Characteristics of men who have sex with men on the internet but identify as heterosexual, compared with heterosexually identified men who have sex with women.

We compared men who have sex with other men on the Internet with the remainder of the sample of men who reported only sex with women on the Internet, in a sample of 1,846 Swedish men recruited from a major Swedish portal. We report on the self-identified heterosexual men in the sample who reported engaging in cybersex in the past year, and for whom there was complete data on sexual identity and the gender of cybersexual partners. Of the 244 cases with full data, 76% were heterosexual in both identity and behavior, 16% were gay or bisexual in identity and reported both male and female cybersexual contacts on the Internet, and 8% indicated their sexual preference was heterosexual but also reported at least one male sexual partner on the Internet. Thus, 11% of self-identified heterosexual men had sex with other men online. Comparing the two groups, the men who had sex with men (MSM) who did not identify (MSM-NI) spent significantly more time per week online, although a similar amount of time on sexual pursuits, as the heterosexual men. The MSM-NI were significantly more likely to agree that their online sexuality had affected their sexuality in a positive way, to have bought sex from prostitutes, to agree that they do things online that they would not do offline, have cybersex more often, use a web-camera and microphone more often, flirt and visit contact sites more often, and agree more often that sexual thoughts and behaviors are causing problems, desire to have sex creates problems, and sometimes fail to meet commitments due to their sexual behavior. These data taken together suggest that MSM-NI online are not uncommon and are characterized by the extent of their cybersexual involvement that sometimes extends to other men. Such men may rationalize this cybersex with other men as not, or minimally, sexual in much the same way as Humphreys characterized MSMs in public restrooms.     

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).     

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 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.     

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.     

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.     

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.     

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.     

"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.     

Suicidality, clinical depression, and anxiety disorders are highly prevalent in men who have sex with men in Mumbai, India: findings from a community-recruited sample

In India men who have sex with men (MSM) are a stigmatized and hidden population, vulnerable to a variety of psychosocial and societal stressors. This population is also much more likely to be HIV-infected compared to the general population. However, little research exists about how psychosocial and societal stressors result in mental health problems. A confidential, quantitative mental-health interview was conducted among 150 MSM in Mumbai, India at The Humsafar Trust, the largest non-governmental organization serving MSM in India. The interview collected information on sociodemographics and assessed self-esteem, social support and DSM-IV psychiatric disorders using the Mini International Neuropsychiatric Interview (MINI). Participants' mean age was 25.1 years (SD?=?5.1); 21% were married to women. Forty-five percent reported current suicidal ideation, with 66% low risk, 19% moderate risk, and 15% high risk for suicide per MINI guidelines. Twenty-nine percent screened in for current major depression and 24% for any anxiety disorder. None of the respondents reported current treatment for any psychiatric disorder. In multivariable models controlling for age, education, income, and sexual identity, participants reporting higher levels of self-esteem and greater levels of satisfaction with the social support they receive from family and friends were at lower risk of suicidality (self-esteem AOR?=?0.85, 95% CI: 0.78-0.93; social support AOR?=?0.76, 95% CI: 0.62-0.93) and major depression (self-esteem AOR?=?0.79, 95% CI: 0.71-0.89; social support AOR?=?0.68, 95% CI: 0.54-0.85). Those who reported greater social support satisfaction were also at lower risk of a clinical diagnosis of an anxiety disorder (AOR?=?0.80; 95% CI: 0.65-0.99). MSM in Mumbai have high rates of suicidal ideation, depression, and anxiety. Programs to improve self-esteem and perceived social support may improve these mental health outcomes. Because they are also a high-risk group for HIV, MSM HIV prevention and treatment services may benefit from incorporating mental health services and referrals into their programs.     

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.     

Radical therapy: A research note on the use of ideological work in maintaining a deviant subculture

A social protest movement which survived the demise of the New Left is explored in terms of ways in which a countercultural group preserved a particular kind of deviant subculture. Radical therapy developed from an opposition to American middle class values as they were institutionalized in psychiatric practice. While identifying themselves as Marxist revolutionaries, members reacted to the decline of social activism by adopting a hidden agenda of psychological transformation activities and duplicating traditional structures in their “radical” therapy. The longevity of radical therapy is explained in terms of its effectiveness in benefitting from the dominant culture while preserving members's deviant identities through various forms of ideological work.     

The lexical decision list task: A research note

The lexical decision list task, a paper-and-pencil version of the standard lexical decision task, is introduced and described. Data are reported demonstrating that subjects' responses to manipulations of phonological confusability, stimulus difficulty, and case presentation are analogous to those obtained with the use of the standard task.     

Effects of psychotherapy with people who have been sexually assaulted: A meta-analysis

This paper presents the results of a meta-analysis of the treatment outcome studies of different types of psychotherapeutic approaches for sexual assault victims experiencing PTSD or rape trauma symptoms. There were 15 outcome studies identified for inclusion in the meta-analysis dating from 1988–2005, and these studies comprised 25 treatment conditions. Separate meta-analyses were conducted according to study design (independent samples and repeated measures), in keeping with meta-analytic conventions. The overall results for the two meta-analyses were highly consistent, and effect sizes were in the large range for independent samples (g = .91) and repeated measures treatments (g = .90). Effects were maintained at follow-up from 6–12 months after treatment. Studies represented diverse treatment approaches, and most treatments were effective in improving outcome according to symptom reduction. A number of moderating variables were examined. Better outcomes were achieved with individual therapy compared to group approaches. The use of semi-structured approaches and homework techniques were positively related to the magnitude of effect size.     

WAIS-R and MMPI profiles of men who have sexually assaulted children: evidence of limited utility

Wechsler Adult Intelligence Scale-Revised (WAIS-R) data were compiled on 101 male sexual offenders of children, and Minnesota Multiphasic Personality Inventory (MMPI) profiles were compiled for a subsample of 81 of these subjects in a replication and extension of the Hall, Maiuro, Vitaliano, and Proctor (1986) MMPI study. The MMPI profiles were heterogeneous and had multiple elevations. No significant relationships between the WAIS-R Full Scale IQ, WAIS-R Performance IQ Minus Verbal IQ Index, or the MMPI scales, and offense characteristics were obtained. These results support the hypothesis of Hall et al. (1986) that psychometric instruments may be of limited utility in characterizing or differentiating among sexual offenders on the basis of criminological variables.