Predictors of moderated drinking in a primarily alcohol-dependent sample of men who have sex with men

Understanding for whom moderated drinking is a viable, achievable, and sustainable goal among those with a range of alcohol use disorders (AUD) remains an important public health question. Despite common acceptance as severe risk factors, there is little empirical evidence to conclude whether co-occurring mental health disorders or drug dependence contribute to an individual's inability to successfully moderate his drinking. Utilizing secondary data analysis, the purpose of this study was to identify predictors of moderation among both treatment-seeking and non-treatment-seeking, primarily alcohol-dependent, problem-drinking men who have sex with men (MSM), with an emphasis on the high risk factors psychiatric comorbidity and drug dependence. Problem drinkers (N = 187) were assessed, provided feedback about their drinking, given the option to receive brief AUD treatment or change their drinking on their own, and then followed for 15 months. Findings revealed that neither psychiatric comorbidity or drug dependence predicted ability to achieve moderation when controlling for alcohol dependence severity. Those who were younger, more highly educated, and had more mild alcohol dependence were more likely to achieve moderated drinking. Impact of treatment on predictors is explored. Limitations of this study and arenas for future research are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Social support,psychological vulnerability,and HIV risk among African American men who have sex with men

Previous research has suggested a need to understand the social-psychological factors contributing to HIV risk among African American men who have sex with men (MSM). We conducted individual in-depth interviews with 34 adult African American MSM to examine their personal experiences about: (i) sources of social support, (ii) psychological responses to the presence or absence of social support and (iii) influences of social support on sexual behaviours. The majority of participants described limited positive encouragement and lack of emotional support from family, as well as few meaningful personal relationships. Feelings of isolation and mistrust about personal relationships led many participants to avoid emotional intimacy and seek physical intimacy through sexual encounters. Findings highlight a need for multilevel interventions that enhance social support networks and address the social-psychological, emotional and interpersonal factors that contribute to HIV risk among African American MSM.     

The use of indigenous interviewers in a study of latino men who have sex with men: A research note

The use of indigenous researchers has long been practiced in ethnographic research; a similar use of indigenous personnel has not been as commonly undertaken in interview studies of men who have sex with men (MSM). This research note reports on the use of indigenous interviewers in a study of Latino MSM’s perceptions about sexual relationships and behaviors. The full study explores sexual relationships among Latino MSM, and HIV risk behaviors undertaken by a population of MSM residing in a community in southern California. This research note describes both the strengths and limitations that arise from employing indigenous interviewers for improving the overall quality of sensitive data. Benefits discussed include improved access to an otherwise highly restricted group, enhanced rapport-building capabilities, and greater understanding of language unique to the study population. Limitations discussed include the use of previously untrained interview personnel and age and gender issues.     

Examining the relationship between use of sexually explicit media and sexual risk behavior in a sample of men who have sex with men in Norway

The purpose of this study was to investigate consumption patterns of gay‐oriented sexually explicit media (SEM) among men who have sex with men (MSM) in Norway, with a particular emphasis on a possible relationship between gay SEM consumption and HIV risk behavior. Participants included 529 MSM living in Norway recruited online to complete a SEM consumption and sexual risk survey. Of the 507 participants who responded to the all items measuring exposure to SEM, 19% reported unprotected anal intercourse with a casual partner (UAI) in last 90 days, and 14% reported having had sero‐discordant UAI. Among those with UAI experience, 23% reported receptive anal intercourse (R‐UAI) and 37% reported insertive anal intercourse (I‐UAI). SEM consumption was found to be significantly associated with sexual risk behaviors. Participants with increased consumption of bareback SEM reported higher odds of UAI and I‐UAI after adjusting for other factors using multivariable statistics. MSM who started using SEM at a later age reported lower odds of UAI and I‐UAI than MSM who started earlier. Future research should aim at understanding how MSM develop and maintain SEM preferences and the relationship between developmental and maintenance factors and HIV sexual risk behavior.     

Trait versus situation-specific intolerance of uncertainty in a clinical sample with anxiety and depressive disorders

Intolerance of uncertainty (IU) has been most heavily implicated in the development and maintenance of generalised anxiety disorder; however, recent research has supported the transdiagnostic conceptualisation of IU by demonstrating that IU contributes to a broad array of symptoms associated with multiple anxiety and depressive disorders. The aim of this study was to examine IU firstly as a trait variable and secondly in reference to a regularly occurring, diagnostically relevant situation in a large clinical sample (N = 218). A measure of situation-specific IU (the Intolerance of Uncertainty Scale-Situation-Specific Version; IUS-SS) is presented. The IUS-SS was found to have a unitary factor structure and high internal consistency. Participants reported significantly more situation-specific IU compared to trait IU. Discriminant validity was indicated by lack of significant relationships with measures of extraversion and alcohol use. Supporting the convergent validity and transdiagnostic nature of the scale, the IUS-SS was positively associated with neuroticism and symptoms of generalised anxiety disorder and social phobia, and explained unique variance in symptoms of depression and panic disorder above and beyond trait IU. Theoretical and clinical implications are discussed.     

iObjectify: Self‐ and other‐objectification on Grindr,a geosocial networking application designed for men who have sex with men

Grindr is a smartphone application for men who have sex with men (MSM). Despite its reputation as a ‘hook‐up app’, little is known about its users' self‐presentation strategies and how this relates to objectification. This article explores objectification on Grindr. The results of Study 1 showed that Grindr users objectified other men more than non‐Grindr users. A content analysis of 1400 Grindr profiles in Study 2 showed that profile pictures with objectifying content were related to searching for sexual encounters. Finally, a survey of Grindr users in Study 3 revealed that objectification processes and sexualized profile pictures were related to some objectification‐relevant online behaviors (e.g., increased use of Grindr, discussion of HIV status). Interestingly, the presence of body focused profile content was more related to sexual orientation disclosure (not being ‘out’) than to objectification. This article presents evidence that Grindr usage and online presentation are related to objectification processes.     

Sexual abuse and HIV-risk behaviour among black and minority ethnic men who have sex with men in the UK

Black and minority ethnic (BME) men who have sex with men (MSM) face a major burden in relation to HIV infection. It was hypothesised that sexual abuse would predict sexual risk-taking, and that this relationship would be mediated by victimisation and maladaptive coping variables. Four hundred and thirty-two BME MSM completed the survey; 54% reported no sexual abuse and 27% reported sexual abuse. Mann–Whitney tests showed that MSM with a history of sexual abuse reported higher frequency of drug use, and of homophobia and racism than those reporting no prior sexual abuse. A structural equation model showed that the experience of sexual abuse was positively associated with sexual risk-taking and that this relationship was mediated by victimisation variables: frequency of racism and frequency of homophobia and by the maladaptive coping variable: frequency of drug use. The findings can inform the design of psycho-sexual and behavioural interventions for BME MSM.     

Irrational beliefs in major depression and generalized anxiety disorders in an Iranian sample: a preliminary study

Previous research on Rational Emotive Theory using western samples has shown that irrational belief systems are associated with emotional disorders such as anxiety and depression. In a replication of this work the present study was conducted to compare the scores of 29 clinically depressed, 31 clinically anxious, and 34 normal controls on the Irrational Beliefs Test in an Iranian sample. Consistent with Ellis's theory, depressed and anxious patients scored higher than the controls on scores for the full scale and all 10 subscales of the Irrational Beliefs Test. Also, the two patient groups differed significantly in their endorsement of 2 out of 10 irrational belief subscales but not in overall score on irrational beliefs. Results were interpreted in light of previous literature.     

Associations between sexual sensation seeking and AIDS-related knowledge,attitudes and behaviors among young men who have sex with men in China

Young men who have sex with men (YMSM) have become high risk groups for HIV infection in China. Recent researches suggest that sexual sensation seeking is significantly associated with AIDS-related knowledge, attitudes and behaviors, but the relationship is not clear in the field of YMSM in China. The present study aimed to evaluate the relationship between sexual sensation seeking and AIDS-related knowledge, attitudes, and behaviors among YMSM in China. A cross-sectional study was conducted in Wuhan, China from May to November 2013. 403 YMSM were recruited and 373 of them completed the questionnaire. Regression analyses indicated that YMSM with high sexual sensation seeking score are more likely to have low awareness of knowledge and negative attitude about condom use, as well as more risky sexual behaviors.     

Social context,sexual practices,and risks for HIV transmission among men who have sex with men: The south beach health survey

In a population-based sample of 193 men who had sex with men in South Beach, Miami-Dade County, Florida, two indicators of social context—choice of sexual relationships and perceived HIV-infection status—were used to analyze residents who engaged in certain sexual practices with their partners. The vast majority (88.6%) of respondents reported engagement in anal sex during the previous 12 months; 20.2% reported unprotected anal intercourse (UAI) with ejaculation with any partner and 12.4% reported UAI with ejaculation with one or more casual partners. Findings supported the hypothesis that primary partner relationships and perceived HIV status are important variables for understanding engagement in UAI with ejaculation. Men who engaged in such behaviors with casual partners were more likely to have negative attitudes towards condoms, report difficulty communicating desires for safer sex, disagree with the belief that AIDS is fatal, and be intoxicated during anal intercourse. Men who reported engaging in anal intercourse, but who never shared unprotected ejaculations, were most likely to be unknowingly infected with HIV, suggesting that many men may become infected while following what they believe to be “safer sex practices.” In designing effective interventions, public health authorities need to take into account socially embedded risk-negotiating practices.     

The effects of HIV-related thought suppression on risk behavior: cognitive escape in men who have sex with men.

This study investigated the relationship between suppressing thoughts about HIV risk and several outcomes related to HIV risk, including sexual risk behavior and HIV prevention service use, in men who have sex with men (MSM). Synthesizing the ironic processing theory (D. M. Wegner, 1994) with a cognitive escape paradigm (D. J. McKiman, D. G. Ostrow, & B. Hope, 1996), it was hypothesized that thought suppression might increase risk by leading MSM to "escape" from sexual safety norms and engage in risky sex behaviors and, via a paradoxical process, increase future use of community prevention services. Results from a sample of MSM (N = 709) indicated that thought suppression was positively related to concurrent sexual risk behavior and to future use of prevention services.     

Transdiagnostic processes in emotional disorders and insomnia: results from a sample of adult outpatients with anxiety and mood disorders

Conceptual similarities between recent models of insomnia and emotional disorders suggest there may be common factors that underlie or maintain these difficulties. Maladaptive cognitive and behavioral processes similar to those described in connection with emotional disorders have been cited as key mechanisms in the maintenance of primary insomnia. Unfortunately, research on this potential overlap is lacking. The present study examined the relationship among anxiety sensitivity (AS), dysfunctional beliefs, fatigue, safety behaviors, and insomnia severity in 59 outpatients with anxiety and mood disorders. Key insomnia processes (dysfunctional beliefs, fatigue, safety behaviors) were all related to insomnia severity in the comorbid sample, although AS was not. However, as hypothesized, AS did moderate the relationship of both dysfunctional beliefs and fatigue with insomnia severity. The relationships between key insomnia processes and insomnia severity was strongest among individuals high in AS. Results support the hypothesis that common mechanisms are involved for insomnia and emotional disorders. AS might function as a mechanism for the maintenance of sleep disturbance in the context of anxiety and mood disorders, suggesting a promising avenue for future research.     

Alcohol use and high-risk sexual behavior among men who have sex with men: the effects of consumption level and partner type.

Alcohol use may increase HIV sexual risk behavior, although findings have varied across study populations and methods. Using event-level data from 1,712 seronegative men who have sex with men, the authors tested the hypothesis that social context would moderate the effect of alcohol consumption on unprotected anal sex (UAS). For encounters involving a primary partner, rates of UAS did not vary as a function of alcohol use. However, consumption of 4 or more drinks tripled the likelihood of UAS for episodes involving a nonprimary partner. Thus, the effects of alcohol vary according to the context in which it is used. Interventions to reduce substance-related risk should be tailored to the demands of maintaining sexual safety with nonprimary partners.     

The fallacy of intimacy: sexual risk behaviour and beliefs about trust and condom use among men who have sex with men in South Africa

The objective of this study is to assess (1) whether beliefs about trust and condom use affect sexual risk behaviour, and (2) if beliefs about trust and condom use impact sexual risk behaviour directly or if this relationship is mediated by other determinants. The Information-Motivation-Behavioural Skills model was used as a framework for the mediation analysis. A diverse cohort of three hundred 18-40 year old men who have sex with men (MSM) residing in Pretoria, South Africa, were recruited and surveyed for this project. Findings indicate that men who report a high frequency of past unprotected anal intercourse are more likely to believe that it is not necessary to use condoms with a trusted or steady partner regardless of their current partnership status. This fallacy of intimacy appears to affect sexual risk behaviour through intentions and attitudes regarding safer sex practices. Based on these findings, we recommend that more attention be given in gaining a better understanding of how beliefs about trust and condom use are formed and how they can be changed among MSM in South Africa.     

The NEO Five-Factor Inventory: latent structure and relationships with dimensions of anxiety and depressive disorders in a large clinical sample

The present study evaluated the latent structure of the NEO Five-Factor Inventory (NEO FFI) and relations between the five-factor model (FFM) of personality and dimensions of DSM-IV anxiety and depressive disorders (panic disorder, generalized anxiety disorder [GAD], obsessive-compulsive disorder, social phobia [SOC], major depressive disorder [MDD]) in a large sample of outpatients (N = 1,980). Exploratory structural equation modeling (ESEM) was used to show that a five-factor solution provided acceptable model fit, albeit with some poorly functioning items. Neuroticism demonstrated significant positive associations with all but one of the disorder constructs whereas Extraversion was inversely related to SOC and MDD. Conscientiousness was inversely related to MDD but demonstrated a positive relationship with GAD. Results are discussed in regard to potential revisions to the NEO FFI, the evaluation of other NEO instruments using ESEM, and clinical implications of structural paths between FFM domains and specific emotional disorders.     

Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample.

The comorbidity of current and lifetime DSM-IV anxiety and mood disorders was examined in 1,127 outpatients who were assessed with the Anxiety Disorders Interview Schedule for DSM-IV: Lifetime version (ADIS-IV-L). The current and lifetime prevalence of additional Axis I disorders in principal anxiety and mood disorders was found to be 57% and 81%, respectively. The principal diagnostic categories associated with the highest comorbidity rates were mood disorders, posttraumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). A high rate of lifetime comorbidity was found between the anxiety and mood disorders; the lifetime association with mood disorders was particularly strong for PTSD, GAD, obsessive-compulsive disorder, and social phobia. The findings are discussed in regard to their implications for the classification of emotional disorders.     

"HIV testing is so gay": the role of masculine gender role conformity in HIV testing among men who have sex with men

Men who have sex with men (MSM) account for more than half of all new cases of HIV infection in the United States. Yet, many MSM are unaware of their HIV serostatus. Consistent with research indicating that gender role conformity impacts health behaviors, this study examined how masculine norms may influence HIV testing among MSM in the United States. Data from 170 self-identified MSM (age M = 46.45, SD = 12.18) of self-reported negative or unknown HIV serostatus living in the United States were used in this study. About half (52%) of participants reported that they had been tested for HIV within the past 12 months; 48% reported that they had not. Logistic regression was used to examine the association between domains of masculine gender role conformity and HIV testing within the past 12 months, controlling for number of sexual partners in the last 12 months. The masculine norm of heterosexual self-presentation (i.e., desire to be perceived by others as heterosexual) was negatively associated with HIV testing (B = -0.74, SE B = 0.36, O.R. = 0.48, 95% CI [0.24, 0.96]), after controlling for the effect of number of sexual partners. Psychologists and other health professionals may remain mindful of potential implications of HIV testing among MSM, including potential for MSM to view HIV testing as an "outing" procedure.