Social Responsibility,Substance Use,and Sexual Risk Behavior in Men Who Have Sex With Men

Considerable public health literature focuses on relationships between problematic human characteristics (e.g., psychopathology) and unhealthy behaviors. A recent movement termed positive psychology emphasizes the advantages of assessing relationships between human strengths (e.g., altruism) and beneficial health behaviors. The present study assessed social responsibility, an orientation to help or protect others even when there is nothing to be gained as an individual, and its relationship to HIV-relevant behaviors. In our sample of 350 men who have sex with men (MSM), social responsibility was negatively correlated with substance use and HIV risk behaviors. Men who had been tested for HIV and knew their HIV status—a behavior that helps men protect their partners but does not protect themselves from the virus—also scored higher in social responsibility. Interventions designed to reduce HIV risk behavior in MSM may benefit from efforts to promote human strengths.     

Sexual Coercion Among Gay and Bisexual Men in Aotearoa/New Zealand

Until recently, sexual coercion among gay men has been regarded as virtually oxymoronic. Discourses of male sexuality as ever-present and driven, and discourses of masculinity that portray men as in control and invulnerable, converge to almost disavow the possibilities that sex could be unwanted by men, or that men could be vulnerable to being pressured into sex against their will. This article reports on interviews with 19 gay and bisexual men about their experiences of forced, coerced, or unwanted sex. We identified four general patterns in these accounts: (1) incidents involving physical force; (2) experiences in which a man's ability to refuse sex was compromised by intoxication; (3) dynamics where young and inexperienced men were coerced or pressured into unwanted sex; and (4) situations in which men felt obligated to engage in unwanted sex. Specific issues included barriers to reporting sexual assault, power dynamics in intergenerational sex, and the difficulty of refusing unwanted sex. Importantly, many of the factors identified as driving sexual coercion relate not to gay sexuality per se, but rather to masculine sexuality. Conversely, some of the factors relating to men's vulnerability to coercion were exacerbated by some features of gay sexual culture; in particular those aspects associated with existing in a marginalized territory within a wider heteronormative context.     

Sexual Behaviors,Sexual Health Practices,and Community Engagement Among Gay and Bisexually Identified Men Living in Rural Areas of the United States

Limited research has focused on the sexual behaviors of men who have sex with men (MSM) from rural communities. We examined the sexual and health-related behaviors of MSM living in rural areas of the United States in order to understand the sexual health repertoire of this population. A total of 5,357 participants living in rural settings were recruited online and completed an anonymous Internet-based survey that assessed sexual behaviors, condom use, and men’s engagement with various community activities and events. These data provide a greater understanding of sexual health profiles that exist among rural MSM and will help inform the design of effective programs for men in these often underserved communities.     

Age of Onset of Alcohol Consumption and Subsequent Negative Health Outcomes in Gay and Bisexual Men Who Have Sex With Men

ABSTRACT

The correlation between current alcohol use and sexual risk behaviors among men who have sex with men (MSM) is well documented, but little is known about age of drinking onset and current risks among this population. Data from a 2008 Internet survey of 8,452 MSM in the United States were used to assess factors associated with age of onset of alcohol use. In a multivariable model, drinking onset before age 15 was significantly associated with a higher number of lifetime male anal sex partners and being behaviorally bisexual in the past 12 months. Men who reported depressive symptoms in the past two weeks or who screened positive for alcohol abuse in the past 60 days were more likely to have early age of drinking onset. Findings suggest the need for targeting younger adolescents for alcohol screening, particularly sexual minority youth, to prevent risk behaviors in adulthood.     

A Systematic Review of Sexual Dysfunction Measures for Gay Men: How Do Current Measures Measure Up?

The measurement of subjective components of sexual functioning is of increasing importance in clinical research and practice. Differences have been reported in prevalence rates and experiences of sexual difficulties between heterosexual and gay men. The aim of this article is to identify reliable and valid measures of sexual dysfunction suitable for use with gay men. Seven measures were reviewed; details about item development, dimensionality, reliability, and validity are provided. Heteronormative and heterosexist wording were evident throughout. Several areas of concern emerged in relation to psychometric properties (e.g., questionable validity). No psychometrically robust sexual function measure was identified for use with gay populations.     

When the Emotions Really Started Kicking In,Which Ended Up Being a Problem: Sex,HIV, and Emotions Among Young Gay and Bisexual Men

Interviews from 10 young gay and bisexual men aged 18 to 29 were examined to explore how young gay and bisexual men make decisions regarding sexual behaviors in the age of AIDS. Three main themes emerged: (a) disconnections between what an individual knows about HIV, their motivations to remain HIV-negative, and their sexual behaviors; (b) a struggle to connect emotionally and intimately with another man; and (c) a power dynamic whereby the individual acts as an autonomous decider in the decision-making process. Participants indicated high levels of HIV knowledge, and were engaged in a struggle to balance emotional experiences with sexual partners in a complex gendered dynamic. Findings from this analysis indicate a need to reexamine the social-cognitive theoretical frameworks that have guided gay men's HIV-prevention efforts, as these frameworks have failed to account for the psychologically complex emotional experiences and gender dynamics that are part of sexual decision making.     

Sexual Satisfaction,Solitary, and Dyadic Sexual Desire in Men According to Sexual Orientation

ABSTRACT

Research on male sexual desire and satisfaction according to sexual orientation remains insufficient. An online survey was fulfilled by 415 men (142 gay; 273 heterosexual), and participants completed the SDI-2 and the GMSEX. Main findings suggested that gay men scored significantly higher on both solitary sexual desire and attractive person-related dyadic sexual desire subscales, but not on a partner-related dyadic sexual desire subscale, compared to heterosexual men. Despite sexual orientation, partner-related dyadic sexual desire positively predicts sexual satisfaction, whereas solitary and attractive person-related dyadic sexual desire negatively predicts sexual satisfaction in men. Overall, gay men appear to experience higher levels of both attractive person-related dyadic and solitary sexual desire. Also, experiencing sexual desire toward a partner predicts positively, whereas experiencing desire to engage in sexual behavior with oneself and toward an attractive person predict negatively sexual satisfaction in men.     

Methods Used and Topics Addressed in Quantitative Health Research on Gay,Bisexual and Other Men Who Have Sex With Men: A Systematic Review of the Literature

Research on sexual minority men (gay, bisexual, and other men who have sex with men) was examined with regard to the measures of sexual orientation used, the methods of research, and the main health outcomes under study. A systematic review of English-language quantitative studies was conducted focused on the health of sexual minority men published in 2010 (n = 250). The results provide a snapshot of the literature and revealed that research on sexual minority men overwhelmingly focused on HIV, STIs, and sexual health for which sexual orientation was most commonly defined behaviorally. For topics of mental health or body/fitness outcomes, sexual orientation was most commonly defined by identity. Most study samples were venue-based, and only 8.8% of published papers drew data from population-based samples. The findings suggest that there exists a need for research on sexual minority men’s health beyond STIs and HIV that will examine mental and physical health outcomes beyond sexual risk, uses probability-based samples, and addresses intersectional concerns related to race/ethnicity and age.     

“We’re Disgusted With Queers,not Fearful of Them”: The Interrelationships Among Disgust,Gay Men’s Sexual Behavior,and Homonegativity

ABSTRACT

Using a combination of personal reflections, published literature, and original empirical research, we argue that the disgust triggered by gay men’s sexual practices (specifically, anal intercourse) is a critical, though overlooked, contributor to heterosexual men and women’s homonegativity (i.e., negative attitudes and behaviors directed toward men who are or are perceived to be gay). We conclude our article by articulating several directions for future inquiry that we believe will advance current understanding of prejudice and discrimination directed toward gay men.     

Gay Community Involvement: Its Interrelationships and Associations With Internet Use and HIV Risk Behaviors in Swedish Men Who Have Sex With Men

We measured aspects of “community involvement” chosen for men who have sex with men (MSM) in Sweden (gay places, media accessed, Internet, gay festivals, and social engagement, measured as proportion of gay friends) in two Swedish Internet-based samples from 2006 (n?=?3,202) and 2008 (n?=?4,715). Data showed low to moderate reliability with a moderate (0.57) alpha coefficient. While there is moderate internal consistency, as might be anticipated from measures of actual community involvement, they can be treated as scales. The Internet scale indicated the lowest reliability, perhaps due to respondents having Internet sites of primary choice, rather than a high level of usage across several sites. A hypothesized lack of correlation between traditional domains of the gay community and the Internet did not appear: correlations between the Internet measure and the other measures were positive and significant, but among the lowest correlations obtained between the community measures, ranging from 0.06 to 0.24. Those who use the Internet extensively are less likely to be involved in other aspects of the community. Sexual risk was associated with high social engagement at sexual meeting sites and with Internet use. Gay community involvement, including the Internet community, may be complex and associated with both increase in HIV sexual risk behaviors (by measuring use of sexual risk sites) and preventive measures (HIV testing).     

Public Sexual Cultures: A Systematic Review of Qualitative Research Investigating Men's Sexual Behaviors with Men in Public Spaces

Resurgent HIV and sexually transmitted infection incidence among men who have sex with men (MSM) requires an urgent re-examination of sexual transmission sites. To these ends, we systematically review qualitative literature concerning men's sexual behaviors within public sex environments (PSEs). Sex, therein, is negotiated by the highly codified, largely nonverbal practice of “cruising.” A generic, shared PSE sexual culture emerges from the literature—across locations, countries, and decades—because of the importance of concealment and common structural constraints on sexual encounters in PSEs. However, differences in local geography and facilities may transform key features of this, resulting in specific, local sexual cultures emerging for each locale. We argue that, although sexual cultures developed to minimize nonsexual cruising risks, they may be exploited to improve contemporary in situ outreach work.     

Stereotypes,Emotions, and Behaviors Toward Lesbians,Gay Men,Bisexual Women,and Bisexual Men

The utility of the Stereotype Content Model (Fiske, Cuddy, Glick, & Xu, 2002) and the Behaviors from Intergroup Affect and Stereotypes map (Cuddy, Fiske, & Glick, 2007) were examined in the context of heterosexuals’ attitudes toward sexual minorities. Heterosexual adults completed a survey measuring stereotypes, emotions, and behavioral tendencies toward lesbians, gay men, bisexual women, and bisexual men. Stereotype content differed across groups and showed “gendered” and “valenced” effects on emotions and behavioral tendencies. Competence predicted behaviors for men, whereas warmth and competence predicted behaviors for women, and, for the most part, more was better. Admiration and contempt mediated most of these relationships across most subgroups, but pity and envy played smaller roles for some subgroups. Across all groups, competence played a more predictive role than warmth.     

The Relationship Between Body Image and Sexual Functioning Among Gay and Bisexual Men

ABSTRACT

Gay and bisexual men report high body dissatisfaction compared to heterosexual counterparts, but no studies to date have examined how this may impact their sexual functioning. The present study investigated body image domains as predictors of sexual functioning problems (inhibited desire, erectile dysfunction, and premature ejaculation) among an online community sample of 185 gay and bisexual men, ages 18–40. Participants reported moderate to high body image satisfaction and sexual functioning consistent with previous literature with nonclinical male samples. Overall, the total variance accounted for by regression models was low. Body image variables were not predictive of sexual desire. However, increased drive for muscularity and lower affective body esteem were predictive of erectile difficulties. Additionally, negative behavioral body image in sexual situations and evaluative body dissatisfaction were associated with premature ejaculation. Understanding this relationship may have implications for gay and bisexual men’s health and wellbeing. Future research directions are discussed.     

Minority Stress,Parenting Styles,and Mental Health in Brazilian Homosexual Men

ABSTRACT

Homosexual men are constantly exposed to prejudice and violence in Brazil. The aim of this study was to investigate the relationship between minority stress, parenting styles, and indicators of mental health problems in a sample of homosexual men. Method: quantitative, cross-sectional, correlational, and retrospective design. Participants were 101 Brazilian men who selfidentified as homosexuals, aged between 18 and 55 years. Results: concealing sexual identity was a predictor of depression and stress. Parental responsiveness was associated with a lower incidence of enacted stigma and depression. Conclusions: the mental health of homosexual men can be negatively affected by the need to conceal their sexual orientation. Parental responsiveness is a protective factor in terms of experiencing enacted stigma and depression. The results found in the study may be useful for counselors and social workers who are working with LGBT people and their families.     

A Population-Based Study of Coupling and Physical Activity by Sexual Orientation for Men

ABSTRACT

Research has suggested that men in relationships are more physically active than men who are single. This study provides a weighted analysis of physical activity by coupling status for men of different sexual orientations. Aggregated data from the United States 2013–2014 National Health Interview Survey were used to conduct multivariate logistic regression analyses. Compared to straight men (n = 29,926), gay men (n = 623) were less likely to be in a relationship (AOR 0.32, CI: 0.25–0.41). Coupled gay men did more physical activity than coupled straight men and were 1.62 (CI: 1.05–2.50) times more likely to be active, 1.67 (CI: 1.10–2.51) times more likely to be high active, 1.89 (CI: 1.24–2.89) times more likely to engage in muscle-strengthening activities, and 2.00 (CI: 1.28–3.11) times more likely to meet aerobic and muscle-strengthening recommendations. Coupling facilitates physical activity for men. However, more research is needed to help explore underlying mechanisms for differences by sexuality.     

Exploring Shame,Guilt, and Risky Substance Use Among Sexual Minority Men and Women

This study examined the interrelations among shame-proneness, guilt-proneness, internalized heterosexism (IH), and problematic substance use among 389 gay, lesbian, and bisexual men and women. Problematic alcohol and drug use were positively related to shame-proneness and negatively related to guilt-proneness. Bisexuals reported riskier substance use behaviors, lower levels of guilt-proneness, and higher levels of IH than gay men and lesbians. Furthermore, study findings indicated that shame and IH are related. Additional investigations of these associations would supplement current understandings of sexual minority stress and advance the development of substance-related intervention and prevention efforts targeting sexual minorities.     

Risk-Taking Behaviors of Gay and Bisexual Men in New York City Post 9/11

Until now, the reactions of gay and bisexual populations have been largely overlooked in response to terror and disaster. This study assesses risk-taking behaviors in gay and bisexual men two weeks before and after the 9/11 attacks in Manhattan. For the purposes of this study, risk-taking behaviors include drug use and unprotected anal sex. These behaviors and associated desires were examined in relation to race/ethnicity, age, geographic location, and HIV status, within and across time. The results of this study demonstrate that HIV status may be a pivotal demographic feature in understanding risk-taking behaviors post disaster. No changes in drug use were reported pre and post 9/11. However, there was an increase in risky sexual behaviors in relation to serostatus, with HIV-positive men reporting a higher number of sexual partners post 9/11. In contrast, the number of sexual partners remained constant in HIV-negative men. There was also an interaction effect, demonstrating that HIV-positive men were more likely than HIV-negative men to act on their desire for sex. Thus, as a population already faced with the prospect of death, HIV-positive men may be a population more vulnerable in the face of terror and disaster.     

On Holiday: A Risk Behavior Profile for Men Who Have Vacationed at Gay Resorts

Sexual risk behavior is higher when people vacation as compared to when they are at home. The current study uses survey data to compare sexual risk behavior of gay men who vacation at gay resorts to those who do not. Independent predictors of vacationing at gay resorts included income level, relationship status, ever having attended a circuit party, and HIV serostatus. For men who visit resorts to meet sex partners, independent predictors included relationship status, ever having attended a circuit party, HIV serostatus, number of male sex partners in the past six months, and number of anal insertive male partners using a condom. These results show a need for the development of structural interventions in the gay resort and hotel setting.     

The Relationship Between Homosexuality,Internalized Homo-Negativity,and Mental Health in Men Who Have Sex with Men

ABSTRACT

Whether homosexuality or internalized homo-negativity is the critical variable affecting the mental health of men who have sex with men has long been debated. As part of a larger study, 422 Midwestern homosexual men completed questionnaires examining degree of homosexuality, internalized homo-negativity, and depression. Logistic regression modeling identified internalized homo-negativity, but not degree of homosexuality, as significantly associated with greater adjustment depression (OR?=?1.5), major depression (OR?=?2.6), dysthymia (OR?=?1.5), and likelihood of being in therapy (OR?=?1.4). Internalized homo-negativity was also negatively associated with overall sexual health, psychosexual maturation, comfort with sexual orientation, “outness,” and peer socialization. Internalized homo-negativity, not homosexuality, appears associated with negative health outcomes. Providers should promote sexual health and avoid interventions that reinforce internalized homo-negativity.     

Reconfiguring Queer Asia as Disjunctive Modernities: Notes on the Subjective Production of Working-Class Gay Men in Hong Kong

ABSTRACT

Informed by the framing of queer Asia as disjunctive modernities, this article argues for the analytic relevance of class to Hong Kong queer culture amid proliferating sexual progress. Based on ethnographic research concerning a support group for middle-aged, working-class gay men in a non-governmental organization (NGO), the findings demonstrate how their understanding and experiences of class were displaced into the culturally specific discourses of aging and generational difference. By examining the ideological work underlying three sets of local discourses (namely, generational experiences, urban redevelopment, and industrial transformation), the analysis reveals a temporal logic of class relation that governed the informants’ class displacements and, in turn, safeguarded the reproduction of inequalities in their lives. This article concludes by highlighting the interferential potential of class for understanding the queer cultural and subjective formations in other East Asian societies that went through similar processes of postwar economic development and class formation.