AIDS-related death: A review of how bereaved gay men are affected

This paper reviews the current literature in relation to how gay men are affected by AIDS related bereavement. It seems that bereavement reactions have changed as the epidemic has progressed. Initially, it seemed that gay men were very badly affected by AIDS related bereavements, especially the experience of multiple bereavements. However, while the experience of such bereavement cna be vary stressful it seems that gay men are less afected in the long term than was previously thought. The paper places this change within a cultural and political context and user this context to consider current bereavement reactions.     

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.     

The Mpowerment Project: community-building with young gay and bisexual men to prevent HIV1

The Mpowerment Project is a community-level HIV prevention intervention for young gay and bisexual men ages 18–27. The program seeks to build a strong, supportive young gay and bisexual men's community where young gay and bisexual men nurture and protect each other, particularly with regard to HIV prevention. The program's theoretical framework draws from the areas of diffusion of innovations, community organizing, peer influence, and personal empowerment. The Mpowerment Project promotes a norm for safer sex through a variety of social, outreach and small group activities. The project is run by a Core Group of 12–15 young gay and bisexual men who, with volunteers, design and carry out all project activities. Implemented in 4 communities (Eugene, OR; Santa Barbara, CA; Albuquerque, NM; Austin, TX), the Mpowerment Project has proven to be effective in reducing high risk sex. This paper discusses the development and implementation of the program and various challenges encountered.     

"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.     

Negative HIV-specific expectancies and AIDS-related bereavement as predictors of symptom onset in asymptomatic HIV-positive gay men.

This study examined negative HIV-related expectancies, AIDS-related bereavement, and the interaction of expectancies and bereavement as predictors of the onset of significant HIV-related symptoms among previously asymptomatic HIV-positive gay men. From a longitudinal psychobiological investigation, 72 men were selected who had been HIV-positive and asymptomatic from study entry (approximately 3 years). Participants were followed for an additional 2 1/2 to 3 1/2 years after psychosocial assessment, with symptom status assessed every 6 months. The interaction of negative HIV-specific expectancies and bereavement was a significant predictor of symptom onset. Negative HIV-specific expectancies predicted the subsequent development of symptoms among bereaved men, controlling for immunological status, use of zidovudine, high-risk sexual behavior, substance use, and depression.     

Psychiatric diagnoses in infancy: A comparison

This study investigated the specificity of diagnostic classification in two standardized systems: DSM-IV and Diagnostic Classification: Zero to Three. A sample of 82 infants aged 1–24 months suffering from various psychogenic and functional pediatric symptoms was diagnosed applying both systems. For DC: 0–3 (the Diagnostic Classification on Mental Health and Developmental Disorders of Infancy and Early Childhood), this study presents results with respect to the specificity of symptom patterns. Twelve out of 27 symptoms, specific for disorders in early infancy, showed high specificity and were significantly discriminative for the diagnostic entities. These symptoms were differentiated for frequency and severity of occurrence for each diagnosis. In the sample, DSM-IV and DC: 0–3 diagnoses were compared. Additionally, 13 items of biographical-biological data were collected (e.g., low SES combined with very young or older mothers resulted in an increased risk for psychiatric disorders in early infancy). The data provide support for the idea that the use of DC: 0–3 in early infancy may be helpful in relation to daily routines and research by increasing the range of clearly defined diagnostic entities.     

AIDS-related factors predictive of suicidal ideation of low and high intent among gay and bisexual men.

AIDS-related stressors were studied in relationship to suicidal ideation and suicide intent among 778 gay and bisexual men (none with AIDS). Over the previous six months, 27% (n = 212) reported suicidal ideation. Subjects who reported suicidal ideation (compared to those who did not) were more likely to report recent (last 6 months) bereavement of partner, recent ARC diagnosis, and multiple close friends with ARC. Suicide ideators were divided by a median split on a self-report scale of suicide intent into low (n = 105) and high (n = 107) intent suicide ideators. News of HIV seropositivity was specifically related to low intent suicidal ideation. High intent suicidal ideation was associated with having a partner with AIDS or ARC, or multiple close friends with AIDS, or having ARC. Generally speaking, while temporally discrete AIDS-related events were associated the report of suicidal ideation, ongoing stressors which may more greatly challenge adaptational capacities were more associated with high intent suicidal ideation.     

Support for an expanded tripartite influence model with gay men

This study investigated whether an expanded tripartite influence model would represent gay men's experiences. This model was extended by adding partners and gay community involvement as sources of social influence and considering dual body image pathways (muscularity and body fat dissatisfaction) to muscularity enhancement and disordered eating behaviors. Latent variable structural equation modeling analyses upheld this model for 346 gay men. Dual body image pathways to body change behaviors were supported, although three unanticipated interrelationships emerged, suggesting that muscularity and body fat concerns and behaviors may be more integrated for gay men. Internalization of the mesomorphic ideal, appearance comparison, muscularity dissatisfaction, and body fat dissatisfaction were key mediators in the model. Of the sources of social influence, friend and media pressure to be lean, gay community involvement, and partner, friend, media, and family pressures to be muscular made incremental contributions. Unexpectedly, certain sources were directly connected to body change behaviors.     

Understanding the impact of HIV diagnosis amongst gay men in Scotland: An interpretative phenomenological analysis

Objectives: Although a wide literature details the psychological impact of human immunodeficiency virus (HIV) diagnosis, it predates the introduction of effective treatment for HIV (i.e. anti-retroviral therapies, ARTs). This article explores the psychological impact of HIV diagnosis in post-ART accounts. This is important, given the recent policy developments which focus upon increasing HIV testing and thus diagnoses.

Design: This study presents a qualitative exploration of the experiential accounts of HIV-positive gay men living in Scotland. A total of 14 HIV-positive gay men took part in open-ended interviews.

Methods: Interpretative phenomenological analysis was employed to identify recurrent themes across the interviews.

Results: Our analysis focuses upon the participants’ struggles in adjusting to their HIV status. Diagnosis was a deeply shocking and unexpected experience. Stigma and fear of prejudice dominated their accounts. HIV was understood, variously, as a shameful, fatal and life-changing condition. Overall, within these accounts there was little sense of HIV normalisation.

Conclusions: In Scotland, where HIV prevalence is low, and where no accessible HIV-positive sub-culture exists, there is on-going psychological distress and morbidity amongst gay men testing HIV positive. As HIV-related policy increasingly focuses on increasing rates of antibody testing, there is a need to reduce the psychosocial costs associated with HIV-positive diagnoses.     

Age-associated memory impairment diagnoses: problems of reliability and concerns for terminology.

Objective memory criteria for diagnosing age-associated memory impairment (AAMI), age-consistent memory impairment, and late-life forgetfulness (LLF) were applied to 523 cognitively normal older persons divided into 2 groups on the basis of the clinical memory assessment battery they received. Seventy-seven percent of Group 2 and 98% of Group 1 met the Crook et al. (1986) cognitive criteria for AAMI on at least 1 test. Rates based on individual tests varied from 7% to 96%. Objective-cognitive criteria for LLF were met by no members of Group 1 but by 31% of Group 2. Results suggest that, as proposed, the criteria for age-related diagnoses lack reliability. Concerns regarding the diagnosis of normal memory in older populations are considered.     

Issues in psychotherapy with lesbians and gay men. A survey of psychologists

In 1984, a task force of the American Psychological Association (APA) Committee on Lesbian and Gay Concerns was charged with investigating bias in psychotherapy with lesbians and gay men. The task force surveyed a large and diverse sample of psychologists to elicit information about specific instances of respondent-defined biased and sensitive psychotherapy practice. Open-ended responses were used to separately identify major themes of biased and sensitive practice and to illustrate each with concrete examples. Results suggest that psychologists vary widely in their adherence to a standard of unbiased practice with gay men and lesbians. To bring individual practice into accord with APA policy will require continued and expanded efforts to educate practitioners about sexual orientation.     

The Male Body Attitudes Scale: A confirmatory factor analysis with a sample of gay men

The Male Body Attitudes Scale (MBAS; Tylka, Bergeron, & Schwartz, 2005) is a recently created instrument which assesses males’ attitudes regarding their muscularity, body fat, and height. Although the MBAS was created via exploratory and confirmatory factor analyses, its factor structure has yet to be replicated with more diverse samples. The aim of the current study was to conduct a confirmatory factor analysis of the MBAS with a sample of gay men. Results from an online sample of 207 self-identified gay men revealed that the original three-factor structure of the MBAS, as well as a two-factor structure, consisting of muscularity and body fat, displayed strong factorial validity. These findings suggest that either a two- or three-factor structure may be used when assessing body image concerns in gay men.     

A developmentally keyed scheme for the placement of gay men into psychotherapy groups

Patients can meet their needs for intimacy and individuation within the context of long-term psychotherapy groups. This is especially true for gay male patients as they work toward the development of a positive gay identity. Coming out is a social phenomenon, which is why groups are especially suited to the tasks involved. Historically, mixed groups of gay and nongay men and women have not been a safe or neutral treatment atmosphere for gay men due to therapists' prejudicial assumptions and a lack of understanding of gay male development. A developmental scheme will be presented which is keyed to the particular needs of gay men depending on their developmental stage of functioning. This scheme should serve as a more rational and appropriate guide for the diagnosis, treatment planning, and assigning of gay men to long-term psychotherapy groups.     

Hair today, gone tomorrow: a comparison of body hair removal practices in gay and heterosexual men

Although hairlessness is rapidly becoming a component of the ideal male body, little research has examined men's concerns about their body hair or their hair removal practices. Samples of gay and heterosexual men completed questionnaires that assessed whether they had ever removed their back, buttock or pubic hair, the frequency with which they did so, the methods used and their self-reported reasons for removing this hair, as well as their level of appearance investment. Results indicated that many gay and heterosexual men remove their back, buttock and pubic hair regularly and that their primary reason for doing so is to maintain or improve their appearance. The frequency of hair removal was also associated with the motivational salience component of appearance investment. The findings offer further support to the premise that gay and heterosexual men exhibit similar body image concerns.