Social identity and physical health: Accelerated HIV progression in rejection-sensitive gay men.

Research linking sensitivity to others and their evaluation of the self to alterations in physiologic function led the authors to examine whether HIV infection might progress more rapidly in gay men who are particularly sensitive to social rejection. Analyses of data from a 9-year prospective study of 72 initially healthy HIV-positive gay men indicated that rejection-sensitive individuals experienced a significant acceleration in times to a critically low CD4 T lymphocyte level, times to AIDS diagnosis, and times to HIV-related mortality (despite control for a variety of potential biobehavioral confounders). Accelerated HIV progression was not observed in rejection-sensitive gay men who concealed their homosexual identity, suggesting that concealment may protect such individuals from negative health effects. Data distinguishing rejection sensitivity from other health-relevant psychosocial characteristics are presented, and possible links to HIV pathophysiology are described. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Virtual and physical venues as contexts for HIV risk among rural men who have sex with men.

Rural men who have sex with men (MSM) have few identifiable venues in which to congregate and meet potential sex partners. The Internet provides a venue for rural MSM to meet, and this is potentially troubling because studies of urban MSM suggest that HIV risk is higher for men who date online. The goals of this study were to identify venues where rural MSM meet their sexual partners and to examine their association with high-risk sexual practices. Six hundred sixty-three predominantly single, gay, Caucasian MSM completed an online survey of their sexual activities. Results showed that the Internet and bars were the most popular venues for meeting sex partners. Highest rates of risk behaviors were associated with Internet dating and venues in which immediate sexual encounters typically occur, suggesting that prevention in rural areas should target multiple-risk environments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological consequences of AIDS-related bereavement among gay men.

745 New York City gay men were interviewed in 1985 to determine the relation between acquired immune deficiency syndrome (AIDS)-related bereavement and psychological distress. Bereavement was experienced by 27% of the sample, one third of whom had experienced multiple losses. A direct relation was found between the number of bereavements and symptoms of traumatic stress response, demoralization, sleep problems, sedative use, recreational drug use, and the use of psychological services because of AIDS concerns. These relations remained strong after controlling for the appraised threat of AIDS, the knowledge of a positive human immunodeficiency virus (HIV) antibody status, the presence of AIDS-related complex (ARC) symptoms, and sexual behavior history. Because symptoms of distress increased directly with the number of bereavements, it does not appear that gay men are adapting psychologically to repeated experiences with AIDS-related bereavement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood physical abuse, internalized homophobia, and experiential avoidance among lesbians and gay men.

This study explored relations among childhood physical abuse, internalized homophobia, experiential avoidance, and current psychological symptoms in a community sample of 122 adult lesbians and 115 adult gay men. Childhood physical abuse predicted depression and posttraumatic stress disorder (PTSD) symptoms. Furthermore, for gay men, internalized homophobia completely mediated the relation between childhood physical abuse and depression symptoms and partially mediated the relation between childhood physical abuse and PTSD symptoms. However, experiential avoidance did not mediate these relations. In contrast, experiential avoidance partially mediated the relation between childhood physical abuse and PTSD symptoms among lesbians; however, internalized homophobia did not mediate these relations. These findings suggest that internalized homophobia and experiential avoidance may have differential mediating roles in predicting psychological symptoms among lesbians and gay men who have experienced childhood physical abuse. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Perceptions of general practice among homosexual men

BACKGROUND: Primary care has an important role to play in the prevention and management of the human immunodeficiency virus (HIV). It has been suggested that homosexual men experience a variety of problems in relation to primary care. AIM: As part of a larger study, it was decided to examine the extent to which a sample of homosexually active men experienced difficulties in general practice and whether they consulted their general practitioner for problems related to HIV or the acquired immune deficiency syndrome (AIDS). METHOD: Homosexual men were recruited for interview in 1991-92 from a variety of sources including genitourinary clinics and homosexual organizations. RESULTS: Of 623 men registered with a general practitioner 44% had not informed their general practitioner of their sexual orientation and 44% of the 77 men who were HIV antibody positive, as confirmed by the study, had not informed their general practitioner of this fact. Men who viewed their practice as unsympathetic towards homosexual men were less likely to have informed their general practitioner of their sexual orientation or HIV status. The majority of men (87%) nevertheless viewed primary care as an appropriate source of HIV/AIDS advice. CONCLUSION: There is considerable scope for improvement in the acceptability of general practice to homosexual men.     

Surveillance of sexual behaviour among homosexual men in a central London health authority

Flagellin gene central regions from 111 isolates of Pseudomonas fluorescens SBW25 obtained from soil during a field release experiment were analysed using a combined PCR/RFLP technique to look for variation. In addition, a 858 bp flagellin gene sequence from the original strain and the last isolate obtained from the release site were compared. There was no variation in flagellin gene sequences indicating that the gene was stable over the period of the release, and that the flagellin gene is a suitable marker for use in the detection of bacteria in release experiments. A comparison of Ps. fluorescens SBW25 flagellin with other sequenced flagellins revealed closest homology to the flagellin of Ps. putida PRS2000.     

HIV sexual risk behavior following bereavement in gay men.

The present study followed a group of 100 gay men up to 1 year before and 1 year after losing a partner to AIDS (University of California, San Francisco Coping Project). Following bereavement, participants were at increased risk for engaging in unprotected anal intercourse: at 4 to 6 months for HIV-negative men and at 8 to 12 months for HIV-positive men. Sociodemographic variables, HIV serostatus, substance use, depression, prebereavement relationship quality, and social support did not explain sexual risk-taking in this sample. However; men who engaged in unprotected anal intercourse were twice as likely to be involved in a new primary relationship as those who did not. The authors concluded that risk varies over time by HIV status and may involve engagement in new relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender role conflict and psychological well-being among gay men.

The authors used the Gender Role Conflict Scale, Attitudes Toward Seeking Professional Psychological Help Scale, and Hopkins Symptom Checklist to examine the relation of gender role conflict to certain aspects of (N?=?117) gay men's psychological experience. Gay men with less gender role conflict had a more positive view of seeking psychological help and reported fewer symptoms of anger, anxiety, and depression. On the basis of these findings, some tentative counseling implications are considered and directions for future research are proposed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drug use and unprotected anal intercourse among gay men.

Examined the link between unprotected insertive and receptive anal intercourse and drug use with sex in 604 gay men. Data spanning 4 12-mo periods from 1980 to 1987 indicate that the link between drug use and high-risk sex diminished as the acquired immune deficiency syndrome (AIDS) epidemic progressed. Strong and significant cross-sectional associations were found between drug use with sex and both types of anal intercourse in the year prior to the onset of AIDS. By 1987 the magnitude of these associations was markedly reduced. Findings support both causal and noncausal interpretations of the link between substance use and high-risk sex among gay men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual HIV risk behaviour among men who have sex with both men and women

The aim of this study was to describe the sexual behaviour of men who had sex with both men and women in the preceding five years (behaviourally bisexual men), specifically to examine their needs in relation to HIV prevention. Anonymous telephone interviews were carried out with respondents recruited though advertisements in UK newspapers and magazines with (sexual) 'personal' or 'contact' sections. Data are reported from 745 respondents. Respondents report relatively high and approximately equal numbers of male and female sexual partners in the year preceding interview. There is a clear patterning of sexual activity by type of partner (regular or casual). A high proportion report anal intercourse with female and male partners. A third disclose their homosexual practices to regular female partners. Although self-reported HIV seroprevalence is low (less than 1%), the levels of unprotected sex with multiple sexual partners indicate substantial potential for transmission of sexually transmitted infections, including HIV. While low seroprevalence suggests that there is little overlap with existing core groups of HIV infection, the study provides information to judge the priority of targeting HIV prevention initiatives and suggests ways in which initiatives could be undertaken.     

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)     

Impact of combination therapies on HIV risk perceptions and sexual risk among HIV-positive and HIV-negative gay and bisexual men.

The availability of improved HIV treatments may prompt reduced concern about HIV and sexual risk. Gay and bisexual men (N?=?554, 17% HIV-positive) completed measures of treatment attitudes, sexual risk, and assumptions regarding the infectiousness of sexual partners. A substantial minority reported reduced HIV concern related to treatment advances. Reduced HIV concern was an independent predictor of sexual risk, particularly among HIV-positive men. In response to hypothetical scenarios describing sex with an HIV-positive partner, participants rated the risk of unprotected sex to be lower if the partner was taking combination treatments and had an undetectable viral load, relative to scenarios with a seropositive partner not taking combination treatments. Prevention efforts must address attitudinal shifts prompted by recent treatment successes, stressing the continued importance of safer sex, and that an undetectable viral load does not eliminate infection risks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biphasic aspects of homosexual identity formation.

Contends that during adolesence when homosexual self-labeling first occurs, the simultaneous awareness of homoerotic desires and the social odium associated with them tends to bring about conflict and a suppression of homosexual promptings among many homosexual males. The most common developmental consequence of this inhibition is a confounding of the process of identity formation. A biphasic pattern of identity development may occur so that during the 3rd decade or later unfinished psychological tasks of primary adolescence are resumed. It is suggested that the psychodynamics and phenomenology of this 2nd phase of identity formation bear a striking resemblance to those of primary psychological adolescence. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized trial to reduce club drug use and HIV risk behaviors among men who have sex with men.

The authors examined the effectiveness of motivational interviewing (MI) on club drug use and risky sex in non-treatment-seeking men who have sex with men (MSM). MSM (N = 150) were assessed and randomly assigned to 4 sessions of MI or an educational control intervention. Follow-up occurred at quarterly intervals for 1 year. Primary outcomes were days of any club drug use and number of unsafe sex acts. On average, club drug use declined during follow-up. A significant interaction effect showed that MI was associated with less club drug use during follow-up compared with education but only among participants with lower severity of drug dependence (p     

Substance use and perceived AIDS exposure among homosexual men in Alaska.

Examined demographic factors, drug and alcohol use, and number of sex partners to predict perceived risk of AIDS exposure. Data came from a survey of 323 homosexual men (aged 14–60 yrs) in Alaska. Nitrite use was the most important predictor and accounted for 6.91% of the explained variance. Nitrite use, in combination with number of sex partners, explained 8.76% of the variance. Men who socialized at adult book stores used significantly more nitrites and had significantly more male sex partners in the preceding year than those who did not. In addition to nitrite use, alcohol and barbiturate use were also higher in the perceived-risk group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lesbians, gay men, and their families. Some therapeutic issues

Although a body of scientific data about working with parents and families of gays and lesbians has not yet developed, there is a growing body of literature of an anecdotal and personal nature that has been cited. These works provide therapists with background information and clients needing assistance with guided reading. Therapists working with families and friends of gay men can find the experience rewarding and the therapeutic interventions effective. Much of the work is common sense, listening with the "third" ear for those underlying issues separate from the son's gayness that may affect the person's attitudes, feelings, and responses. Maintaining a professional demeanor while conveying a sense of caring and concern for the individuals is a key issue. As gay people become more visible in society and as the number of individuals coming out increases, there will be a need for more therapists who can assist families with their own coming out process. This article provides some basic guidelines and, as individual therapists gain more experience in this area, it will be important that others report those experiences, sharing them with the rest of the therapist community.     

Stress and coping among gay men: Age and ethnic differences.

Previous studies suggest that perceived stigmatization of sexual minority status, ethnicity, and age are associated with negative mental health outcomes, and other studies suggest that coping styles may influence these outcomes. However, no studies have examined these relationships among gay men of varying ethnicities and age groups. Three hundred eighty-three Black and White, younger, middle-aged, and older adult gay men completed measures of perceived stigmatization, coping style, and mental health outcomes. Black older adult gay men reported significantly higher levels of perceived ageism than the older White group, significantly higher levels of perceived racism than the younger Black group, significantly higher levels of homonegativity than the younger Black and the White groups, and were more likely to use disengaged coping styles than White gay men. However, Black older adult gay men did not experience significantly higher levels of negative mental health outcomes. Results suggest that further research should examine how older Black gay men, who perceive higher levels of stigma while reporting greater use of less effective coping styles, do not appear to be experiencing more negative mental health outcomes as a result. (PsycINFO Database Record (c) 2010 APA, all rights reserved)