

The constructof the black womanas whoreis reproduced primarily by young black males in contemporary settings throughmusic and humor (e.g., "gangsta" rappers,comedians,and other "blackartists").This constructhas been marketed by the U.S. capitalistsystem, which has learnedthat thereare large profits to be made fromblack-on-black displays of disrespect.Out of this construct,the notion or "skeezer"-a female who is known to provideany type of sexual of the "freak" urservice in exchangefor a "hitof crackcocaine"- has evolved in contemporary ban youth anddrugcultures. these types of semantic/cognitivelabels contributeto manyof Unfortunately, the conjugalproblemsexperiencedbetween low-income black men and women, and, I am afraid,make it easier to exploit black women as objects for commercial sex-as whores. Just as we expect brotherly behavior from someone we call or motherly behavior from someone we call "mother,"we may con"brother," or sciously subconsciously expect "bitch"-likebehavior from someone we call bebehaviorfrom someone we call whore,and "freak"-like "bitch,""whore"-like haviorfrom someone we call freak. In CuSAG research,we continue to explore the "domainsof meaning"that underliethese constructsof blackfemininity.One of the methodswe use in this inare provided quiryis a techniqueof "freeassociation"in which studyparticipants with a list of termsand arethenasked to say the firstthingthatcomes to mind.We includedin our list of termsthe words men and women.Young black male participantsbetweenthe ages of 24 and35 sometimesfreely associatedthe wordswhores and bitches with "female."Female participantsfrequentlygave the response of thatwearsa skirt")to the wordmen. Some of the males also re"dogs"("anything ferredto men as dogs either in the word associationor in long narrative responses in other sections of the interviews. But in contrastto women's use of the term, men's use of the termdogs was discussed approvinglyby thus reflectingthe masculine value of sexual prowess.Women used the termwith angeror to voice sharp criticismof males in general. The termdog discussed in our researchis the same dog referredto in rapmusic, which is popularamongyoung blackmen and women in the 1990s. Rapmusic has experiencedsuch popularityand commercialsuccess that it has crossed over and become popularwith many white youths as well. The dog of rap (or hip hop) music, however,does not simply glorify the dog who is good at sexual gamesmanship or prowess.This dog also speaks to young men who are partof a long interchain of black males who have been denied access to economic and generational in men. The anger in sexual power in a society thathighly values these attributes the lyrics andimages of gangstarapis often directedat the perceivedsourceof the barriersthat block the full participationof black males in the totality of ideal Americanmasculinity:females who have been traditionally perceived as the prisexual of masculine 1992). marypawns power (Lott

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What Does All of This Have to Do with AIDS?

The Fragmented Gender Self and Health Research Exploring Self-Esteem

Most readersof this article who are familiar with literatureon health risks might view my concept of fragmentedmasculinityas similarto the popularconcept of self-esteem.Indeedthereis a relationshipbetween the two constructs.The bulk of the health-related researchon self-esteem, however, are simple correlational studies thatshow a relationshipbetween self-esteem and health-related behavior.The lowera person'sself-esteem,the greateris the probability thata person will behave in ways thatput him or her at risk for specific illness conditions(e.g. Sobo 1995). Little of this research,however, is informedby theorizingaboutthe formationof self emergingfrom interactions with others.Althoughmost of this researchutilizes validatedpsychometricscales as a means to test the strengthof this relationship,it cannot explore the sociocultural contexts and processes in the meaningsof the risk behaviorsthatmay be exhibitedby personswith low self-esteem. Finally, much of the self-esteem literaturefocuses on females and adolescents; little attentionis given to males. I suggest thatresearchon self-esteem can be strengthened by qualitativeapproachesto the study of gender identity.For example, I mentionedearliera male who reflectedthatjail provideda refugefrom seeing himself as a studyparticipant failure in the eyes of his wife, his children,and others who are close to him. His comment suggests thatpeople's sense of self is influencedby evaluationsof their performanceof certainsocial roles. Although such evaluationsmay lead to low in referenceto the evaluationof adultgenself-esteem, they may not, particularly der roles. Thus an adult might conceivably score high on a self-esteem test, and still have a low sense of self in termsof adult gender-roleperformance. In either case, however,society may adoptthe language,attitudes,andbehaviorthatit associates with a status.For some economically, sexually, and sociopoliticallypowerless black men, this phenomenonhas lead to whatFranklin(1994:281) refersto as "retreatist" masculinity, which is characterizedby a withdrawalfrom society. These aremen, says Franklin, who have "grownwearyof participating in a system thatdenies themthe meansof achievingwhatmost membersof society achieve. So they drift into high ratesof joblessness ... drug addiction,alcoholism,and homelessness" (1994:281)-all considered to be directly or indirectly risks for HIV/AIDS.
Socioeconomic Marginality, Crack Cocaine, and the "Hustling Life"

Idealconstructs of male economic and sexual power,andthe lack of access to thatpowerby blackmales, has given rise to new problemsin the 1970s and 1980s thathave implicationsfor HIV/AIDS. Persistentpoverty,chronicunemployment, and employmentwith menial pay have historicallycharacterized the plight of the majorityof blackmen in Americansociety, and have led some of them to what we term America's "hustlingculture."Male study participants,for example, have talked abouthow black men have had to "hustle"in orderto survive in America. They definedhustlingto includeboth legal moneymakingactivities (e.g., holding several menial jobs simultaneously) and illegal activities (e.g., running "con"

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games). They also defined hustlingto mean exhibiting the generallyacceptedentrepreneurial skills that all American men are socialized to have as a means for

achieving the core ideal American male attributeof wealth (Whiteheadet al. 1994). The differencebetween rich white males and themselves,they said, is that white males have the entireglobe to hustle, and they have only one or two poorinner-cityblocks. They also explainedprofoundlythatthe morea man in Americais denied legal employmentand hustlingopportunities,the higher the probabilityis thathe will turnto illegal activitiesto achieve the economic capacitythatwill bring him "respect" as a man. With the tremendous decline in opportunities for legal employmentandlegal hustling among low-income black males in the 1980s, drug trafficking,particularly in crackcocaine among young black men (and women), increasedthe crack tradeandhelpedto facilitateotherillegal facetsof the hustlingcultureincludinginexpensive commercialsex and "crackhouses" (see Inciardi1993, 1995). Crackis in poor communitiesbecause its processingmakes it possible to very marketable sell cheaply (Inciardi1993, 1995). Moreover,crack traffickersmake as much as six times the amountthat they could make on the same amountof pure cocaine (Ratner 1993a). The drug is also said to have a powerful but short-lived"high," which translatesinto inexpensivebut frequentpurchases. The craving for crack cocaine is said to be so strongamong addictsthat not only do they engage in frenziedactivitiesto get the drug,butthey may give up normal sexual inhibitionsand sacrificepersonalhygiene to get it (Ratner1993a; see also Gormanthis issue). Thus sexualexchangesofferingall types of sex desiredby a client may occurmanytimes duringa single day to feed the need for the drug.For example, Bourgois and Dunlap(1993) reportedthat in some inner-citycommunities female crack addictsofferedoral sex for as little as threedollars.Inciardihas also reportedthat some women in crack houses provide sex at bargain-basement
prices in order to get as much of the drug as they want. Crack houses provide

women with a "safe haven"for using drugswithoutbeing hassled by membersof theirfamily, by the police, or by the violence on the streets(Inciardi1993, 1995). to crackhouses in orderto procurecheap sex. In sum, Men are said to be attracted to prostituteeager crackhouses providethe ideal situationfor crackentrepreneurs females and at the same time to sell more drugsto male customers crack-addicted for theirown use or for its use in exchange for sex. In crack for HIV transmission. Such scenariosprovidemultipleopportunities
houses numerous unsafe sexual activities are carried out with multiple partners in a single day. When drugs are involved in such settings, using condoms or any other form of protection is not a consideration. According to Inciardi, many of the males who participate in crack-house sexual activities want oral sex. At the same time, a number of them have difficulty achieving erections because of their frequent drug

use, a situationthatoften resultsin long sessions of fellatio thatcan lead to a breaking of the penile skin. Women in these situations are also placed at risk by swallowing semen and because they have sores or cracks in their lips from sucking crack pipes or the penises of clients (Inciardi 1993, 1995). The interplay among American constructs of ideal masculine economic-sexual power, the increasing lack of access to those ideals for some men, the American male "hustling" culture, the rise in recent usage of crack cocaine in poor neighborhoods, and the exchange of sex for crack described by Ratner and his colleagues

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but in some in(1993b) not only createda milieu for increasedHIV transmission, stances providedan illusion of providing access to long-denied masculine economic andsexual power. Young men readyto take the risksof becominginvolved in the crack trade found themselves with payoffs beyond their wildest dreams. Money and drugsalso gave them access to, and control over, women who in the past might not have given them any attention. When I first startedurbanresearchin 1990, 1 was astonishedthatyoung men crack cocaine, as replacinga man's "rap"(verbal talked of "drugs," particularly ability), or even materialpossessions, as means to get a woman. One of the most as a vehicle for masculinetransformadisturbingcommentson crack's attraction tion from powerless to powerful (economically and sexually) was providedby a in Baltimorein 1990. This young (late 20s) drugtrafmale focus-groupparticipant ficker, who wore a very expensive leathercoat, gold chains aroundhis neck, and had threegold teeth with one of his initials on each, stated:
Look man,two yearsago, I didn'thave anything.I couldn'tbuyanything,couldn't get a woman... andmy family thoughtthatI was worthless.I was gettingfucked over by everyone. Now I have clothes, money, cars, and women living in 20 differenthouses. I providefor them. I providefor them. They don't have to turn to nobody else. I did it all myself, and nobody messes with me! You know why? Because I have scratch[money].

Crackuse reportedly began to decline duringthe middle 1990s, andheroinreturnedas a leading drug in the innercity. While heroin is sometimesnow mixed with crackcocaine andsmoked, its traditional mode of use, needle injection,is still popular,and thus furthercontributesto injectiondruguse as the primarymode of HIV transmissionamong African Americans. Given the demonstrated relationships among drug use, sexual behaviors,and HIV transmission,one of the most damagingconsequencesfor low-income AfricanAmericansis the probabilitythat the constructof black woman as whore was strengthened. "Rapping,""SweetTalk,"and YoungWomenat Risk Earlier,I cited the U.S. Centersfor Disease Control'sreport(CDC 1995) that HIV/AIDS is growing faster among African Americanfemales than among any otherU.S. populationwith the exceptionof adolescents.Among blackfemales, the disease is spreadingfastest among adolescents.Some of the reasonsfor the problem amongadolescentsare the same reasonsthatwe continueto have increasesin pregnanciesamongboth black and white adolescents:(1) moreadolescentsare initiating sexual intercourseat earlierages than in past decades;(2) adolescentsare less likely to use condoms or other forms of contraception thanolder population and the evidence adolescent sexual activity,a siz(3) segments; despite regarding able proportion of Americanparentsand policy makersoppose targetingadolescents for contraceptives,includingcondoms. African Americanadolescentshave been foundto initiatesexual intercourse earlierthantheirwhitecounterparts and to use condomsless frequently. Anotherfactorthatmay contribute to thehigh ratesof sexual activity among AfricanAmericanadolescentfemales in low-income communities is the way in which they are targetedas sexual prospectsby older males.

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The evidence for sexual liaisons betweenadolescentfemales and older males is still sketchy.Anecdotalevidence coming from all aroundthe countryjustifies a call for more systematic research on this phenomena. One of the reasons that CuSAG was asked to carryout the adolescentfemale STD study in which we are presentlyinvolved is because the local healthdepartment requestingthe research discoveredthat some of the adultmale clients utilizing their sexually transmitted disease (STD) clinics reportedhaving female partners17 yearsof age and younger.'3Our preliminary analysis of the datafrom this study suggests a general consensus among our study participants that such liaisons are common in their communities.There is also a near consensus amongour adolescentstudy participants as sexualpartners thatoldermales arepreferred over adolescentboys because they are more "mature," and "knowhow to treatfemales with respect." "romantic," In earlier CuSAG studies in Baltimore STD clinics (Whitehead 1990a, who talkedof targetingadolescent 1990b),therewere adultmale studyparticipants females for sex because young girls aremoresusceptibleto romanceand the male thanthe "womanwho has been around" (althoughothermales were adamant "rap" that thatage or one's rapdid not make a differenceas long as you had some "drug"; "drugis all you need to get anythingyou want from bitches aroundhere"). I first observedthis patternof older males targeting"school girls" for sex in Jamaicaduringmy ethnographicresearchthere in the mid-1970s. I first encounwith adultmales teredthis phenomenonwhile conductingparticipant-observation who made overturestoward adolescent females on the way home from school sharedwith me reasons for their (Whitehead1986). My male study participants in which to those sharedby males in the such were similar activities, participation later Baltimore studies: "school girls love sweet talk, and that's how you get who had also observedthis male them."Adult Jamaicanfemale studyparticipants or knew otheryoungfemaleswho hadbecomeimpregnated haddaughters, behavior, by older men agreedwith this assessmentof adolescentfemale susceptibility. The female study participants, however, providedsome insight on the types in this kind of activity. They proposedthat males who of males that participated older, pursuedadolescentfemales were males who were unsuccessfulin attracting more mature,women. They furthersuggested that such men were unsuccessful with older women because these men usuallyhad low incomes and had nothingto offer a womanin termsof economic support. Moreover,male economic supportis more relevant to older women than it might be to school girls, because older women often have childrenor othersfor whom they areeconomicallyresponsible. And finally, olderwomen often have haddisappointing experienceswith such men and are less reticent,or are more skilled, at rejectingthem thanare school girls. Certainoccurrencesduringthe 1990 CuSAG Baltimorestudies (Whitehead 1990a and 1990b) made me begin to wonderwhetheror not women's perceptions of the ways in which males pursue sexual partnerswas age based. Those studies were sponsoredby researchcontractsthatrequestedfocus-groupinterviews with primarilyAfrican American males and females seeking services at STD clinics. During discussions that included the earlier mentioned references to males as between 15 and 19 "dogs,"we began to notice that adolescentfemale participants yearsof age were considerablyless criticalof men thanwere older female participants.Anger at and criticism of men seemedto be strongestin women rangingin in their commentsfrom female participants age from about22 to 37. Interestingly,

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40s and50s were for the most partmoresubduedandtingedwith sarcasticresignation ("mostmen arejust no good"). We also noticed similar age differencesamong male participants. First, we notedmales in theirmiddle and late twentiescoming to the focus groupswith girlfriendswho appearedto be in theirmiddle teens (15 to 17). We also observedthat there was much more braggadocioon the partof the young men (roughlyin ages from about 17 to 29), particularlywith regardsto sexual conquests and control. Conversely,men in their late 30s and 40s, some of whom did partakein some of the sexual boasting,tendedto be muchmoreseriousabouttheirpersonalcondition, and the conditionsof AfricanAmericansin general.(This is an important point to which I will returnlater in a discussionof what I call "gendermaturity.") The narrative and observational datafromboth the Jamaicanand the U.S. researchsites has broughtme to the inferencethatmales of low economic, sociopolitical, and sexual statusaremore likely thanhigh-incomemales to targetadolescent females for sexual liaisons becauseyoungfemales areless likely to expect as much out of them economically as older, more experiencedfemales, and are more susceptibleto male sweet talk.I also hypothesize,withinthe generalthemesof this article, thatmore systematicresearchon this topic would show thatolder males who targetadolescentfemales aredoing so not only to meet physical sexual needs, but sexual prowess, a masculinereputational traitperceivedas enalso to demonstrate hancinga man's social statuswith male peers. These hypotheses,if correct,would suggest thatthe low-income males in our researchare not thatdifferentfrom males of otherculturalbackgrounds. Even the idea of males in their late twenties having sexual partnersin theirmiddle teens is not outside of the realm of traditional humanmatingpatterns-although it is not desirablein contemporary Americanculturefor females in this age categoryto be involved in such relationships. Perhaps,most culturalgroupswould find most disturbingthe prospectof these young females being drawninto helping males establish their economic status. It is not that this constructdoes not exist in other cultures. In fact, according to Levi-Strauss,the role of females as a commodity in male economic activities is probablyas old and as widespreadas the organization of humancommunitiesaroundrules of kinship.14Most disturbingis the contemporaryevolution of this constructinto behaviors(commercialsex andtradein sex for drugs)thatmay be destructiveto the institutionsof family and community. The young drug traffickerquoted above with the gold teeth, leatherjacket, and "womenin 20 houses," and his focus grouppals, offered detailed information on how "small businessmen"like himself get their business "off the groundand moving." They explained how females are targets both as drug clients and as potentialcommodities in the sex for drug/moneymarketplace. Young women become targets as a result of their curiosity about sex and drugs. Welfare mothers become targets because they are known to have monthly incomes. Once these women are "hooked,"drug dealerscan take over their apartments, turnthem into crackhouses, and, if they have daughters, even recruittheirchildreninto the trade. Of course, such narratives areonly anecdotal.They could also represent male evinced braggadocio,ratherthanfactualscenarios;othergroupsof drugtraffickers greatdisdainfor such behaviorsand a surprisingsense of concernregardingsuch destructiveelements in their communities.Such comments,however, are worthy of more systematic research in light of the data that suggest the possibility of

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in the adolescent female entrepreneurial strategies.For example, the participants for older men over adolescentmales studyalmost unanimouslystateda preference as sexual partnersbecause of theirperceptionthat older males are more likely to have jobs and money to spend on females. Where this constructmakes females vulnerableto risky sexual practices,however,is in theirassessmentof visible materialmale possessions, particularly, as discussed earlier,the possession of a late model luxurycar, as a symbol of economic capacity.This type of assessmenthas led some adolescentfemales in the Washingtonareato get into cars with men they do not know, because cars symbolize men's ability to spend money on females. Being seen with a male who has such a car also affordsthe adolescentfemale an elevated social statuswith her female peers.Such behaviors,of course, place these HIV/AIDSor some otherSTD, or even young women at greatrisk for contracting to be beatenor killed.'5 Anotherfindingfromthe CuSAGresearch thatmight indicatethatadolescent females in low-income, inner-citycommunitiescould be at riskfor involvementin to older men, not males in their sex-drugactivitiesis the fact thatthey areattracted 40s and 50s, but males in their late teens, 20s, and early 30s. These are the years when male sexual drive is strongest,and when the reputational theme of sexual prowess might be most pronounced.This assumptionis supportedby the comments andbehaviorsof young males in the Baltimoremale focus groups.These are also the ages of manyof the young AfricanAmericanmales who became involved in drug traffickingduringthe late 1980s and 1990s. Thus, young women who infor romantic reasons,or even in expectation itially enterheterosexual relationships of monetaryrewardsor enhancedsocial status,found their relationshipevolving into one characterized by commercialsex anddrugs. In conclusion,I would like to reiterate the need for more focused researchon the inferencesthatI have pulled out of our ongoing CuSAG researchactivities in inner-citycommunities.If the scenariosthatI have been discussinghere do occur in these communities,they indicatenot only serious risks for the transmissionof HIV/AIDSamongAfricanAmericanfemales,but they have seriouslong-termimplicationsfor AfricanAmericansas a humancommunity.Firstof all, such findings could indicatethat some adolescentAfricanAmericanfemales might be initiated into commercialsexual activities before they are aware of what is happeningto them.Second, the survivalof blacksin the Americashas been greatlyfacilitatedby who have traditionally "networks of mothers" takenon muchof the burdenof raising blackchildrento adulthood.If motherson welfareor poor workingmothersare as drugclients or sexual commodities,who being recruited by drugentrepreneurs will carryon this traditionof taking care of AfricanAmericanchildren?And finally, when we considerthe fact thatdrugtraffickingwas one of the fastest growing sectorsof the global economy duringthe 1980s (Harrison1990), we wonderif global capitalismhas found a way to continueto use the bodies of poor women for profit, when it can no longer find any use for theirlabor. This last issue bringsus back to the persistenceof the social and culturalconstructsfrom the plantationpast. On the plantation,the sexuality of female slaves was exploitedfor pleasureandprofit.Neitherblackwomen norblackmen hadcontrolover who hadsexualaccess to blackwomen.Nor did theyhave any controlover femalereproductive free laborfor the plantation owner capacityas children provided and profit when they were sold. Today, povertyand drug addictioncontributeto

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women's loss of controlover theirsexuality.For some females in low-income, inner-citycommunitieswho have fallen prey to drug addictionandcommercialsex, the plantationconstructof the black woman as whore has been maintainedand strengthened.
The Hustling Culture, the Incarceration Epidemic among Black Males, and the Risk of HIV Disease in African American Communities

When illegal hustling activities are men's primarymeans of achieving the Americanmasculineideal of sexual and economic power, AfricanAmericansface I have previouslycited Washingtoninan increasedchanceof being incarcerated. of all Americanmen with both formantswho spoke of hustlingas a male attribute said thatAfriWashingtoninformants legal and illegal components.Furthermore, can Americanshave alwayshad to dependmore on illegal hustlesthanwhite men been denied both legal hustling (holdingmultiple because they have traditionally menialjobs, for example)and mainstream (Whitehead employmentopportunities et al. 1994). Historically,this helps to accountfor the consistentlyhigherratesof incarceration amongAfricanAmericanmen thanamong white males. The increase in drug trafficking opportunities and drug-relatedviolence amonglower-income,black,inner-citymales duringthe 1980s helps to explainthe dramaticincrease in the rate of incarceration of African Americanmales during thatdecade.'6An analysisof the U.S. Bureauof Justice statisticsfor 1990 indicate thaton any given day in 1994, one out of every threeAfricanAmericanmales between the ages of 20 and 29 were under the jurisdictionof the judicial system, eitherin eitherprison,in jail, on probation,or on parole(MauerandHuling 1995). These statistics coincide with a decrease in both legal unemploymentand legal for AfricanAmericanmen duringthe 1980s, which is in turn hustlingopportunities an outcomeof the declinein America'seconomy andthe social andeconomicpolicies of the ReaganandBush administrations (Phillips 1991; Ratner1993a;Whitehead et al. 1994). WhatI have called the "incarceration epidemic"(Whitehead1994) for young black men has had a devastatingeffect on the black family and the black commuit has resultedin the increasedrisk for HIV transmission in the nity. In particular, community.This epidemicis so extensive thatit may be becomingpartof the reality of dating/mating patternsin inner-citycommunities.This possibilityemerged during a focus-groupdiscussion that was part of a study on adolescentfemales. Adolescentfemales were askedto give advice to otheryoung femalescontemplatThis questionwas intendedto elicit theirreflectionsregarding new relationships. ing negotiationsaboutsex and/orcondom use. The first group interviewed,however, began talking about "makingsure that he hasn't just gotten out of jail"; or "thatthe police ain't looking for him." The risk for transmissionof HIV/AIDS in African Americancommunities may be facilitatedby the black male incarceration epidemic andjudicialpractices and policies thatfail to requireHIV testingpriorto, during,or at theend of a jail or prison term, and/oroppose the distributionof condoms and clean needles in jails and prisons(Hageret al. 1995; Hammettet al. 1994; Hankins 1994;Maguireet al. 1995; Parker1995; Polonskyet al. 1994; Roberts1995; Rothonet al. 1994). Some of these policies arebasedon the incorrectassumptionthatprimary risk behaviors

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such as injectiondrug use and sex do not occur in jails and prisons.Althoughthe majorriskfactorfor HIV-1 infectionandAIDS is injectiondruguse priorto incarceration(Vlahov 1992), it is widely known thatmen can get drugswhile in lockup. Accordingto a series of articlespublishedin the WashingtonPost in June, 1990, a numberof DC guardswere bribedinto becoming "drugrunners" for certainprisoners (Dash 1990a, 1990b, 1990c, 1990d). It is also a popularlyheld notion thatthereis a fair amountof homosexualactivity among members of the prison population (Dynes and Donaldson 1992; WoodenandParker1982). Participation in the hustling/drug cultureplaces men at increasedrisk for contractingHIV-the same behaviorsfor which they are freIncarceration places them in a settingwhere such behavioris quentlyincarcerated. likely to continue and therebyincreasetheirrisk of HIV transmission.Additionally, men who engage in druguse and/orhomosexualacts while in prisonare frequently released into the community before preventiveproceduresare taken to protectthe community.Moreover,as membersof the D.C. hustling/drugculture in the perpetuation of the hustlingculture,but intimated,lockup is not a disruption a stage in which hustlingbehaviorand skills are enhanced("theplace where you really learnyour hustlingskills").The high percentageof young black men going throughthe prisonsystem saddlesblack communitieswith male memberswho are furthermarginalizedand stigmatizedand unable to contributeconstructivelyto theircommunity. These aremen whose chancesfor regularemploymentarefurtherlimited,but towardviolence, mighthave been enwhose hustlingskills, as well as orientations hancedby theirprisonexperience.These are men, some of whom may have been involved in homosexualrelationshipswhile in prison,who stronglyidentifythemselves as heterosexualandaremotivatedto continueto prove theirheterosexuality throughthe pursuitof heterosexualrelationships.At the same time, limited ecoin comnomic opportunities may lead some of these men to continueto participate mercial sexual activities as part of their hustles. In summary,in numerousways of destructionin theircommunitiesby further such men may become instruments advancingthe negative side of the hustlingculture,includingthose behaviorsthat to potentialincreasesin HIV transmission. contribute Conclusions and Recommendations FutureResearchNeeds The issues discussed in this articlearevery complex. Yet, if we hope to better risk behaviorsand attitudesso thatwe can develop more effective preunderstand we must move beyond the most popularresearch ventionand treatment programs, researchhypotheses throughthe method of simply testing investigator-initiated use of existing psychometric instruments.While such approaches are usually methodologicallysound, they may have little relevanceto the complex meaning prosystemthatunderliesthe riskbehaviorsof interestto preventionandtreatment grams. on a pointmadein the methodologysection,the findingsreported To reiterate herecan only be consideredexploratory,since they were carriedout in small scale qualitativestudies in which some of the issues discussed were frequentlynot the

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focus of a specific researchactivity. (As is the case in many open ended, flexible, ethnographicand qualitativeresearchprojects,some of the most intriguingfindings were not plannedfor by the investigator.)One of the reasons for presenting this workis to suggest the need for multidisciplinary researchand the development of interventionapproachesthat truly triangulatedifferenttheories, methods, and investigators,as suggestedby Denzin (1970) more thantwo decadesago. Suchtriangulatedapproachesare necessary to explore the role of socioculturalcontext, process,andmeaningwithina systemicmodel, andto effectively addressthe needs of African American men whose perceptions underlie the practice of high-risk behaviors. The qualitativemethodsused to collect the datareportedon in the articleare essential to understanding sociocultural context, process, and meaningrelevantto HIV/AIDSrisks,attitudes,andbehaviorsamong lower-incomemen in America.It is in the studyof historicallyentrenched genderandpowerconstructsthatI believe we will come to betterunderstand the conjugaldifficulties encounteredby marginalized low-income men and women, particularly those difficulties that relate to sexual behavior and the use of prophylactics.It is through the investigationof largersociocultural(historical,economic, and sociopolitical)contexts thatwe can betterunderstand how the value of economic capacityas a core attribute of mascutraits linity may lead men of low socioeconomic statusto emphasize reputational as a means of expressingtheirsense of self as men. Further researchon men and masculinityand the role of the relationship between sexual andeconomic powershouldincludeAmericanmales of diverseraces and classes in studysamples.Inclusionof these populationswould move the study of masculinityaway from simply focusing on AfricanAmericanmale reputational attributes and towarda betterunderstanding of Americanmasculinityin general. While the literature on African Americanfamily structure has focused on sexual as an attribute of black I know of no studiesof this masmen, prowess comparative culine attribute thatcut acrossethnic(except Hispanic"macho")andclass groups. In such research,economic capacityratherthanrace or ethnicityshouldbe the privariable. maryindependent Gender "Maturation" and Transformation To some, the interpretations of the CuSAGdatathathave been presented here might be somewhatbleak. Our research,however, also offers possible strategies for effectively addressingsome of the issues discussed, if they are found, through more focused research,to exist broadlyin low-income inner-citycommunities.I have presentedthe argument thatwe need to exploremale genderfragmentation as a risk factor of HIV transmissionin low-income communities. As such, readers is simply to providemoreemploymight expect thatmy primaryrecommendation ment opportunities for low-income AfricanAmericans.Although such a strategy would be partof any intervention I also recommendaddressingthe probprogram, lems of masculinegenderconstruction andthe fragmented genderself. This necessitatesa processof empowerment thatfocuses on constructsof self andcommunity improvement. I recommendstrategiesof male empowermentthat will lead to what I call transformation involvesa change genderor masculinity transformation. Masculinity

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from existing constructs of masculinity, which are deleterious to the gender self of men of low socioeconomic status, their sexual partners, and their communities. I have argued that existing constructs of ideal masculinity are conducive to a fragmented masculinity. The goal of masculinity transformation is to achieve a sense of masculine gender identity that is whole. Masculine transformation is a strategy of empowerment that moves away from notions of masculinity that focus on gaining economic capacity to achieve sexual control, or on sexual power to achieve social (with male peers) or economic status. It is a process of masculine transformation, the goal of which is enhancement of employment skills and improved heterosexual'7 communication, compromise, and respect. It emphasizes community service, goal-setting, and discipline in achieving goals, and integrates body, mind, and "spirit" (a wholesome outlook on the world, and one's place in it). In addition to peer training, strategies of masculine transformation should include training older, more mature males, including low-income males, to work with preadolescent and adolescent boys and young adult men. This idea came out of our observations of the many focus groups in CuSAG research that explored domains of meaning. Going back to the first studies conducted by CuSAG in 1990, we began to notice what I have labeled as a process of "gender maturation" that seemed to parallel age. As discussed earlier, young men (males in their teens and 20s) make many more comments about sexual conquests and control than do older men (males in their late 30s and 40s). While some older men do participate in sexual boasting, they are much more serious about the personal difficulties of providing for their families, and about the conditions of African Americans in general. They are quite cynical about the U.S. political system and about the purported goodwill of some whites toward blacks. They are also very critical of blacks who participate in self-destructive behaviors, and were strong advocates of black selfhelp strategies. They frequently got into debates with young men in their groups, and questioned whether there was anything constructive about their sexual behavior and their treatment of women. Some of the older men were even critical of the speech patterns used by young black males, particularly the frequent use of such terms as YO!, bitches, niggers, whores, and so on. For the most part, older men seemed to have moved beyond the "dog" phase of their lives, and were critical of younger men who seemed to still value such attitudes and behavior. One of the intriguing challenges for me during my years of working with health promotion programs has been to develop an effective method for reaching adolescent males. Based on our observations of focus-group discussions in which some males were able to persuade others to avoid high-risk behaviors, we believe that such group discussions could serve as an excellent format of interventions. Age-based differences in the content of these discussions has led me to a concept that I call "gender maturation." CuSAG research also suggests to me that this concept might be an effective basis for designing intervention programs geared to low-income African American males. Focus-group participants themselves have suggested that mature low-income men-those who have put the dog behind them-should be involved in such interventions. Our focus participants strongly argue that older males with experiences similar to those of troubled young men today could be effective teachers. Among our participants in the 50 or more male focus groups that CuSAG has carried out in the Baltimore-Washington urban corridor, one-third had spent time

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in jail and/or used or sold drugs. In many of these groups, male participants in their late 30s and 40s expressed concern for the younger males in their communities whose lives were taking on a similar direction. Some of them were involved in community-based self-help activities; others expressed a desire to get involved. Men in our study, "Urban Male HIV Ethnography," provided a philosophy for helping the young. This study included a series of 5 focus groups carried out with a single group of males. Some of the men in this group, in their late 20s and 40s, succeeded in getting their lives back on track, and expressed community service as an attribute of ideal masculinity. They talked about how they were raised, especially about the role of church morality, and of discipline beyond that provided by their parents. Nevertheless, they said that as young men they "lost their way." They expressed great concern for lost young men and women in their communities who did not have the same childhood foundation. Thus they are "lost and have nothing to get back to." As one man explained: "it's like they are drowning and we want to throw them a line, but we don't know where to find the rope." It seems to me that if we are able to develop strategies that provide training, it will help men on their road to masculine wholeness, and will work to help younger men overcome their fragmented masculinity. In short, I recommend masculine transformation, along with the usual HIV/AIDS education materials, to effectively address HIV/AIDS in low-income American communities.
NOTES

This articleincludesdata from researchpartiallysupportedby the Acknowledgments. HealthResourcesandServices Administration (CAN 2-3703030), the Centerfor Substance Abuse Prevention(H 13 SP06060), theNationalInstitute of MentalHealth(U 10 MH48068), the National Instituteof Health (R01-HD27114), the Agency for Health Care Policy and Research(U01 HSO 7392), theNationalInstitutes of DrugAbuse (Subcontract), theCenters for Disease ControlandPrevention(severalsubcontracts andconsultations),the Contraceptive ResearchandDevelopmentProject(CONRAD),the BaltimoreCity HealthDepartment, the MarylandState Departmentof Health and Mental Hygiene, and the Prince George's I will always be gratefulto the many residentsof communities County HealthDepartment. in the Baltimore-Washington urbancorridorwho continueto shareintimatedetails of their lives with CuSAG, and I hope thatmy interpretations are correctand serve them well. I am also indebted to several membersof CuSAG staff for the many revisions of this article, including Jawanza Phoenix and Leilani Francisco (former staff members), Mr. James Peterson,Mr. Shawn Maloney, Ms. Tracy Knight,and Ms. CarrieMoy. I am also grateful to my wife, Dr. KarenGentemann,for her assistancewith the final revision. The opinions expressedhereinare mine, and I takesole responsibilityfor the contentsof the manuscript. Correspondencemay be addressedto Tony Whitehead,professor and director,The CulturalSystems Analysis Group,Department 0123 Woods Hall,Univerof Anthropology, sity of Maryland,College Park,MD 20742. 1. One of the problems with the abundanceof social science research on African Americansis that it focuses on low-incomecommunities,and for the most partignoresthe majorityof AfricanAmericanswho are not lower income. While recognizingthis problem, our work has focused on low-income populationsbecause they suffer more from the social and healthconditions that negativelyaffect their qualityof life. While I too call for others to conductanalysis of other segmentsof society, I will continuemy presentfocus with the ongoing hope that my work might effectively informefforts targetingthese qualityof life issues.

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2. I sharewith Wright(1993:422) andKane(1990, cited in Wright 1993) a reluctance to probe aboutpeople's sexuality and the dangersof reportingon it in public discourse.At the same time, however,as an appliedanthropologist anda memberof the AfricanAmerican community,I am also of the opinionthatI have a responsibilityto sharethe workwith others in orderto reducethe virulenceof the conditionsunderinvestigation,especially when I am studying a phenomenonthat has tremendoussignificance for the well-being of the wider community.I stronglybelieve thatsocial scientists,as partof our ethical responsibilitiesto our study populationsand to science, shouldtry to give as complete a pictureas possible of the context of the phenomenathatwe study.Partof our responsibilityto study participants is to analyze data in ways that place participants' behavioraland cognitive constructsin largersocioculturalandhistoricalcontexts.Narrowdescriptiveanalyses (thatdo not locate contexts) can only provide a one-sided view that is unfairto findings in macrostructural those we study and is poor science. Thus, if our objective is to use the researchto inform the developmentof programs andpolicies, thenthose policies andprogramswill be limited, misdirected,ineffective, or potentiallyharmfulto those targeted. 3. While I find Wright'sarticleof greatvalue, I thinkthe categorizationprovidedby LaudHumphreys(1970:49) of the "inserter" (the man who insertshis penis, whetheranally or orally, into the orifice of another)and the "insertee"(the one in whose orifice the penis of anotheris inserted)offers a moreconcise way of conceptualizingthisdistinction.Whether thanwhetherone is insertingor receiving one is activeor passivesexuallyis moreambiguous the penis. 4. Petersonand colleagues (1992) also found that a small proportionof their sample had engaged in unprotected vaginal intercoursewith primaryor secondarypartners.This led them to conclude that bisexual activity may be an importantsource of transmissionin the AfricanAmericanpopulation. 5. A partiallist of scholars of this traditioninclude Bonvillain 1995; Brandes 1980; del Valle 1993; Dwyer 1978; Memisi 1975; Paul 1974; Rosaldo 1974; Whitehead 1986, 1992a. 6. An example of family planning interferingwith "God's work" came from my researchin Jamaica(Whitehead1976), wheresome men andwomen believed thatcondoms devices (IUDs) "couldget lost in a woman's womb."Use of these devices and intrauterine was consideredsinful.Whenbabies,who werethoughtof as preordained by God, were born with physical or mental deformities, people explained these defects as punishmentfor interferingwith God's gift of providingwomen with children. on a practicein which young 7. Forexample,in the Pacific,R.C. Kelly (1976) reported boys, in orderto become men, are injectedwith semen because it is believed that they are born without it. Such association of semen with masculine strengthhas also been found among people who most likely had no contactwith one another,such as the Fore of New Guineaand Moroccansof North Africa.Among both of these groups, it has been reported that a man can come under anotherman's influence if a drop of his semen is found and in a culturallydefined manner(Dwyer 1978; Forge 1970). Also see the work manipulated by Eisler (1995), and La Barre (1984). While there is little documentationon similar masculine constructsin Europeanand North American societies, it could be because we evidence of attachingmasculinepower have not done the work. Because the cross-cultural to semen is so broad,and we do not have the empiricalevidence to say thatsuch beliefs do not exist, maybe seriousconsiderationsof such an areaof study is legitimate.For example, coaches who still imply that athletes should not have sex the night prior to a big athletic basedon similarbeliefs, even thoughthey mighteven event may be makingsuch statements exist at a subconsciouslevel. 8. Angrosino(1986) also talkedof a similarproblemin doing work in the Caribbean wherehe was expectedto exhibitmasculinestrengthmuchas all "Texans"(Americanmen) were expected to exhibit this attribute.

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9. A partiallist of writerssupportingthis point include:Akbar 1991;Anderson 1989, 1990; Hannerz 1969, 1970; LeMelle 1995; Liebow 1967; Madhubuti1990; Majors and et al. 1994; Billson 1991;MajorsandGordon1994;Taylor 1981;Valentine1978;Whitehead Wilson 1987. 10. Scholars who make this point include: Bamberger1974; Blank 1980; Bonvillain 1995; Bookman and Morgen 1988; Brandes 1980; Campbell 1964; Caplan 1987; Denich andWhitehead1981; 1974;Dwyer 1978;Kimbrell1995;Morgen 1989;Ortner1981;Ortner Poovey 1988; Ralston 1987; Sacks 1974, 1979; Sanday 1974, 1981; Sanday and Goodenough 1990; Schlegel 1977; Schoefel 1978; Strather 1972, 1987; West and Zimmerman 1985. 11. In traditionalsocieties, control over a woman's reproductivecapacity is usually defined by determiningthe kinship group to which her children are assigned. With the populationcontrol(or family planning)programs,this controlover emergenceof state-run women's reproductive capacitywas extended to decisions regardingwhen a womancould have children. Thus, I found that low-income males in Jamaica did not oppose family of paternity.In fact, some masculineattribute planningsimply on the basis of the important men did not oppose contraception but showed a vigoroushungerfor knowledgeon new and effective methods. But they did oppose the state-runfamily planningprograms,which had taken away their masculineprerogativesover the reproductive capacitiesof theirpartners. In the United States today, some feminist groups argue that abortionrights representthe functions. rightof a woman to have controlover her body and its reproductive 12. In the case of the slave, this also meantthatAfricansocial and culturalstructures, including those relating to gender, intergenderrelationships,and institutionallife, were either destroyedor severely modified. This is significant because in many of the cultures from which slaves were taken,the roles of males and females in the institutions of marriage and kinship, and the regulationof female sexuality (sexual access and reproduction) were well defined. 13. In 1994, the Prince Georges County (Maryland)Health DepartmentSexually Transmitted Disease ControlPrograminterviewed358 men between the ages of 20 and 25 who had gonorrhea.They were able to document27 cases where these men had exposed women 17 years old or youngerto gonorrhea.PGCHDstatesthatthey have only been able to documenta small amountof this behavior. 14. According to Levi-Strauss(1969), in many human cultures, the institutionof can be interpreted as a formof economicexchangebetweengroupsof men,wherein marriage the primarycommodityis females. 15. An April 19,1997 New YorkTimesarticlereported a case in EastSt. LouisMissouri in which a 28-year-oldmale targetedyoung females as sexual partners, some of whom were "barelyinto puberty" (Nossiter 1997). The young man was describedas "smoothtalking," dressing in a flashy manner,and the owner of several fancy cars, who took his girl friends on shoppingtripsin malls in East St. Louis and St. Louis. Althoughhe had been diagnosed with HIV in 1992, he went on to expose 62 young women to the disease, 13 of which tested murderin January1997. positive by the time of his deathfrom a suspecteddrug-related 16. Fay Harrison as an important (1990) discussesdrugtrafficking componentof world capitalismduringthe 1980s and as one of the fastest growing sectors of the international economy during that decade. Gun traffickingalso increasedin importancein the international economy duringthis period, and both drug and gun traffickingbecame partof the economies of many local U.S. urbanneighborhoods,which contributedto underground increasedviolence and homicide rates in the United States. Harrison(1997) has discussed the importanceof guns within the paradigmof what I am calling reputational masculinity in urbanJamaica;and I am presentlypreparinga book on this role in U.S. urbancontexts. 17. Our intention is not to exclude homosexual relationships.I believe that similar programsaroundproblemsof genderidentityare also needed for MSWMs, but this would

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requirea different type of program.Included here would be the different categories of MSWMsdiscussedby Wright(1993).

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Akbar,Na'im Publishers. 1991 Visions for Black Men. Nashville, TN: Winston-Derek Anderson,Elijah 1990 StreetWise. Chicago:Universityof ChicagoPress. Angrosino,MichaelV. 1986 Son and Lover: The AnthropologistNonthreateningMale. In Self, Sex, and Fieldwork.Tony LarryWhiteheadandMaryEllen Conway, Genderin Cross-Cultural eds. Pp. 64-83. Chicago:Universityof Illinois Press. Joan Bamberger, 1974 The Mythof Matriarchy: Why MenRule in PrimitiveSociety.In Women,Culture, and Society. Michelle ZimbalistRosaldo and Louise Lamphere,eds. Pp. 263-279. Stanford,CA: StanfordUniversityPress. Bastide,Roger In Color andRace. John Hope Franklin,ed. Pp. 1968 Color,Racism, and Christianity. 34-49. Boston: Beacon Press. Billingsley, Andrew 1968 Black Families in White America.EnglewoodCliffs, NJ: PrenticeHall. Blake,Judith 1961 Family Structuresin Jamaica:Social Context of Reproduction.New York: Free Press. Blank,Arapera 1980 The Role and Status of Maori Women. In Women in New Zealand Society. PhilladaBunkle and Beryl Hughes, eds. Pp. 34-51. Auckland,New Zealand:George Allen and Unwind. Bonvillain,Nancy Constructsof Gender.EnglewoodCliffs, NJ:Prentice 1995 WomenandMen:Cultural Hall. Bookman,Ann, and SandraMorgen,eds. 1988 Womenandthe Politicsof Empowerment. TempleUniversityPress. Philadelphia: Bourgois,Phillipe,and Eloise Dunlap 1993 Exorcising Sex for Crack:An Ethnographic Perspectivefrom Harlem.In Crack Pipe as Pimp. Mitchell S. Ratner,ed. Pp. 97-132. New York:LexingtonBooks. Bowser, BeniaminP. 1994 Black Men and AIDS: Preventionand Black Sexuality.In The AmericanBlack Male: His Present Status and His Future.RichardG. Majorsand Jacobs U. Gordon, eds. Pp. 115-126. Chicago:Nelson-Hall Inc. Brandes,Stanley H. 1980 Metaphorsof Masculinity:Sex and Statusin AndalusianFolklore.Philadelphia: Universityof PennsylvaniaPress. Campbell,J. K. andMoralValuesin a Greek A Studyof Institutions 1964 Honor,FamilyandPatronage: MountainCommunity.Oxford:ClarendonPress. Caplan,Pat, ed. of Sexuality. London:Tavistock. 1987 The CulturalConstruction Castiglia,PatriciaT. 1990 AdolescentFathers.Journalof PediatricHealthCare.4(6):311-313.

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EUROPEAN CONFERENCE: "MEDICAL ANTHROPOLOGY AT HOME" The European Conference, "Medical Anthropology At Home," will be held April 15-18, 1998, in Zeist, The Netherlands. The overall aim of the conference is to bring together medical anthropologists to discuss theoretical, methodological, and practical issues of studying health and medicine in one's own society. Paper abstracts are invited. For more information contact Dr. Els van Dongen, Medical Anthropology Unit, University of Amsterdam, Oudezijds Achterburgwal 185, 1012 DK Amsterdam, The Netherlands, Tel. +31 20 5252670; Fax +31 20 5253010; email: vandongen@pscw.uva.nl.