Social Theory & Health, 2007, 5, (245–266)

r 2007 Palgrave Macmillan Ltd All rights reserved. 1477-8211/07 $30.00

www.palgrave-journals.com/sth

Tapping the Core: Behavioral

Characteristics of the Low-Income,
African-American Male Core Group
LEIGH A WILLIS

Department of Sociology, Institute for African-American Studies, 315 Baldwin

Hall, The University of Georgia, Georgia, USA. E-mail: LAWILLIS@UGA.EDU

African-Americans (AA) have been among the hardest hit by the hidden epidemic of
sexually transmitted diseases (STDs) in the US. One potential means of reversing this
epidemiological trend is to identify groups responsible for the sustained prevalence of
STD in the AA community, who are commonly known as ‘core groups’. However, there
is a lack of specific information about characteristics and attitudes of this group as
researchers have yet to empirically define this ‘core group’. The primary purposes of this
study are to define and confirm the existence of the social epidemiological concept
known as the core group among AAs and to determine the sexual beliefs and practices
of AA male core group using habitus. Data from 266 low-income, AA males between the
ages of 16 and 78 recruited from an inner-city STD clinic in the southeast are analyzed.
Findings indicate differences between core and non-core men in sexual activity, STDs,
age and age of sexual initiation, monogamy, trading money or drugs for sex, sexual
preoccupation, and beliefs and attitudes.
Social Theory & Health (2007) 5, 245–266. doi:10.1057/palgrave.sth.8700089

Keywords: epidemiology; STI/STD; habitus; sexual risk; African-Americans; men

INTRODUCTION

In the last 25 years, the incidence of HIV and sexually transmitted disease (STD)
among African-Americans (AA) has dramatically increased (Centers for Disease
Control and Prevention, 2004). Currently AAs constitute 12.5% of the population,
while they accounted for over 54% of all new HIV diagnosis and 56% of new
AIDS cases reported in 2002 (Centers for Disease Control and Prevention, 2003).
As of 2003, HIV was the ninth leading cause of death for all
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AAs (Centers for Disease Control and Prevention, 2005). Furthermore, the rate of
adult and adolescent cases among AA has been seven to 11 times the rate for
whites for the last 6 years (Centers for Disease Control and Prevention, 2004). AAs
also have higher rates of gonorrhea, syphilis and chlamydia (McNeil and Williams,
2004).
The increasing rate of HIV and STDs among AAs is alarming for a variety of
reasons. First, this increase is occurring as the rate of HIV is decreasing in other
segments of the population. For example, from 1985 to 2001, the proportion of
AIDS cases among AA increased from 23% to 49%, while among whites
decreased from 62% to 31% (Centers for Disease Control and Prevention, 2001).
Second, if left unaddressed the spread of HIV and STDs will continue to have a
significant impact on the reproductive health and generation of human capital of
AAs. As of 2003, HIV/AIDS is the fourth leading cause of death among AA
women during the child-bearing years (20–40) (Centers for Disease Control and
Prevention, 2004). Similarly, AA children bear a high burden of disease as
evidenced by AA children having the highest rate of pediatric AIDS cases in 2002,
58.7 per 100,000 compared to 5.9 per 100,000 for whites (Centers for Disease
Control and Prevention, 2003). Also, when left untreated STDs influence
reproductive health through sterility in men and women and birth defects in
children (Brunham et al., 1990).
Third, this phenomenon indicates a shift in the means of transmission of
HIV/AIDS among AA men who have sex with men to the heterosexual population.
Specifically, heterosexual sexual contact is now the primary means of transmission
among AA women (Centers for Disease Control and Prevention, 2004). Fourth,
perhaps even more disturbing is that the increase is occurring at a time when there
has been considerable research and intervention development devoted to
preventing HIV and STDs in the general population and among AAs in particular.
The limited effectiveness of prevention activities may be the result of previous
efforts focusing on changing attitudes and risk behaviors among AA women and
MSMs, while ignoring a key group, AA men who identify as heterosexual (Millett
et al., 2006). Understanding the behaviors and beliefs of this group, in particular, is
a critical and overlooked step in STD prevention.

In light of the consistent increase in HIV, sustained prevalence of STD and

lack of a clear definition of the core group, the primary purpose of this study is to
explore and confirm the existence of the social epidemiological concept known as
the core group among AAs. The secondary purpose of this study is to explore the
sexual beliefs and practices of AA male core group.
Many epidemiological studies focusing on STD and HIV have attempted to
explain the spread and persistence of STDs through the core group concept; that is,
those individuals who are responsible for sustaining HIV and STDs in
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a given population over time (Rothenberg, 1983; Yorke et al., 1978). Although
epidemiological research has sought to refine this critical concept, an empirical
definition has proven to be nebulous, thus limiting its application for three basic
reasons. First, while the core group is accepted as a valid theoretical and practical
construct, at present research seeking to define and verify characteristics of a core
group has been inconsistent (Thomas and Tucker, 1996). Next, few if any of these
studies examine psychosocial and relationship factors that influence behaviors
leading to transmission. Lastly, most epidemiological studies do not place these
factors in the proper social, economic and environmental contexts necessary to
ensure the effectiveness of prevention activities among AAs. Given the consistent
prevalence of STDs and recent increase of HIV in the AA community coupled with
the shortfall of prevention efforts, there is a need for research that defines and
explores the AA core group.

In order to define, confirm and explore the core group this paper will draw on
several literatures. First, this paper begins with a discussion of the ‘sexual habitus’
of inner-city AA men as it relates to the spread of STDs. Immediately following
the discussion of the sexual habitus, the core group concept is reviewed. Third,
methods and plan of analysis are described. Finally, the results and discussion are
presented along with suggestions for future research.

Habitus
In an attempt to discern the origins of sexual behavior of heterosexual AA men, it
is necessary to explicate the forces affecting this behavior. Given sexual behavior
is usually determined by expectations of society, community, family, peer group
and situational opportunities, sexual behaviors are largely the function of the
internalization of social structure. The concept of habitus is particularly applicable
to understanding the sexual behavior of low-income, urban, AA men because it
focuses on the influence of socialization, class-rooted behavior and the
environmental context of such behavior. Thus, habitus is useful in understanding
the sexual behavior of AA men.
Habitus, as described by Bourdieu (1984), is the internalization of external
social structures and conditions by individuals, which produce enduring
orientations toward actions that consistently channel behavior in particular,
habitual ways as opposed to others. It is an acquired set of social views encoded in
early socialization, realized through praxis (social actions). Habitus starts to form
in childhood socialization and life experiences reflected through the individual’s
class circumstances. Bourdieu believed that early experiences are important to the
habitus because it becomes fixed and resists change. Early experiences in particular
become fixed in an individual’s mind
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as a ‘habit-forming force’ and ‘set of deeply interiorized master patterns’

(Bourdieu, 1984, 23), which resist change.
As every group has views and theories about their role in the world,
consequently each group develops its own habitus, which is internalized by
members. According to the theory, this is true because people in the same groups,
classes and societies are likely to share the same habitus due to shared experience
(Swartz, 1997). The mores and norms of a group or class, along with its position in
the world and society, influence the development of a specific habitus or
dispositions to act in a given way. Thus, habitus influences individual actors’
interpretations by placing actions within the context of a larger framework. For the
most part people are unaware of their use of habitus, therefore we can think of it as
routine, prescriptive, unthinking and habitual. Similarly, people are passive in the
construction of their own habitus. Conceptualized, habitus is a set of practical
thoughts and actions people as well as groups use habitually and unconsciously
when faced with given situations to resolve matters in a predictable manner.

In sum, the living conditions of a society, group or class, its position in the
world and society, spawn a specific habitus or dispositions to act in a given
situation. Simply put, habitus gives us multiple paths for our actions by providing
us with categories of what is possible. Habitus is not innate and must be
constructed and internalized from social activities such as school, family or the
workplace. Therefore, it is safe to reason that habitus is often encoded
unconsciously during socialization. Class and living conditions also shape the
construction of habitus. As a result, classes and groups within societies will
develop a unique habitus of their own. This implies that habitus is developed and
reinforced through social interactions with one’s own social group and society as a
whole. Overall, habitus is what is responsible for an individuals’ disposition to act
in a particular manner in a given situation. In short, we learn various roles in
society or group and then we have the ability to make the right move at the right
time.

Formation of sexual habitus of low-income AA men

Habitus is a crucial concept to this study because it takes into account the class,
social and economic factors in society that affect individual behavior. The concept
of habitus is particularly applicable to understanding the sexual behavior of low-
income, AA men because it explains the effect of social structure on the behavior
of classes and groups. Since class, history and environment influence habitus, it
strengthens the argument made by many researchers regarding the sexual behavior
of low-income AA men. For instance, Staples and others have argued that
historically the community regulated sexuality through monitoring the dating
patterns of children and
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young adults (Staples, 1999). This was particularly true when AA commu-nities
were more cohesive. It was common for dating behavior to be organized in the
context of the neighborhood, church and school. For the most part, dating was a
very casual process in which attachments were formed which led to marriage.
During this time, the community had powerful sanctioning and monitoring
functions regarding dating. Consequently, young people were made aware that they
had reputations to uphold, so they were not blatantly promiscuous due to the social
control enacted by the community at large (ie, church, family and peers). As the
communities declined due to economic and social changes, the monitoring function
of the community did as well. Simply, due to social mobility middle-class blacks
left the inner cities taking with them critical social and economic capital.

Anderson (1990), Wilson (1987, 1996) and others have argued that changes in
economic and social structure in the AA community have significantly impacted in
the lives of low-income men. Specifically, the combined changes in the economy
coupled with low levels of education reduced the number of marriageable AA men
(Bowman and Sanders, 1998; Staples, 1999). Also, stipulations put on family
assistance removed the physical and symbolic presence of the father from the home
(Jewell, 2003). As a result, this created a social environment in many low-income,
AA communities where growing up fatherless became the rule rather than the
exception (Anderson, 1999; Billson, 1996; Johnson and Staples, 2005; Wilson,
1996). Now the ‘fatherless’ generation is entering its sexual prime, leading to the
construction of a risky sexual habitus. This habitus arises because many young
males have not been able to observe a meaningful male/female relationship.
Instead, it is commonplace for a man to have several partners, while he remains
unattached.

There are several key ingredients in the construction of this habitus. First,
young men in low-income areas are aware of the limited opportunities available to
them. As a result, many decide against forming stable unions with partners as they
enter adulthood (Anderson, 1999; Johnson and Staples, 2005; South, 1993; South
and Lloyd, 1992; Staples and Johnson, 1993). Owing to the perception of future
inability to support a family, marriage is seen as unattainable or undesirable
(Bowman and Sanders, 1998; Darity and Myers, 1987; Laumann et al., 2004;
Wilson and Neckerman, 1986).
Second, excess mortality coupled with high rates of incarceration of AA men,
has caused a sex ratio imbalance among AAs (Johnson and Staples, 2005; South,
1993; South and Lloyd, 1992). The imbalance is problematic because it causes
many women to unknowingly or unwittingly share partners unless they choose to
date and marry with those outside of their racial and ethnic group (Laumann et al.,
2004; Wyatt et al., 1999). Furthermore, AA men
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and women are aware of the implications of the imbalance. AA men realize they
have advantage in relationships because it is easier for them acquire another
partner. This influences the likelihood of preventive behaviors such as condom use.
For example, if a woman insists on wearing a condom during intercourse and her
male partner refuses for whatever reason, he may terminate the relationship and
search for a partner who will not insist on wearing one (Harvey and Bird, 2004).
Overall, the sex ratio imbalance has created a sexual relationship market which
caters to the needs of men (sellers) rather than women (buyers) (Ferguson et al.,
2006). The imbalance is a structural factor that influences the development of the
risky habitus among AA men.

Third, there is the social myth that AA men are hypersexual, which some may
internalize or may view this as a source of pride or self-esteem that they feel the
need to live up to (Collins, 2004; Majors and Gordon, 1994). Often, young AA
men may see this hypersexual behavior played out in the community or in the
popular media. Fourth, given the decrease in social control and monitoring by the
community there is often the expectation of the peer group, that one become a
‘player’ and have as many sexual partners as possible to prove their manhood and
increase their social standing (Harper et al., 2004; Majors and Gordon, 1994;
Staples, 1982; Youm and Laumann, 2002). The norm is to prove manhood sexually
due to an inability to attain it economically. Fifth, there appears to be a disdain of
condom use given that the STD and fertility rates remain relatively high (Crosby et
al., 2005; Essien et al., 2005b; Grimley et al., 2004; Ross et al., 2003). The
current structure of low-income AA communities fosters attitudes, practices and
patterns of risky sexual behavior.

After reviewing the literature regarding the social and economic structure of
low-income, AA communities, it is clear that some heterosexual, low-income, AA
men have developed a distinct sexually risky habitus. This habitus promotes
widespread promiscuity and a lack of emotional attachment to sexual partners
particularly in low-income communities. However, it is important to remember that
not every member of a group internalizes the surrounding structure the same way;
as such, some men do not adopt the ‘promiscuous’ habitus. Still, the characteristic
promiscuity that is a part of the habitus of many low-income AA men places them
in a high-risk category for STD known as the ‘core group’.

Core group concept

Yorke et al., 1978 first conceptualized and used the term ‘core group’ as they
speculated about the dynamics that led to the transmission of STDs specifically
gonorrhea. Following the principle that most STDs are easily
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1

curable thus making the individual susceptible to disease again, there was a need to
explain how such diseases maintain background prevalence. They deduced that a
subset of the at-risk segment of the population was indirectly or directly
responsible for all cases of the disease in a population and in fact, may be integral
in the re-emergence and spread of STDs throughout the general population in
recent years (Eng and William, 1997). Some have speculated that if the core were
treated and somehow prevented from infecting others, STDs would be eliminated
(Blower et al., 2004; Boily et al., 2002; Rothenberg, 1983; Yorke et al., 1978).
While initially this term was epidemiological, Potterat (1992, 16) gave the core a
more behavioral definition, ‘ygroups of people whose sexual and health behaviors
are such that microorganisms find many opportunities for sustained transmission.’
Some have conceptualized the core as ‘people who change sexual partners
frequently’ (Garnett et al., 1992, 189).

Since its conceptualization, researchers have sought to define character-istics

of the core, but a review of literature demonstrates that empirically defining core
characteristics has been a formidable challenge. As a result, there is no consensus
among researchers as to the definition of the core group. The uncertainty of the
term has caused many to be frustrated and unsure of how to use the concept in
research, with some calling for a new concept and others moving toward ‘sexual
networks’ as a means of understanding the transmis-sion of STD (Potterat and
Muth, 1996; Rothenburg and Narramore, 1996; Wasserheit, 1995). Still, as
Wasserheit points out the utility of the concept cannot be shortchanged,‘The core
group concept cannot be ignored when one considers the effectiveness of STD
prevention programs rather than simply the effectiveness of individual
interventions’ (Wasserheit, 1995,165).
Although research on characteristics of the core has had limited success, one
area which has shown promise is the confirmation of core groups in geographic
areas (eg, neighborhoods, zip codes, streets) (Potterat, 1992; Potterat et al., 1985;
Rothenberg, 1983; Zenilman et al., 1999). As Thomas and Tucker (1996) point
out, characteristics and definitions of the non-spatial approaches to the core group
vary by study. Furthermore, Laumann and Youm (1996, 1999) have attempted to
provide clear definitions and characteristics of the core group.

In an effort to better understand the core group and its relationship to the rest
of the population, Laumann and Youm (1996, 1999) reduced the concepts of the
‘core’, ‘peripheral’ and ‘adjacent’ subgroups originally described by Rothenberg
(1983) to the individual level. They defined the core as those individuals, who
have had four or more partners in the past 12 months, some of which were
concurrent. The adjacent group were defined as ‘those who had one or two
partners who were concurrent or had been paid for sex’ (1996,
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22). The adjacent group includes those who had three partners that may have been
concurrent and people who had four or more non-concurrent partners. Finally,
Laumann and Youm defined the peripheral group as people ‘who had only one or
two partners, none of whom were concurrent or paid.’ (1996, 22).
Laumann and Youm (1996) describe a core group as encompassing three types
of individuals: lifetime members, current members and newcomers. Lifetime
members of the core are men and women who report having 11 or more sex
partners in their lifetime (since the age of 18) and described some of those
partnerships as having overlapped in time (non-monogamous). Current core
members are men and women who have had more than more four sexual partners
in the last 12 months and describe some of those partnerships as having overlapped
in time. Newcomers to the core are those potential core members in their mid-
twenties who have not acquired more than 11 partners, but are well on their way to
doing so. It is important to note every ethnic/ racial group features each of the
subgroups including a current core. Furthermore, these distinctions concerning the
core are important because they provide insight about the spread of STDs in the
AA community. Laumann and Youm hold that the high rate of infection among
AAs in comparison to other groups may be the result of a larger core.

It seems that the traditional exchange of sex appeal from women for the
economic support men is declining in low-income communities, given the high rate
of AA male incarceration, unemployment and female-headed households.
Consequently, AA women are better able to define their own status and are
becoming more economically independent of men. Further-more, given the
circumstances many women now only seek to have their emotional and physical
needs met by men, rather than their financial ones. Staples (1999) points out,
‘While men must confront this new reality, women must realize that emotional
needs can be taken care of by men in all social classes.’ ‘Although similar
education and income can mean greater compat-ibility in values and interests, there
are no guarantees of this compatibility or of personal happiness’ (p. 43). Therefore,
it follows that women would have relationships and sexual contact with men of
lower socioeconomic status who may be members of the core. It is likely that high
incidence of STDs among AAs is due to the increased ‘sexual mobility’ of this
core. The spread of disease from core to periphery is diagrammed in Figures 1 and
2. In addition, Laumann and associates found that AA men demonstrate stronger
racial homophily in their mating patterns, than other groups (Laumann et al.,
2004). This strong in-group preference may serve as a catalyst in the prevalence of
STDs within the AA community.

Given the importance of the core group concept, the lack of a consensus
definition of the core group, lack of information on potential AA men in the
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Core Adjacent Peripheral

Figure 1: Traditional core group model of STI/STD transmission.

Core Adjacent Peripheral

Figure 2: Core Group model of STI/STD transmission among AA.

core this study has three goals. The first is to confirm the existence of the core
group by testing a core group definition. Second, this study attempts to discern if
there are attitudinal differences among AAs within and outside of the core. The
following hypotheses will be tested:

Core versus non-core membership

H1: Core group members will be younger and have a lower age at first
intercourse than non-core members.

H2: Core group members will have higher mean indicators of sexual risk than
non-core members. (Lifetime number of sexual partners, number of partners in the
last 3 months, sex partner ratio and total lifetime number of STDs.)

Behavioral and attitudinal differences

H3: Core group member will be less likely to have ever engaged in monogamy
than non-core members.

H4: Core group members will be more likely to think about sex and to have
engaged in the sex trade than non-core members.

H5: Core group members will be more likely to hold attitudes that oppose
regular condom usage.

H6: Core members will be more likely to hold traditional beliefs regarding
sex.

Cross-sectional, self-reported, behavioral and attitudinal data will be used in

concert with longitudinal medical record data to test hypotheses.
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METHOD

Participants
The initial data were collected during the summer of 1996 from a county STD
clinic in a major metropolitan area in the southeast. The sample contained 266 men
of ages 16–70. Respondents were recruited while waiting to be voluntarily
examined. It is safe to assume that the sample drawn from this population is low
income because typically county publicly funded clinics serve the lower and under-
classes (Cockerham, 2007). Respondents were compensated six dollars for
participating and were made aware of their right to terminate the interview at any
time with compensation. Participants did not lose their place in line while they
waited to see a doctor using a computer system that kept their place. The study had
a 97% recruitment rate, so the sample bias is small.

Survey instrument
AA male college students administered the 25-min questionnaire. Topics included
in the survey were sex-role attitudes, nature of the relationship with sexual
partners, and measures of sexual risk taking behavior.

Medical record data

The medical data were collected during the spring and fall of 1998 such as to give
each respondent in the study a 2-year follow-up period based on the date of their
interview. Data were abstracted using the County Department of Health computer
records. There were some limitations in the patient records; patients were allowed
to keep their visits anonymous, so their records were discarded and their names
were removed for the system. As a result, only 271 out of 336 (80.7 %)
respondents had medical records in the system and were able to be fully analyzed.

Variables
Core group predictors
To verify the existence of and to explore the core group concept the following
measures were used:
Age: The respondent’s age was obtained from clinic records.
Sexual orientation: Response options were women, men or both. If a
respondent indicated they had sex with men or both they were not included in the
study.
Age at first sex: The age at which the respondents of first had intercourse.
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Number of partners in the last 3 months: The number of sexual partners

the respondent had in the last 3 months.
Lifetime number of sexual partners: The number of sexual partners the
individual has acquired represents the total number of sexual partners an individual
has had throughout the course of their life. This number starts with the first person
they had intercourse with and continues up to the time the respondent agreed to
participate in the study.
Sex partner ratio: To approximate the rate at which the respondent acquires
partners a ratio was created by dividing the lifetime number of sexual partners
reported by the number of years since they first became sexually active. The
number of years sexually active was calculated by subtracting the age at which
they first had sex by their current age.
Number of STDs: The number of STDs for each respondent was obtained
from information provided by the County Department of Health. The number
represents the total number of STDs the respondent acquired from the time they
first came to the clinic, to the end of the 2-year follow-up period created by the
interview. The information concerning STDs included the total number of STDs as
well as the name. Still, it is possible the number of STDs is underrepresented
because the men may choose to have their symptoms treated in another clinic.

Behavioral characteristics and attitudes

Sexual preoccupation: Sexual preoccupation has been listed as a potential
characteristic of the core group. The response options were (1) never or seldom,
(2) occasionally, (3) frequently and (4) all the time. This item was orthogonally
recoded (0) never seldom/occasionally and (1) frequently/all the time.
Sexual bartering: This statement sought to determine if respondent engaged
in sexual bartering using drugs or money. The response options to this question
were coded Yes (1) or No (0).
Sexual knowledge: These items measured general knowledge about sexual
practices and risk for disease. These items were rated on a four-point Likert scale,
(4) strongly agree, (3) agree, (2) disagree, (1) strongly disagree. Some items were
reverse coded. This item was orthogonally recoded (0) disagree and (1) agree.

Traditional masculine sexual beliefs. These items measured traditional

beliefs of how men and women ‘should’ act regarding sex. These items were rated
on a four-point Likert scale, (4) strongly agree, (3) agree, (2) disagree and (1)
strongly disagree. This item was orthogonally coded (0) disagree and
(1) agree.
Monogamy: Monogamy is relevant because it indicates whether the
respondent has ever had multiple partners in the course of a relationship.
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This variable acknowledges if the respondent has ever been in a monogamous

relationship in the past. The response options to this question were coded Yes (1)
or No (0).

Dependent core group variables

Given the measures available in the present study, core group men were considered
a core member if they met any of the criteria which are derived from Laumann and
Youm (1996):

1) Men over the age of 25 years, reporting 11 or more sex partners in their
lifetime and a sexual partner ratio greater than 1.
2) Men who have had more than two sexual partners in the last 3 months and
have a sexual partner ratio greater than 1.
3) Men younger than 25 years of age, having less than 11 lifetime partners, and a
sexual partner ratio greater than 1.

Men who do not meet any of these criteria will be considered non core.

RESULTS
Analysis
To determine the validity of these group definitions and explore the possibility of
meaningful differences demographic differences between proposed groups, t-tests
will be performed. To determine, attitudinal differences logistic regression were
executed. The data were analyzed using SAS using age of the respondent as a
control. Given the high standard error, skewed distribution of data and the
exploratory nature of this research the level of statistical significance at 0.10.

Descriptive statistics
Table 1 shows that the sample is relatively young (M ¼ 28.32 years) and started
having sex slightly earlier than the current national average of 16

Table 1. Selected descriptive statistics

Variable Mean M ode STD deviation Missing

a
Age 28.32 23.61 8.49 2
Age first sex 14.71 16 2.28 1
Lifetime no. of partners 36.01 20.00 87.01 14
No. of partners in the last 3 months 2.29 1 2.07 0
Sex partner ratio 2.75 N/A 4.69 17
Total no. of STDS 3.69 1 4.14 0
N 268
a
=multimodal.

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years (M ¼ 14.71 years) (CDC 2006), although the mode indicates that many men
are at the national average. Given the high mean number of sexual partners (M ¼
36.01), it is safe to say the sample is sexually active although the mode is lower
(20.00) thus, indicating that some individuals in the sample are less sexually active.
The sample has a mean number of partners in the last 3 months over 2 (M ¼ 2.29),
although the mode indicates a number of men only have had one partner during
that period. The sex partner ratio of the sample is almost three per year (2.75), with
no true mode. Finally, while the sample has an average lifetime number of almost
four STDs (M ¼ 3.69), the mode (1) indicates that some in the sample have not had
quite as many.

Core versus non-core membership

As Table 2 indicates the t-tests revealed several key differences between core and
non-core members. As a group, core members have a lower mean age and age of
first sexual intercourse. Core members have a higher mean number of lifetime
partners and partners in the last 3 months, sex partner ratio and total numbers of
STDs.

Behavioral and attitudinal differences

Odds ratios in Table 3 indicate that controlling for age, core members were less
likely to have had a monogamous relationship for a year or longer. Core members
were over two times more likely to engage in the sex trade and were one and a half
times as likely to have thought about sex. In regard to condom use, core members
were more likely to hold the following views: it is hard to use condoms with a
steady sex partner; it is difficult to start using condoms with a steady sex partner;
condoms are not needed due to other forms of birth control; it is acceptable to stop
using condoms once you are familiar with your partner than were non-core
members. Similarly, core group members were over one and a half times more
likely to feel that men need sex more often than women and that they are always
ready for sex.

Table 2. Comparison of demographic variables core group sample characteristics

Variable Core group Non-core group Difference

****
Age 26.80 31.00 ₃4.20****
Age first sex 14.55 16.24 ₃1.69
Lifetime no. of partners 47.17 14.51 32.66 **

No. of partners in the last 3 months 2.62 1.50 1.12****

Sex partner ratio 3.54 1.20 2.34****
Total no. of STDs 3.75 1.50 2.25***
N 166 86
****Po0.001, ***Po0.01, **Po0.05.

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Table 3. Logistic regression model of behavioral and attitudinal variables predicting core and
non-core membership

Variable b OR 95% C I
****
Age ₃0.330 0.928 0.890, 0.968
***
Monogamy ₃0.219** 0.434 0.215, 0.874
Sexual bartering 0.187 2.311 1.011, 5.283

Thinking about sex 0.195** 1.567 1.049, 2.340

Women use other birth control so condoms are
unnecessary 0.147* 1.460 0.418, 1.123
Men should feel free to have sex with other men 0.100 1.330 0.855, 1.968
Safe to have sex w/o condom if you know partner ₃0.160* 1.458 0.926, 2.296
It’s really hard to start using condoms with a steady
sex ₃0.044 0.913 0.605, 1.379
partner 0.163*
It’s okay to stop using condoms once you get to know
your 1.510 0.911, 2.502
partner
Men can not get AIDS from a woman ₃0.035 0.907 0.518, 1.586
Aids is a gay men’s disease ₃0.023** 0.936 0.532, 1.644
Men need sex more than women 0.205 1.588 1.006, 2.507
Men are always ready for sex 0.223*** 1.692 1.106, 2.588
Its better if a woman is a Virgin when she marries 0.004 1.009 0.694, 1.467
w2 47.14****
DF 14
N C ore: 161;
non-core: 84
****Po 0.001, ***Po0.01, **Po0.05, *Po0.10.

DISCUSSION

Overall, the results confirmed all of the hypotheses.

H1: Core group members will be younger and have a lower age at first
intercourse than non-core members.

As predicted, core group members had a younger mean age and lower age of
sexual initiation than non-core members did.

H2: Core group members will have higher mean indicators of sexual risk than
non-core members. (Lifetime number of sexual partners, number of partners in the
last 3 months, sex partner ratio and total lifetime number of STDs.)

As hypothesized, core group members had higher mean number of lifetime number
of sexual partners, number of partners in the last 3 months, sex partner ratio and
total lifetime number of STDs compared to non-core members.
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H3: Core group member will be less likely to have ever engaged in monogamy
than non-core members will.

Consistent with the literature and hypotheses, core group members were less likely
to have ever been in a monogamous relationship for a year or less than non-core
members were.

H4: Core group members will be more likely to think about sex and to have
engaged in the sex trade than non-core members will.

As predicted, core group members were more likely to be sexually preoccupied and
to have traded money or drugs for sex than non-core members were.

H5: Core group members will be more likely to hold attitudes that oppose
regular condom usage.

As predicted condom core, group members were more likely to hold beliefs and
attitudes, which opposed condom usage in some instances. Specifically, core
members were more likely to agree with the statements that did not favor sustained
condom use than non-core members. In particular, core group members were more
likely to agree that condoms were not necessary due to other forms of birth control,
that it safe to have sex without a condom if you know your partner and it is
acceptable to stop using condoms once you are familiar with your partner.

H6: Core members will be more likely to hold traditional beliefs regarding
sex.

Consistent with the hypothesis core members were more likely to have traditional
beliefs regarding masculinity and sex than non-core members. Specifically, core
members were more likely than non-core members to agree that men need sex
more than women do and men are always ready for sex.

These results have important theoretical and practical significance.

Theoretically, these results provide a clearer definition of a core group and
evidence of the sexual habitus of low-income, AA men. Defining core groups is
important given its utility in epidemiology and the inability of prior research to do
so. Despite, the limitations of the data it is reasonable to conclude that this study
identified distinct core and non-core groups in this population. Simply put, these
results provide quantitative support for the
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definitions of the core offered by Potterat (1992) and Garnett et al. (1992), as core
men were more sexually active than non-core men. Specifically, core men had a
higher number lifetime number of partners, partners in the last 3 months and sex
partner ratio. Therefore, it is not surprising that core men had a higher mean
number of STDs. Contrastingly, as the study identified an empirically valid, non-
core group, this research demonstrates that the cultural myth of all low-income AA
men being ‘oversexed’ and members of the core is erroneous. This finding is
explained by the theory of habitus because as Bourdieu posited not every member
in a group adopts the group habitus.

While the findings uncovered more definitive core characteristics, they also
demonstrate the presence of a sexual habitus of low-income, AA men. This
particular sexual habitus is rooted in the economic and social conditions of low-
income AAs. Specifically, the finding that core men were less likely to have ever
been in a monogamous relationship highlights the effect of the sex ratio imbalance
among AA on this particular habitus. It is likely the relationship market, lack of
economic prospects and peer group expectations contribute to a lack of monogamy
among this group.
The findings that core members were more likely to endorse statements that it
is acceptable to taper condom use once you know your partner is consistent with
the habitus. These attitudes highlight the reproductive health risk of this group to
women; given core men have a higher number of partners and more STDs. Simply
put, the notion that by ‘knowing’ their partner they can somehow tell whether they
have a STD is problematic because if they are not monogamous and not using
condoms they put their partner at risk for an STD. After all the men and their
partners may not be aware that they have an STD given that many STDs are
asymptomatic (Eng and William, 1997). Other studies have found that increasing
partner familiarity is associated with decreased condom usage (Essien et al.,
2005a; Geringer et al., 1993; Grimley et al., 2004; Maxwell and Bastani, 1999;
Ross et al., 2003; Thorburn et al., 2005). Also, given a man has a degree of
leverage due to the sex ratio imbalance and women being aware of it and not
wanting to lose their partner, it is likely that once he feels a condom is not
necessary then they are not used (Ferguson et al., 2006; Harvey and Bird, 2004;
Wyatt et al., 1999).

Another means by which habitus influences condom use is through its new
view of manhood. In this definition of manhood, the number of partners and
children serve as a measure of masculinity rather than the traditional concept
manhood (economic provision). Although core group men were more likely to feel
condoms are not necessary given women’s use of other forms of birth control, it is
likely given the sex ratio imbalance, women may
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1

opt not to use any birth control in the hopes of getting pregnant to ensuring a
lasting relationship with the father or to raise their self-esteem (Gibbs, 1984;
Staples, 1999). Still, this result does not definitively indicate that these men do not
want to father a child given that it barely attained statistical significance and
findings of similar studies indicate that although pregnancy is to be avoided, it is
not entirely undesirable outcome (Davies et al., 2004; Jenkins, 2002).

The finding that core members were more likely to engage in sexual bartering
further underscores the risk behavior found in the core. In the same way, the
finding that core men were more likely to be sexually preoccupied paired with the
traditional beliefs, men are always ready for and need sex more than women further
demonstrate the influence of the habitus, which holds more traditional sex beliefs.
From the endorsement of these attitudes in addition to sexual preoccupation, it
seems likely core men actively create, seek out and capitalize on opportunities to
have sex as their group habitus dictates. These beliefs are interrelated because if a
man is sexually preoccupied, feels men need sex and are always ready for sex then
it seems likely that he would have no objection to trading drugs or money for sex if
the opportunity presents itself.

Practically, these results are important because they provide key information
health practitioners and researchers can use to fight the hidden epidemic of STDs.
Specifically, this study provides insight into the psyche of core members, which is
critical given lack of understanding about male motivations for condom usage. The
beliefs that it is acceptable for men not to use condoms once they feel they ‘know
their partner’ and because ‘women use other means of birth control’ are the type of
attitudes that need to be changed if STDs are to be prevented. Especially, since
men in the core were found to be less likely to practice monogamy. So this
information can inform scientists as they plan health education and promotion
campaigns and interventions which target heterosexual, AA, core men.

LIMITATIONS

While this research has theoretical and practical utility, it has limitations regarding
external and internal validity. First, in reference to external validity, this sample is
from one region of the country, the south. The south has higher rates of STD than
other regions. Given the unique nature of the south, it is difficult to generalize to
the rest of nation. Second, since the sample is from a publicly funded STD clinic, it
is not representative of all AA men. However, the study population is appropriate,
since the goal of the study
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was to confirm a core group among low-income, sexually active, AA men. Third,
the sample is all AA, which potentially reduces the studies applicability to the
general population. Fourth, the sampling frame for recruitment, a STD clinic,
reduces the ability to make meaningful distinctions beyond the core/non-core
dichotomy. Simply, the collection of data from an STD clinic may have reduced
the likelihood of recruiting ‘true’ peripherals into the sample.

There were also were three challenges to the internal validity. First, some of
the questions asked may require a different metric of time. For instance,
monogamy may have needed a shorter length of time than a year given the higher
relationship turn over of core men. Second, given some of the data is based on
memory, it is prone to recall bias. Third, the data may contain self-presentational
bias due to respondents being deceptive about their sexual activities. Fourth, in the
same way, while the men claimed to heterosexual, it is possible that the men
included in sample had engaged in sex with men.

CONCLUSION

By finding support for hypotheses, this study provides a clearer definition of the
core, as well as insight as to the type of low-income men who make up the AA
core. Compared to non-core men, core men on average, were younger, initiated sex
earlier, reported more sex partners (lifetime and in the last 3 months), as well as
had a higher number of STDs. In the same way, characteristically, core men were
more likely to not have been in monogamous relationship for a year or more, trade
money or drugs for sex and be sexually preoccupied.

In addition, this study was successful in identifying beliefs and attitudes

unique to the AA core, which influence sexual and health behaviors. To reiterate,
core men were more likely to hold attitudes such that they will stop using condoms
once they are familiar with their partner. In addition, core men are likely to be
more traditional (hyper-masculine) in their expectations of how a man should
behave sexually in sexual appetite and readiness. It is likely these behaviors and
dispositions are the product of the sexual of habitus, which is a reflection of the
social and economic conditions of low-income AA men.

In closing, given that these findings are only exploratory, it is imperative that
research on core groups continues to advance. In particular, future research should
continue to focus on further empirical verification and definition of the core group
concept including studies of adjacent and peripheral groups. In the same way, since
this study focused on making
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distinctions between core and non-core, going forward research should address the
other groups that make up the epidemiological model, adjacent and peripheral.
Once more, further exploration of the core in other racial and ethnic groups is
necessary in order to determine if there are any differences or similarities between
groups. Moreover, it is important to investigate the beliefs and attitudes of the core
group in the future. Given its utility in the current study, habitus may emerge as a
key theory in explaining the actions, practices and beliefs of the core men and their
impact on health. Finally, it is critical that research in this area continues because
the more definitive information researchers have about core groups they can
construct more effective interventions to help eliminate the hidden epidemic of
STDs.

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