| Summary: | Objectives: We examined sexual identity and its relationship with risky sexual behavior among 60 men who have sex with men in Accra, Ghana and Lomé, Togo. Methods: We used mixed-methods to investigate this relationship. Results: Quantitative results show that negative sexual identity leads to risky sexual behavior. For example, exchanging sex for valued resources is, positively associated with identity confusion. But as revealed by the qualitative findings, the relationship between sexual identity and risky sexual behavior may stem from homophobic perception. Conclusions: More research is needed to disentangle the complex issues of sexual identity and sexual risk behavior.
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