An outbreak of foal yersiniosis in Poland: pathological and bacteriological examination

This study surveyed 430 men at an urban gay pride celebration to assess fatalism, current life satisfaction, and perceived expected years of life among men who have sex with men. Analyses showed that men who engaged in unprotected anal intercourse outside of exclusive relationships reported a greater fatalistic outlook, were more dissatisfied with life, and perceived a shorter life for themselves than men who practiced only safer sex and men who were in exclusive relationships. Gay men in exclusive relationships scored higher than nonexclusively partnered gay men on the measure of current life satisfaction. These results suggest that efforts to prevent HIV infection among gay men should include building personal self-worth, support of long-term relationships, and future goal orientations.     

Influence of HIV status and age on cognitive representations of others

In 2 studies the postulate that the perception of time left in life influences the ways that people conceptualize social relationships was explored. It was hypothesized that when time is limited, emotional aspects of relationships are highly salient. In Study 1, a card-sort paradigm involving similarity judgments demonstrated, for a sample of persons 18 to 88 years old, that the prominence of affect in the mental representations of prospective social partners is positively associated with age. In Study 2, the same experimental approach was applied to a sample of young gay men similar to one another in age, but notably different in their health status (that is, HIV negative; HIV positive, asymptomatic; and HIV positive, symptomatic). It was found that, with age held constant, increasing closeness to the end of life is also associated with an increasing prominence of affect in the mental representations of social partners. The results suggest that the perception of limited time, rather than chronological age, is the critical variable influencing mental representations of social partners.     

Fatalism, current life satisfaction, and risk for HIV infection among gay and bisexual men.

This study surveyed 430 men at an urban gay pride celebration to assess fatalism, current life satisfaction, and perceived expected years of life among men who have sex with men. Analyses showed that men who engaged in unprotected anal intercourse outside of exclusive relationships reported a greater fatalistic outlook, were more dissatisfied with life, and perceived a shorter life for themselves than men who practiced only safer sex and men who were in exclusive relationships. Gay men in exclusive relationships scored higher than nonexclusively partnered gay men on the measure of current life satisfaction. These results suggest that efforts to prevent HIV infection among gay men should include building personal self-worth, support of long-term relationships, and future goal orientations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reframing HIV prevention for gay men in the United States.

The HIV epidemic in the United States has affected at least two generations of gay men. Despite numerous efforts to intervene on this public health crisis, HIV infections continue to escalate, especially among young men. This condition is compounded by an ever-growing number of gay men who are aging and living with HIV. We must enact an innovative and proactive vision and framework for HIV prevention that moves us beyond the undertakings rooted in social–cognitive paradigms that have informed this work for the past 25 years. A new framework for HIV prevention must give voice to gay men; must consider the totality of their lives; must delineate the underlying logic, which directs their relation to sex and HIV; and must concurrently respect their diverse life experiences. This approach should be rooted in a biopsychosocial paradigm, should be informed by both theory and practice, and should be directed by three theoretical lenses—a theory of syndemics, developmental theories, and contextual understandings of HIV disease. Taken together, these elements are a call to action for research and practice psychologists who are working to improve the lives of gay men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Ruling in" and "ruling out": two approaches to the micro-rationing of health care

Seropositive gay and bisexual men who reveal their sexual orientation or HIV/AIDS status to their employer risk discriminatory reprisals. However, non-disclosure may limit potential social, emotional, and tangible support. Among our sample of 389 seropositive gay and bisexual men employed in the US, 52% were 'out' to their employer and 35% had disclosed their serostatus to him or her. Among gay men, employer awareness of their sexual orientation was related to their being European American (vs Latino or African American), being HIV-seropositive for more than 4 years, and having a gay or bisexual employer. Disclosure of HIV infection in the total sample was related to being European American, HIV-seropositive for more than 4 years, symptomatic (vs asymptomatic), 'out' at work, and having a gay or bisexual employer. Men who had informed their employers of their HIV status reported consequences that were substantially more positive than those anticipated by men who had not disclosed. Policy and research implications for improving the work environment for gay and bisexual men living with HIV are considered.     

Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms: Results from a prospective study of bereaved gay men.

Objective: Minority stress is the most frequently hypothesized risk factor for the increased rates of adverse behavioral and mental health outcomes among sexual minorities. However, there is a paucity of longitudinal research addressing this hypothesis. Design: Prospective, community-based cohort of 74 bereaved gay men. Participants were assessed before the partner or close friend died of AIDS and then at 1, 6, 13, and 18 months postloss. Main Outcome Measures: HIV risk behavior (unprotected anal intercourse), substance use and abuse symptoms, and depressive symptoms. Results: Hierarchical Linear Modeling analyses revealed that changes in internalized homophobia, discrimination experiences, and expectations of rejection were differentially associated with HIV risk behavior, substance use, and depressive symptoms, respectively. In contrast to the significant effects of minority stress, bereavement-related stressors (e.g., length of partner illness, quality of relationship with deceased) were largely unrelated to these outcomes. Conclusion: The results provide evidence for the predictive validity of minority stress, even in the context of a major life stressor, and suggest the importance of targeting minority stress experiences in HIV and mental health interventions with gay men. Future studies are needed to assess the mechanisms through which minority stress is associated with adverse health outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disclosing HIV seropositivity to significant others

OBJECTIVES: To examine gay men's patterns of self-disclosure of HIV seropositivity to friends, lovers, relatives and colleagues; to assess the effects of disclosure; and to identify reasons for not disclosing to particular individuals. DESIGN: Longitudinal questionnaire survey of gay men. METHODS: A total of 163 HIV-positive men participating in the AIDS Behavioral Research Project, a longitudinal study of San Francisco gay men, completed questionnaires about their self-disclosure patterns, health status, and psychological well-being. RESULTS: HIV-positive men were most likely to disclose their status to lovers and closest gay friends. Asymptomatic men were less likely to disclose to relatives and colleagues than symptomatic men. Friends and lovers were rated as responding more helpfully than relatives and colleagues. Men who perceived their significant others as responding more helpfully were less depressed and anxious currently and 1 year later. A variety of reasons were given for not disclosing, including not wanting to worry others, fear of discrimination, fear of disrupting relationships, and emotional self-protection. CONCLUSION: While disclosure can have advantages for both HIV-positive individuals and their significant others, HIV-positive individuals must be assured that the benefits of doing so will outweigh the potential costs.     

Gay youth and their precautionary sexual behaviors: the Sydney men and sexual health study

Many commentators have positioned Western gay youth as a high-risk group for HIV infection and obscured important cultural, social, and contextual differences between populations. This study compares risk of HIV transmission factors among 216 young (under 25 years) and 822 older (25 years or over) homosexually active men, recruited through Sydney gay community and other sources. Bivariate and multivariate analyses of survey data that were collected by personal interviews consistently supported our hypothesis of no difference in HIV-related risk factors between young and older men. Although young men in this cohort were more likely to be of unknown serostatus, they were at least as knowledgeable, as attached to gay community, and as precautionary in their sexual behaviors with regular and casual male partners as their older counterparts. Safety campaigns targeting these young gay men should focus, for example, on their lower rates of HIV antibody testing and not be based on a false premise of hedonistic, uninformed, and disenfranchised youth.     

Withdrawing attention at little or no cost: detection and discrimination tasks

At the request of the Dutch government, a group of researchers looked into the experiences of gay men and lesbians in organized, nonprofessional sports. The principal finding was that gay men and lesbians do not experience much discrimination. This circumstance results from the invisibility and silencing of homosexuality in athletics, both by sports organizations and by gay men and lesbians themselves. But in those sports where lesbians have become open about their sexuality, especially in soccer, they do encounter a high level of discrimination. Gay men, on the other hand, have not become visible in any sport. Several suggestions are offered on how to open up sports for lesbians and gay men.     

Continued high-risk sex among HIV seropositive gay and bisexual men seeking HIV prevention services.

The authors examined HIV risk-related sexual behaviors in an ethnically diverse sample of HIV seropositive gay and bisexual men (N?=?86). Measures of sexual behavior, substance use, condom attitudes, behavior change intentions, and engagement in risk-reducing practices were completed. Thirty-nine percent of the men reported engaging in unprotected anal intercourse in the past 3 months. Unprotected anal intercourse was associated with using nitrite inhalants, sex partners who used substances before sex, and low intentions to change risk behavior. These results highlight the difficulties that people living with HIV infection face in maintaining a lifetime of safer sex and the necessity of integrating clinical and prevention interventions for these persons. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Repeated bereavement, depressed mood, and immune parameters in HIV seropositive and seronegative gay men.

The relationships among bereavement, depressed mood, and immunologic patterns prognostic for the development of AIDS were determined in a sample of HIV seropositive gay men and a comparison group of HIV seronegative gay men. Immunologic parameters were assessed in 45 men who had recently experienced the deaths of close friends and 45 matched nonbereaved men. No immune differences were found between bereaved and nonbereaved men. Among the HIV seropositive nonbereaved men, higher depressed mood was significantly associated with fewer CD4 (helper/inducer) T lymphocytes, more activated CD8 (suppressor/cytotoxic) T cells, and lower proliferative responses to the mitogen phytohemagglutinin. In summary, HIV seropositive men who reported higher levels of depressed mood not associated with bereavement demonstrated immunologic patterns consistent with HIV activity and progression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experiences of women in cardiothoracic surgery. A gender comparison

OBJECTIVE: To assess the career and practice experiences of cardiothoracic surgeons, with references to gender similarities and differences. DESIGN: Four-step mailed 115-question survey. SUBJECTS: All identified women, and a cohort of men, certified by the American Board of Thoracic Surgery. MAIN OUTCOME MEASURES: Academic rank, career background, salary, perceptions and experiences of harassment or discrimination, and personal life characteristics. RESULTS: No differences were found in training backgrounds. More men (64%) than women (52%) were in university practices. Comparable proportions of men and women were assistant professors (27%), but more men (27%) than women (13.6%) were full professors. Fifty-eight percent of women and 21% of men reported salaries of less than $250000; 62% of men and 32% of women had incomes over $350000. Career satisfaction was comparable between genders; however, women perceived the promotion process as unfair and unrelated to academic rank. Both genders encouraged men toward a surgical career; men were less likely than women to encourage women to pursue a surgical career (P < .01). Women, much more than men, believed that discrimination hindered their career development (P < .001). Characteristics of personal life were also considerably different between the genders. CONCLUSION: Although practice and training parameters for male and female cardiothoracic surgeons are comparable, work experiences, personal life, and career rewards such as salary and promotion, and perception of discrimination are different.     

Relationships among HIV risk beliefs, attitudes, and behaviors in sexually active, seronegative gay men

Safer-sex guidelines established during the early days of the HIV/AIDS epidemic have undergone very little revision despite some controversy. Although these guidelines have been widely disseminated in the gay community, many gay men continue to engage in behaviors that are believed to put them at high risk for transmission of HIV. This suggests either that they have not accepted safer-sex guidelines as accurate or that other factors override personal implementation of the guidelines. The study examined seronegative gay men's beliefs about the accuracy of safer sex guidelines and the men's participation in behaviors risky for transmitting HIV. The greatest disagreement between the men's beliefs and behaviors centered on the risk of oral intercourse; this suggests a need for clarification of the safer sex message about this behavior. The findings of this study support the need to reformulate safer-sex guidelines. When unprotected oral and anal sex are classified at the same level of risk, those who engage in unprotected oral sex may proceed to unprotected anal sex with less reservation.     

Risk for HIV infection among bisexual men seeking HIV-prevention services and risks posed to their female partners.

The present study interviewed gay (n?=?473) and bisexual men (n?=?146) as part of an HIV prevention program and investigated social cognitive factors associated with HIV risk. Results indicated that HIV risk in homosexual men was associated with sexual openness and connections to gay communities, factors not associated with risk for bisexual men. Compared with men at lower risk, those who practiced high-risk sex scored lower on measures of perceived safer sex norms, safer sex self-efficacy, and social skills. Bisexual men with primary female partners often had not disclosed their bisexuality to female partners (75%), and 64% had not modified their behavior to protect female partners. Bisexual men who engage in high-risk behaviors therefore pose a risk to female partners who may be unaware of their involvement with men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence of high-risk sex among HIV-positive gay and bisexual men: a longitudinal analysis

INTRODUCTION: This longitudinal study examined the prevalence and demographic correlates of unprotected insertive and receptive anal intercourse among HIV-positive gay and bisexual men who were aware of their serostatus. METHODS: Participants (n = 395), sampled randomly at two HIV outpatient clinics in Los Angeles, completed two waves of self-administered questionnaires (separated by approximately 7-9 months) that measured sexual behaviors in the previous 60 days. RESULTS: The cross-sectional prevalence of unprotected insertive anal intercourse was 11.2% at time 1 and 7.1% at time 2. Longitudinal analysis indicated that nearly 15% of the participants had engaged in that high-risk behavior either at time 1 or time 2 and approximately 4% had engaged in the behavior at each time period. Similar rates of unprotected receptive anal intercourse were observed. These high-risk activities were more prevalent with seropositive and unknown serostatus partners than with seronegative partners. The rate of anal intercourse risk behaviors was higher among asymptomatic men and among those who were exclusively gay. CONCLUSION: The findings demonstrate considerable differences in the prevalence of stable and occasional high-risk sexual behaviors among HIV-positive gay and bisexual men. Simple cross-sectional analyses cannot capture the stability or variation in behavior across time and, thus, may generate misleading conclusions about disease transmission, especially if the partner's HIV serostatus is not considered in the analysis. The findings indicate a need for focused safer-sex interventions for seropositive men. The HIV outpatient clinic is an ideal setting for such interventions.     

Strategies for modifying sexual behavior for primary and secondary prevention of HIV disease.

Sexual behavior change is needed for both the primary and secondary prevention of HIV disease. Remarkable progress has been made in modifying high-risk behaviors in selected populations (e.g., gay men living in the epicenters of the epidemic). However, many at-risk populations (e.g., gay men living outside these epicenters, homosexual men who are young or Black, ethnic minorities—especially women of childbearing age, and persons over age 50) have received relatively little research attention and may be at risk for further infection. A community-level approach to behavior change represents one kind of comprehensive strategy to achieve significant reduction in the spread of HIV. Effective approaches at this level require component interventions that are effective in changing behavior and acceptable to target populations. Also needed is an infrastructure to support behavioral change efforts. Lacking at present is a comprehensive and coordinated structure to conceptualize, stimulate, and support the continuum of behavioral research needed for the control of HIV and other sexually transmitted diseases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managing multiple-minority identities: African American men who have sex with men at predominately white universities.

This study examined how African American men who have sex with men (AAMSM) manage their multiple-minority identities, including being both racial and sexual minorities at predominately White educational institutions (PWI). Using a phenomenological paradigm, AAMSM college students participated in semistructured interviews. Results suggest that AAMSM at PWIs view race, gender, and religious beliefs as of primary importance, and sexual orientation and social class as less salient aspects of their identities. Further, AAMSM attending PWIs reported experiencing both discrimination and stereotyping based on their race and sexual orientation, and their appraised risk of rejection and acceptance influenced their perception of identity options. AAMSM’s construction of their identity influenced their interpersonal associations with the African American, gay, African American and gay, and campus communities at large. Implications for future research and higher education administrators and mental health professionals are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceiving AIDS-related risk: Accuracy as a function of differences in actual risk.

Investigates the perceived risk of an HIV infection. Cognitive antecedents of biases in risk perception and their effects on behavioral intentions were investigated. The purpose of this study was to determine the relative accuracy of risk assessments for samples that vary in actual risk for AIDS. Ss were citizens of Amsterdam, heterosexuals with private partners, gay men, and heterosexuals with prostitution partners. Although optimistically biased in all samples, perceptions of risk were related to previous risk behavior in high-risk samples only. Pessimism was more pronounced in samples higher at risk. Optimists had lower levels of previous risk behavior and increased intentions to adopt safe sex practices. Ss in samples higher at risk had, therefore, relatively adequate perceptions of risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internalized heterosexism among HIV-positive, gay-identified men: Implications for HIV prevention and care.

Internalized heterosexism (IH), or the internalization of societal antihomosexual attitudes, has been consistently linked to depression and low self-esteem among gay men, and it has been inconclusively associated with substance use and sexual risk in gay and bisexual men. Using structural equation modeling, the authors tested a model framed in social action theory (C. K. Ewart, 1991, 2004) in which IH is associated with HIV transmission risk and poor adherence to HIV antiretroviral therapy (ART) through the mechanisms of negative affect and stimulant use. Data from a sample of 465 gay-identified men interviewed as part of an HIV risk reduction behavioral trial were used to test the fit of the model. Results support the hypothesized model in which IH was associated with unprotected receptive (but not insertive) anal intercourse with HIV-negative or unknown HIV status partners, and with ART nonadherence indirectly via increased negative affect and more regular stimulant use. The model accounted for 15% of the variance in unprotected receptive anal intercourse and 17% of the variance in ART nonadherence. Findings support the potential utility of addressing IH in HIV prevention and treatment with HIV-positive gay men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family moderators of the relation between hassles and behavior problems in inner-city youth

Qualitative data from individual interviews with 18-29 year old African American men, who have sex with men (n = 76) were used to examine the relationship of negative attitudes toward homosexuality, self-esteem, and risk for HIV. Respondents perceived members of their communities as holding negative attitudes toward homosexuality, and many thought the African American community was less accepting of homosexuality than the white community. There was evidence that these negative attitudes are internalized by some of the young African American men themselves. Respondents mentioned several ways that negative attitudes toward homosexuality could lead to lower self-esteem and psychological distress in young gay and bisexual men. In addition, respondents articulated several mechanisms by which low self-esteem and psychological distress might be associated with sexual behaviors that put one at risk for HIV. We concluded that addressing and changing society's negative views of homosexuality are important components of a comprehensive approach to reducing the transmission of HIV, especially among young people in communities of color.