HIV-Positive Men Sexually Active with Women: Sexual Behaviors and Sexual Risks

This study examines patterns of sexual behavior, sexual relating, and sexual risk among HIV-positive men sexually active with women. A total of 278 HIV-positive men were interviewed every 6–12 months between 1994 and 2002 and reported considerable variability in sexual behaviors over time. Many were not sexually active at all for months at a time; many continued to have multiple female and at times male partners. Over one-third of the cohort had one or more periods when they had engaged in unprotected sex with a female partner who was HIV-negative or status unknown (unsafe sex). Periods of unsafe sex alternated with periods of safer sex. Contextual factors such as partner relations, housing status, active drug use, and recently exchanging sex showed the strongest association with increased odds of unsafe sex. A number of predictors of unsafe sex among African American men were not significant among the Latino sub-population, suggesting race/ethnic differences in factors contributing to heterosexual transmission. Implications for prevention interventions are discussed.Aidala, Lee, Howard, Caban, Abramson, and Messeri are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th St, Suite 1119, New York, NY 10032, USA.     

Sexual Partnering and HIV Risk among Black Men Who Have Sex with Men: New York City

Black men who have sex with men (MSM) are disproportionately affected with HIV in the US. Limited event-specific data have been reported in Black MSM to help understand factors associated with increased risk of infection. Cross-sectional National HIV Behavioral Surveillance Study data from 503 MSM who reported ≥1 male sexual partner in the past year in New York City (NYC) were analyzed. Case-crossover analysis compared last protected and last unprotected anal intercourse (UAI). A total of 503 MSM were enrolled. Among 349 tested for HIV, 18% were positive. Black MSM (N = 117) were more likely to test HIV positive and not know their HIV-positive status than other racial/ethnic groups. Case-crossover analysis of 208 MSM found that men were more likely to engage in protected anal intercourse with a first time partner and with a partner of unknown HIV status. Although Black MSM were more likely to have Black male partners, they were not more likely to have UAI with those partners or to have a partner aged >40 years. In conclusion, HIV prevalence was high among Black MSM in NYC, as was lack of awareness of HIV-positive status. Having a sexual partner of same race/ethnicity or older age was not associated with having UAI among Black MSM.     

Knowledge,Attitudes, and Sexual Behaviors in HIV/AIDS and Predictors Affecting Condom Use among Men Who Have Sex with Men in South Korea

ObjectivesIn South Korea, men who have sex with men (MSM) are rather understudied, but are known to be at high risk for human immunodeficiency virus infection (HIV)/acquired immunodeficiency syndrome (AIDS). This study was to access HIV/AIDS knowledge, attitudes, and risk behaviors, and to identify the factors of condom use in HIV prevention.MethodsWe recruited 1070 MSM in Korea, using the Internet to maximize the confidentiality of the MSM.ResultsThe prevalence of self-reported and sexually transmitted infections and HIV in the total sample was 10.7% and 2.7%, respectively. Factual knowledge and phobias regarding HIV/AIDS and self-efficacy were relatively high among the MSM. After controlling for age, education, marital status, and sexual identity, predictors of condom use at most recent anal sex included knowledge (OR = 1.25; p < 0.0001); self-efficacy (OR = 1.33; p = 0.02), additionally, having HIV testing (OR = 1.45; p = 0.02); and having a regular partner (OR = 0.53; p < 0.0001) were also positively associated with condom use.ConclusionThe intervention programs for MSM in Korea may need to take the idiosyncratic societal and cultural pressures of the region into consideration in order to reduce infection risk.     

Perceptions Towards Condom Use, Sexual Activity, and HIV Disclosure among HIV-Positive African American Men Who Have Sex with Men: Implications for Heterosexual Transmission

Disproportionately high HIV/AIDS rates and frequent non-gay identification (NGI) among African American men who have sex with men or with both men and women (MSM/W) highlight the importance of understanding how HIV-positive African American MSM/W perceive safer sex, experience living with HIV, and decide to disclose their HIV status. Thirty predominately seropositive and non-gay identifying African American MSM/W in Los Angeles participated in three semi-structured focus group interviews, and a constant comparison method was used to analyze responses regarding condom use, sexual activity after an HIV diagnosis, and HIV serostatus disclosure. Condom use themes included its protective role against disease and pregnancy, acceptability concerns pertaining to aesthetic factors and effectiveness, and situational influences such as exchange sex, substance use, and suspicions from female partners. Themes regarding the impact of HIV on sexual activity included rejection, decreased partner seeking, and isolation. Serostatus disclosure themes included disclosure to selective partners and personal responsibility. Comprehensive HIV risk-reduction strategies that build social support networks, condom self-efficacy, communication skills, and a sense of collective responsibility among NGI African American MSM/W while addressing HIV stigma in the African American community as a whole are suggested.Harawa is with the Charles B. Drew University of Medicine and Sciences, University of California, Los Angeles, CA, USA. Williams is with the Semel Institute of Neuroscience & Human Behavior, Suite C8-871C, 760 Westwood Plaza, Los Angeles, CA 90024-1759, USA. Williams and Ramamurthi are with the Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA, USA; Bingham is with the Los Angeles Department of Health Services, HIV Epidemiology Program, Los Angeles, CA, USA.     

African American church-based HIV testing and linkage to care: assets,challenges and needs

The US National HIV AIDS strategy promotes the use of faith communities to lessen the burden of HIV in African American communities. One specific strategy presented is the use of these non-traditional venues for HIV testing and co-location of services. African American churches can be at the forefront of this endeavour through the provision of HIV testing and linkage to care. However, there are few interventions to promote the churches’ involvement in both HIV testing and linkage to care. We conducted 4 focus groups (n = 39 participants), 4 interviews and 116 surveys in a mixed-methods study to examine the feasibility of a church-based HIV testing and linkage to care intervention in Philadelphia, PA, USA. Our objectives were to examine: (1) available assets, (2) challenges and barriers and (3) needs associated with church-based HIV testing and linkage to care. Analyses revealed several factors of importance, including the role of the church as an access point for testing in low-income neighbourhoods, challenges in openly discussing the relationship between sexuality and HIV, and buy-in among church leadership. These findings can support intervention development and necessitate situating African American church-based HIV testing and linkage to care interventions within a multi-level framework.     

A Comparison of the Social and Sexual Networks of Crack-Using and Non-Crack Using African American Men who Have Sex with Men

The role of crack cocaine in accelerating the HIV epidemic among heterosexual populations has been well documented. Little is known about crack use as an HIV risk factor among African American men who have sex with men (AA MSM), a group disproportionately infected with HIV. We sought to compare the social and sexual network characteristics of crack-using and non-crack using AA MSM in Baltimore, MD, USA and to examine associations of crack use with sexual risk. Participants were recruited using street-based and internet-based outreach, printed advertisements, word of mouth. Inclusion criteria were being aged 18 years or older, African American or of black race/ethnicity, and have self-reported sex with another male in the prior 90 days. Crack use was operationalized as self-report of crack in the prior 90 days. Logistic regression was used to identify variables that were independently associated with crack use. Of 230 enrolled AA MSM, 37% (n = 84) reported crack use. The sexual networks of crack-using AA MSM were composed of a greater number of HIV-positive sex partners, exchange partners, and partners who were both sex and drug partners and fewer networks with whom they always use condoms as compared to non-crack using AA MSM. Crack use was independently associated with increased odds of bisexual identity and networks with a greater number of exchange partners, overlap of drug and sex partners, and lesser condom use. Results of this study highlight sexual network characteristics of crack-smoking AA MSM that may promote transmission of HIV. HIV interventions are needed that are tailored to address the social context of crack-smoking AA MSM risk behaviors.     

Original Research: AIDS Educational Videos for Gay and Bisexual Men: A Content Analysis

Objective: To systematically describe the content of AIDS educational videos targeting gay and bisexual men, and to compare it to the content of videos for heterosexual African American and Latino audiences. Design: AIDS videos targeting gay/bisexual men (n = 35), heterosexual African Americans (n = 14), and heterosexual Latinos (n = 25) were coded for the presence or absence of messages identified by various theoretical models as relevant to HIV education and risk reduction. Results and Conclusions: Videos targeting gay and bisexual men typically emphasized sexual risk reduction techniques, whereas videos for heterosexual minority viewers were more likely to provide information about HIV transmission and audience members' vulnerability to AIDS. Despite their focus on reducing personal risk, most gay/bisexual videos did not depict partner negotiation for safer sex, reinforce the perception that social norms favor sexual risk reduction, or eroticize safer sex practices. Suggestions are offered for future research and for production of AIDS educational videos.     

Neighborhood Disadvantage and Changes in Condom Use among African American Adolescents

Neighborhood context may influence youth sexual decision-making. We examined the association between neighborhood characteristics and condom use in a sample of African American youth followed across the high school years (N = 681; 51% female). Using a three-level hierarchical linear model, we modeled inconsistent condom use over time and then examined its association with youth’s sexual risk trajectories (sexual intercourse frequency, number of partners, and pregnancy concerns) and individual-level characteristics (sex, age, SES, and household composition), and neighborhood disadvantage. While sexual intercourse frequency was associated with inconsistent condom use over time, youth reporting greater pregnancy concerns and number of partners reported more consistent condom use over time. Females were more likely to report more inconsistent condom use over time. Neighborhood disadvantage characteristics were associated with less baseline condom use, but did not have an association with changes in youth’s condom use over the high school years. We discuss the implications for community-based HIV/AIDS prevention for youth.     

高档酒吧男男性行为者艾滋病知识知晓及安全套使用情况调查

[目的]了解高档酒吧男男性行为者(MSM)艾滋病知识知晓及安全套使用情况,为艾滋病干预提供科学依据。[方法]2009年4~7月对青岛市某一MSM活动的高级酒吧与男性发生过口交、肛交并自愿接受HIV抗体检测的男性400人,在知情同意的前提下,对MSM进行匿名问卷调查。[结果]调查MSM人群400人,平均年龄27.51±6.49岁,艾滋病知识知晓率为80.00%。最近6个月内与同性发生肛交性行为时每次都使用安全套者占7.25%;最近6个月内与同性发生商业性行为时每次都使用安全套者占8.82%;最近6个月内与异性发生性行为时每次都使用安全套者占5.83%。与同性发生性关系时,艾滋病知识知晓率越高,安全套使用率越高,而与同性发生商业性性行为及与异性发生性行为时,未发现艾滋病知识知晓率与安全套使用率之间的相关性。[结论]艾滋病知识知晓率是促进MSM人群降低危险性行为的有利因素,但存在着知识态度与行为相分离的现象。     

‘You are not yourself’: Exploring masculinities among heterosexual African men living with HIV in London

It is now clear that gender is an essential factor shaping the narratives of men as well as women. However, there have been few studies of the daily lives or sexual activities of heterosexual men. Hence, strategies developed to prevent the spread of the HIV virus are rarely based on detailed knowledge of the men whose behaviours they are intended to change; this is especially evident in the developing world where the epidemic is most severe. Nor do we know very much about those men who have already been diagnosed as HIV positive. Around 13 million men are now living with HIV of whom around 96% are in low or middle income countries. Migrants from developing countries also make up the majority of positive people in a number of developed countries. In the UK, for example, heterosexual activity is now responsible for about half of all new HIV diagnoses with the majority of those involved being of African origin. But almost nothing is known about the ways in which different constructions of masculinity affect their experiences of illness. This study used qualitative methods to explore the experiences of a sample of black African men who defined themselves as heterosexual and were receiving treatment for HIV and/or AIDS in London. It explored their feelings, their needs, their hopes and their desires as they negotiated their lives in the diaspora.     

Phenomenologies of the Akratic Self: Masculinity, Regrets, and HIV among Men on Methadone

This study explores the motivational bargaining processes that constitute an “act” of heterosexual HIV risk-taking by focusing on the narrative viewpoint of two men in methadone maintenance treatment programs in the Harlem section of New York City. These men reported sexual episodes with complex motivational “event grammars” that were analyzed using qualitative methods. Building on the concept of akrasia (failure to convert intentions into action), I argue that HIV risky heterosex results from temporal displacements of instrumental rationality by two other equally relevant orientations of sexual action, namely, affectual and normative. I conclude that sexual risk occurs in the context of emotions and normative presentations of the masculine self. Consequently, a man's risk of loosing footing or consistent face vis-à-vis his female sex partner, and not the risks of HIV, becomes a priority of the sexual interaction. Sexuality is at its core social and, hence, subject to more powerful forces than personal safety or behaviorist reward.Dr. Fontdevila is with the Center for AIDS Prevention Studies (CAPS), University of California, San Francisco, CA, USA.     

Protective Parenting,Relationship Power Equity,and Condom Use Among Rural African American Emerging Adult Women

Sexually transmitted infections disproportionately affect African Americans, particularly young women. The influence of a set of interrelated protective parenting processes—instrumental and emotional support, sexual risk communication, and encouragement of goals for employment or education—on emerging adult women was examined. Parenting was hypothesized to affect consistent condom use through its association with women's reports of power equity in their intimate relationships. Hypotheses were tested with 135 sexually active women 18 to 21 years of age living in rural southern communities. Structural equation modeling indicated that (a) parenting processes predicted women's self‐reported relationship power equity and consistent condom use and (b) relationship power equity predicted consistent condom use. Limited support emerged for a mediational role of relationship power equity in explaining the influence of parenting on consistent condom use. Parental involvement and young women's establishment of personal control in their intimate relationships are important goals for sexual risk reduction programs.     

Psychosocial Correlates of Unprotected Sex Without Disclosure of HIV-Positivity among African-American,Latino, and White Men Who Have Sex with Men and Women

African-American, Latino, and White men who have sex with men and women (MSMW) may be a bridge of HIV transmission from men to women. Very little research has directly compared culturally specific correlates of the likelihood of unprotected sex among MSMW. The present study examined psychosocial correlates of unprotected sex without disclosure of HIV status with male and female partners among 50 African American, 50 Latino, and 50 White HIV-positive MSMW recruited from AIDS service organizations in Los Angeles County. Multivariate logistic regressions were conducted to examine relationships of race/ethnicity and psychosocial variables (e.g., condom attitudes, self-efficacy for HIV disclosure, sexual identification) to unprotected sex without disclosure of HIV status, for male and female partners separately. For female partners, different effects emerged by race/ethnicity. Among African-Americans, less exclusively homosexual identification and low self-efficacy for disclosure of HIV status to female partners were associated with unprotected sex without disclosure; among Latinos, less exclusively homosexual identification and negative attitudes about condoms were significant. Participants who were more exclusively homosexually identified, who held less positive condom attitudes, and who had low self-efficacy for disclosure to female partners were more likely to have unprotected sex without disclosure of HIV status to male partners. Culturally tailored community-level interventions may help to raise awareness about HIV and bisexuality, and decrease HIV and sexual orientation stigma, thereby increasing African-American and Latino MSMW's comfort in communicating with their female partners about sexuality, HIV and condoms. Addressing norms for condom use and disclosure between male partners is recommended, especially for homosexually identified MSMW.     

History of Arrest and Associated Factors among Men Who Have Sex with Men

Incarceration has been proposed to be a driving factor in the disproportionate impact of HIV in African-American communities. However, few data have been reported on disparities in criminal justice involvement by race among men who have sex with men (MSM). To describe history of arrest and associated factors among, we used data from CDC’s National HIV Behavioral Surveillance system. Respondents were recruited by time–space sampling in venues frequented by MSM in 15 US cities from 2003 to 2005. Data on recent arrest (in the 12 months before the interview), risk behaviors, and demographic information were collected by face-to-face interview for MSM who did not report being HIV-positive. Six hundred seventy-nine (6.8%) of 10,030 respondents reported recent arrest. Compared with white MSM, black MSM were more likely to report recent arrest history (odds ratio (OR), 1.6; 95% confidence interval (CI), 1.3–2.1). Men who were less gay-identified (bisexual [OR, 1.5; 95% CI, 1.1–1.9] or heterosexual [OR, 2.0; 95% CI, 1.2–3.5]) were more likely to report recent arrest than homosexually identified men. In addition, men who reported arrest history were more likely to have used non-injection (OR, 3.0; 95% CI, 2.4–3.6) and injection (OR, 4.7; 95%, 3.3–6.7) drugs, exchanged sex (OR, 2.7; 95% CI, 2.1–3.4), and had a female partner (OR, 1.5; 95% CI, 1.2–2.0) in the 12 months before interview. Recent arrest was associated with insertive unprotected anal intercourse in the 12 months before interview (OR, 1.4; 95% CI, 1.2–1.7). Racial differences in arrest seen in the general US population are also present among MSM, and history of arrest was associated with high-risk sex. Future research and interventions should focus on clarifying the relationship between criminal justice involvement and sexual risk among MSM, particularly black MSM.     

Sexual Marathons and Methamphetamine Use among HIV-Positive Men Who Have Sex with Men

A sexual marathon is defined as prolonged sexual activity over hours and even days. This exploratory study examined the phenomenon of sexual marathons in a sample of 341 HIV-positive methamphetamine-using men who have sex with men (MSM). Eighty-four percent of the men reported engaging in marathon sex while high on methamphetamine. MSM who engaged in sexual marathons and those who did not were compared in terms of background characteristics, methamphetamine use variables, alcohol and illicit drug use, sexual risk behaviors, and psychosocial factors. Men who engaged in marathon sex used significantly more illicit drugs, were more likely to use sildenafil (Viagra) and amyl nitrates, and scored higher on a sexual compulsivity scale compared to men who did not engage in marathon sex. In multivariate analyses, use of sildenafil in the past two months was significantly correlated with participation in sexual marathons. Findings are discussed in terms of their implications for HIV/STI prevention and intervention.     

Sexual Pleasure and Condom Use

The purpose of the present study was to determine whether sexually-experienced individuals’ pleasure ratings for protected and unprotected vaginal intercourse would be related to actual condom use. College participants (80 women and 35 men, M age = 22.29 years) who reported engaging in vaginal intercourse in the past 3 months completed a questionnaire that assessed their perceptions of the pleasurability of unprotected and condom-protected vaginal intercourse and their own sexual behaviors. Both women and men rated unprotected vaginal intercourse as more pleasurable than protected vaginal intercourse. However, men’s pleasure ratings for unprotected vaginal intercourse were higher than women’s. Furthermore, men and women’s pleasure ratings for condom-protected intercourse were correlated with their actual condom use behaviors. Men’s “pleasure decrement” scores indicated a significantly greater reduction in pleasure ratings between unprotected and protected intercourse than women’s scores. Men who perceived a larger decrease in pleasure between unprotected and protected intercourse were less likely to have used condoms in the past 3 months than those who perceived a smaller decrease in pleasure. The results provide evidence that many people believe that condoms reduce sexual pleasure and that men, in particular, who believe that condoms decrease pleasure are less likely to use them. Condom promotion campaigns should work to emphasize the pleasure-enhancing aspects of condom use.     

Unprotected Sexual Behavior Among Heterosexual HIV-Positive Injection Drug Using Men: Associations by Partner Type and Partner Serostatus

Few studies have examined sexual risk behaviors of HIV-positive, heterosexual, injection drug using (IDU) men. We investigated such behaviors and associations with risk among sexually active, HIV-positive IDU men who reported only female sex partners in the 3 months prior to baseline interview. We examined associations separately for four non-exclusive groups of men by crossing partner type (main or casual) and partner serostatus (HIV-positive or HIV-negative/unknown). Of 732 male participants, 469 (64%) were sexually active with only female partners. Of these 469 men, 155 (33%) reported sex with HIV-positive main partners, 127 (27%) with HIV-negative or unknown serostatus main partners, 145 (31%) with HIV-positive casual partners, and 192 (41%) with HIV-negative/unknown serostatus casual partners. Significant multivariate associations for unprotected sex with HIV-negative or unknown serostatus main partners were less self-efficacy to use condoms, weaker partner norms supporting condoms, and more negative condom beliefs. Similar correlates were found for unprotected sex with HIV-positive main and casual partners. In addition, alcohol or drug use during sex was a significant correlate of unprotected sex with HIV-positive main partners, while depression was significant for HIV-positive casual partners. For unprotected sex with HIV-negative/unknown status casual partners, self-efficacy for condom use, sex trade, and education were significant multivariate correlates. A combination of broad and tailored intervention strategies based on the relationship pattern of men's lives may provide the most benefit for reducing unprotected sex with female partners.Purcell and Mizuno are with the Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA; Metsch is with the University of Miami, Miami, FL, USA; Garfein is with the Department of Family and Preventive Medicine, University of California at San Diego, San Diego, CA, USA; Tobin is with the Bloomberg School of Public Health, Baltimore, MD, USA; Knight is with the University of California at San Francisco, San Francisco, CA, USA; Latka is with the Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY, USA.The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.     

Identification of Strategies for Promoting Condom Use: A Prospective Analysis of High-Risk African American Female Teens

Condom promotion strategies for adolescents typically include provision of STD/HIV-associated knowledge, fostering favorable attitudes toward condom use, promoting positive peer norms regarding condom use, improving condom-related communication skills and self-efficacy, and overcoming barriers to condom use. The purpose of this study was to identify which of these constructs were prospectively associated with condom use among a high-risk sample of African American adolescent females reporting sexual activity with a steady male partner. Adolescents, 14–18 years old, were recruited from schools and health clinics. Adolescents completed an in-depth survey and interview at baseline and again 6 months later. Analyses were limited to adolescents with steady partners who reported sexual activity between the baseline and 6-month follow-up assessment periods (N = 179). At baseline, five-scale measures and a single-item measure were used to assess predictive constructs. At follow-up, adolescents were asked about their frequency of condom use over various periods of recall. Multivariate models were created to control for the confounding influence of pregnancy status. The findings were remarkably distinct. The evidence strongly supported the predictive role of perceived barriers toward condom use and peer norms. The measure of sexual communication achieved significance for two of the six assessed outcomes. Alternatively, measures of attitudes toward condom use, condom negotiation self-efficacy, and knowledge about STD/HIV-prevention were consistently nonsignificant. The findings suggest that to improve effectiveness of individual-level STD/HIV prevention programs, designed for this population, program emphasis should be on reducing barriers to condom use, teaching partner communication skills, and fostering positive peer norms relevant to condom use.     

The Urban Environment and Sexual Risk Behavior among Men who have Sex with Men

Increasingly, studies show that characteristics of the urban environment influence a wide variety of health behaviors and disease outcomes, yet few studies have focused on the sexual risk behaviors of men who have sex with men (MSM). This focus is important as many gay men reside in or move to urban areas, and sexual risk behaviors and associated outcomes have increased among some urban MSM in recent years. As interventions aimed at changing individual-level risk behaviors have shown mainly short-term effects, consideration of broader environmental influences is needed. Previous efforts to assess the influence of environmental characteristics on sexual behaviors and related health outcomes among the general population have generally applied three theories as explanatory models: physical disorder, social disorganization and social norms theories. In these models, the intervening mechanisms specified to link environmental characteristics to individual-level outcomes include stress, collective efficacy, and social influence processes, respectively. Whether these models can be empirically supported in generating inferences about the sexual behavior of urban MSM is underdeveloped. Conceptualizing sexual risk among MSM to include social and physical environmental characteristics provides a basis for generating novel and holistic disease prevention and health promotion interventions. Frye, Latka, Putnam, Galea, and Vlahov are with the Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, USA; Koblin is with the New York Blood Center, New York, NY, USA; Halkitis is with the Department of Applied Psychology, New York University, New York, NY, USA; Vlahov is with the Department of Epidemiology, Columbia University, New York, NY, USA; Galea is with the Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA.     

Psychosocial correlates of fruit and vegetable consumption among African American men

OBJECTIVE: To determine the best predictors of fruit and vegetable consumption among African American men age 35 years and older. DESIGN: Data (n = 291) from a 2001 nationally representative mail survey commissioned by the American Cancer Society. PARTICIPANTS: 291 African American men age 35 years and older. MAIN OUTCOME MEASURES: Dependent variables: (1) total fruits and vegetables without fried potatoes, (2) total fruit with juice, and (3) total vegetables without fried potatoes. Independent variables included 3 blocks of predictors: (1) demographics, (2) a set of psychosocial scales, and (3) intent to change variables based on a theoretical algorithm. ANALYSIS: Linear regression models; analysis of variance for the intent to change group. Alpha = .05. RESULTS: Regression model for total fruits and vegetables, significant psychosocial predictors: social norms, benefits, tangible rewards, and barriers-other. Total fruit with juice: social norms, benefits, tangible rewards. Total vegetables, no fried potatoes: tangible rewards, barriers-other interests. CONCLUSIONS AND IMPLICATIONS: For African American men, fruit consumption appears to be motivated by perceived benefits and standards set by important people in their lives; vegetable consumption is a function of extrinsic rewards and preferences for high-calorie, fatty foods. The results suggest that communications to increase fruit and vegetable consumption should be crafted to reflect differences in sources of motivation for eating fruits versus eating vegetables.