Perceived Control and Psychological Adjustment in Gay Men With AIDS1

The relationship of control beliefs to psychological adjustment was investigated in a sample of 24 gay men diagnosed with AIDS, participants in the University of California, Los Angeles site of the Multicenter AIDS Cohort Study (MACS). Distinctions between generalized contingency beliefs and specific competence beliefs and between personal and vicarious control beliefs were included in the questionnaire and interview measures administered. The results support these distinctions and indicate that beliefs in personal control over day-to-day symptoms and over course of illness were positively related to adjustment, whereas beliefs in control by others over course of illness and over medical care and treatment were negatively related to adjustment. These relationships appeared to be strongest for men who reported poorer health. These associations were not accounted for by locus of control beliefs, negative affectivity, or time since diagnosis with AIDS.     

Psychological Adjustment of Lesbians and Gay Men

Previous research has documented that lesbians and gay men proceed through a series of stages in developing a positive lesbian and gay identity. The relationship between lesbian and gay identity and subsequent psychological adjustment has not been evaluated. These empirical studies found that positive lesbian and gay identity is related to psychological adjustment as measured by lower neurotic anxiety and greater ego strength in both an older and a younger sample of lesbians and gay men. Two coping strategies—self-labeling as a homosexual and self-disclosure of sexual orientation to others—were related to development of a positive lesbian or gay identity. These findings suggest that development of a positive lesbian or gay identity is an important task in promoting the psychological adjustment of lesbians and gay men.     

Insert Discourse: Rectal Douching Among Young HIV-Positive and HIV-Negative Men Who Have Sex with Men in Vancouver,Canada

Douching is a common practice among certain groups of women and MSM, and it is conducted for the purpose of cleanliness as part of bodily hygiene maintenance. Although there has been considerable research about female vaginal douching, understandings of rectal douching (RD) for MSM are limited. In the epidemiological and medical literature, RD is presented as a behaviour that removes beneficial bacteria and the surface epithelium layer of the colon, which can, potentially, increase the risk of HIV transmission in MSM. The paucity of research on male douching practices is curious given the primacy of anal sex in HIV prevention initiatives and the widespread nature of rectal douching among this population. This paper provides preliminary data on RD and is intended to engender a dialogue about male douching and the need for additional research into the cultural construction of the body among MSM, namely with respect to the anus. Findings were derived from qualitative interviews with 12 young HIV-positive men who had recently become HIV-infected and 12 HIV-negative age-matched counterparts who were participating in a prospective cohort study. Beliefs about RD differed according to HIV serostatus; HIV-positive men discussed the practice much more openly than their counterparts did. Pre-coital RD is an embedded behaviour about which very little is known. However, it is a critical issue to include in the development of effective HIV prevention strategies and warrants an acknowledgement of importance of the anus in the lives, sexual practices, and identities among MSM.     

Mental Health Stereotypes About Gay Men

Three studies were conducted to examine the mental health stereotypes about gay men among college student and therapist trainee samples. Results from Study 1 indicated that (a) college students and therapist trainees endorsed a stereotype of the mental health of gay men that was similar in terms of its content and strength, and (b) the stereotype was consistent with five DSM-IV-TR disorder categories: mood, anxiety, sexual and gender identity, eating, and personality disorders. In Study 2 and 3 we investigated whether homophobia or a tendency to report cultural beliefs could account for the lack of difference between college students and therapist trainees. Results did not support either explanation.     

The Nature and Correlates of Psychological Adjustment in Gay Men with AIDS-Related Conditions1

This study assessed differences in the psychological adjustment of gay men who tested positive for the antibody to the human immunodeficiency virus (HIV). Twenty-one were symptomatic for AIDS, and 27 were asymptomatic. A group of 15 gay men who tested negative for the HIV was included as a comparison group. Men in the three groups were equivalent on demographic variables. Symptomatic men reported more health problems than either asymptomatic or seronegative men. Relative to men who were symptomatic, those who were asymptomatic reported more death anxiety, less optimism, and greater severity of psychological distress, and reported more frequent use of avoidance and distancing as coping strategies. The poor psychological functioning of asymptomatic subjects was attributed to the uncertainty regarding their future health status. Generally, positive psychological well-being of symptomatic and asymptomatic men was related to the infrequent use of avoidance coping strategies and high satisfaction with perceived social support.     

Childhood Emotional Abuse and Psychological Distress in Gay and Bisexual Men

Despite the high prevalence of childhood emotional abuse (CEA) and adult psychological distress (depression and anxiety) among gay and bisexual men (GBM), there is little research examining the relationships among these variables. This study examined internalized homophobia (IH) as a mediator between CEA and psychological distress in a sample of 286 GBM. Controlling for demographics and childhood sexual and physical abuse, CEA was associated with self-report and clinician-administered measures of psychological distress. Concern about stigma of being gay mediated the relationship between CEA and psychological distress. Internalized antigay attitudes might be important in the relationship between CEA and adult psychological distress. Clinicians might address negative beliefs about the self as a GBM that could be exacerbated due to CEA.     

Social Support Provision to HIV-Infected Gay Men1

The study examined associations between attitudes toward homosexuality, fear of AIDS, blame of persons infected with the HIV-virus, and social support provision to these individuals. A sample of HIV-infected gay men reported on the support they receive from specific members of their social networks. These network members then completed questionnaires assessing the predictor variables. Homophobia, homosexual preference, and the interaction of these two variables were positively associated with blame. Blame, together with fear of AIDS and low levels of psychological well-being, were negatively associated with provision of emotional support. Fear of AIDS was also related to negative changes in the quality of recipients' and providers' relationships. Finally, emotional support was strongly related to adjustment to illness among support recipients. Results suggest important points for intervention to promote adjustment to HIV infection among gay men.     

Family Values and Antipathy Toward Gay Men

The role of family values in promoting prejudice toward gay men was examined. Participants high and low in support for family values were primed with family-relevant or neutral cues and were exposed to either a gay or a straight father who was described as a good or a bad parent. Both individual differences in family value support and situational primes of family values produced derogation of the gay father. Sympathy for the father in a child custody loss was also markedly low when family values were both endorsed and primed, and when the gay father was explicitly depicted as a bad parent. The findings have implications for Rokeach's (1972) belief congruence perspective, and for models that depict values as part of a mental associative network (Biernat, Vescio, & Theno, 1996; Feather, 1990).     

Spiritual Experiences of Gay Men and Lesbians

The spiritual and religious lives of gay men and lesbians are often misunderstood by counselors who have too little information about this rich and diverse population. This article offers an explication of the challenges facing gay persons, a model that will be useful in counseling sessions, and a list of resources for further information.     

Sexual Compulsivity in Gay Men: Controversy and Treatment

Compulsive sex among some gay men has been made a more significant issue by the AIDS epidemic. There is controversy as to whether or not compulsive sex is a disorder or if it should be thought of as addiction. The clinical usefulness of the addictive model is discussed, along with the commonalities between the two most prevalent and successful approaches used to treat this disorder: namely, group treatment and the self-help Twelve Step addictive model.     

Sexual and Intimacy Issues for Aging Gay Men

The authors focus on the special issues involved in providing counseling to aging gay men regarding sex and intimacy. Although the stresses of aging experienced by gay men are similar to those of heterosexual men, older gay men face issues of a stigmatized sexual orientation, invisibility, negative stereotypes, and discrimination regarding aging.     

Real and Illusory Control Over Exposure to HIV in College Students and Gay Men1

Reasons for unsafe sex were examined using an illusions of control framework. Heterosexual college students (N= 301) and gay men (N= 248) were surveyed regarding perceived control over exposure to HIV, of vulnerability to HIV, use of illusory control in chance situations, and real and illusory strategies for protection against HIV. As predicted, the use of illusory control in chance situations was associated with more illusory HIV protection in both samples. Illusory protection strategies were associated with feeling less vulnerable to HIV which was mediated by perceptions of control over exposure to HIV. Suggestions for intervention include providing information about the illusory nature of some protective strategies and a focus on failing to protect oneself from STDs.     

Suicidal Ideation in Gay Men and Lesbians in South Korea: A Test of the Interpersonal‐Psychological Model

Gay men and lesbians in South Korea are alienated and stigmatized due to the country's low tolerance of social differences, resulting in distress and suicidal impulses. This study investigated the predictors of suicidal ideation in a gay and lesbian group in South Korea based on the interpersonal‐psychological theory of suicide. Differences between the gay and lesbian group and the heterosexual group were found in the direct path between perceived burdensomeness and suicidal ideation. The relationship was significant for both groups, but the path coefficient was greater for lesbians and gay men than for heterosexuals. These findings imply that perceived burdensomeness may be a more critical factor in suicidal ideation of lesbians and gay men.     

Understanding and Counseling Gay Men: A Developmental Perspective

The author reviews current concepts and research concerning homosexuality with emphasis on understanding gay men and their relationship behaviors. Because the current focus is on homosexuality as a developmental process, counseling considerations are presented from a developmental perspective and a case example is included.     

Childhood Gender Nonconformity and Body Dissatisfaction in Gay and Heterosexual Men

Although researchers have long hypothesized a relation between gender role orientation (i.e., masculinity and femininity) and body dissatisfaction, findings have been inconsistent. The current study employed a measure of recalled childhood gender nonconformity to examine gender role behaviors in association with body dissatisfaction among an ethnically diverse (76% Caucasian, 2% African American, 8% Asian, and 16.4% Hispanic American) group of predominantly college-aged males of both homosexual (n = 129) and heterosexual (n = 52) orientation. Consistent with past research, gay males reported more body dissatisfaction and recalled more childhood gender atypical behaviors (e.g., disliking athletics, playing with dolls). Group differences in body dissatisfaction, however, disappeared when childhood gender nonconformity was statistically controlled, suggesting childhood atypical gender role behavior may place males at greater risk for adult body dissatisfaction. A within-group analysis also found that a high feminine subtype of gay males had greater body dissatisfaction than less feminine subtypes had. Results support the assertion that gender role behaviors may contribute to body dissatisfaction among gay males.     

Belief in a Just World and Condom Use in a Sample of Gay and Bisexual Men1

Research has shown that, under certain conditions, people with a strong belief in a just world (BJW) perceive themselves to be less at risk for serious negative events (e.g., contracting AIDS). We extended this work by investigating the relation between BJW and high‐risk sexual behavior Gay and bisexual men (N= 102) responded to a questionnaire that measured individual differences in BJW, personality characteristics related to perceived relationship threat (e.g., interpersonal control), and frequency of condom use and anal intercourse. Results generally supported predictions. For example, among respondents low in interpersonal control, a strong BJW was associated with less frequent condom use. These results have implications for research on BJW, as well as research on the predictors of high‐risk sexual behavior.     

Attitudes of University Students toward Lesbians and Gay Men in Turkey

The purpose of this study was to determine the attitudes of university students in Turkey toward lesbians and gay men. Findings indicate that relatively negative attitudes toward lesbians and gay men are prevalent, but attitudes toward lesbians seem to be more positive than attitudes toward gay men. Gender differences directly affect attitudes, and religiosity also has great impact on the attitudes of the students toward lesbians and gay men. An active sex life and liberal attitudes toward premarital relations correlate with more positive attitudes toward homosexual persons. Finally, the data indicate that interpersonal contact with gay men and lesbians is associated with positive attitudes toward homosexuals.     

Gay Identity and HIV Risk for Black and Latino Men Who Have Sex with Men

Strong gay identity among white men who have sex with men (MSM) has been associated with decreased HIV risk, but data for black and Latino MSM (BLMSM) are inconclusive. We examined gay identity and HIV risk among BLMSM to inform social and structural HIV intervention strategies. BLMSM were administered a computerized survey as part of an HIV research study during 2011–2012 conducted in New York City. We used a brief scale of Gay Identity Questionnaire. After data analysis, Stage I (not fully accepting) and Stage II (fully accepting) gay identity were determined based on participant responses. We used logistic regression to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association between gay identity with HIV risk and social determinant factors. Among 111 self-identified BLMSM (median age = 32 years, 68.4% with some college or higher education), 34.2% reported receptive anal sex without condoms in the previous three months. Gay Identity Questionnaire Scale assessment indicated that 22 (19.8%) were Stage I, and 85 (76.6%) were Stage II in this BLMSM sample. Stage II gay identity was more likely seen among BLMSM with high involvement in the gay community (aOR 3.2; CI 1.00, 10.26) and less likely among BLMSM who exchanged sex for food or shelter (aOR 0.15; CI 0.02, 0.98). Fully accepting gay identity may be protective for BLMSM as it relates to transactional sex; these factors warrant further research and consideration as part of HIV prevention strategies.     

GPS: A Randomized Controlled Trial of Sexual Health Counseling for Gay and Bisexual Men Living With HIV

Gay, bisexual, and other men who have sex with men (GBM) continue to have high rates of HIV and sexually transmitted infections, including syphilis. GBM have therefore been identified by public health agencies as a high-priority population to reach with prevention initiatives. Despite the importance of mental health in preventing HIV and related infections, there is a shortage of credentialed mental health professionals to deliver behavioral Counseling interventions. The current study evaluated the efficacy of GPS, a community-based and peer-delivered sexual health promotion motivational interviewing–based intervention for HIV-positive GBM who engaged in condomless anal sex (CAS) in the past 2 months. GPS prevention counseling demonstrated a 43% relative reduction at 3-month follow-up in CAS with serodiscordant partners and significant reductions in sexual compulsivity. The study demonstrated that community-based counselors can administer an efficacious motivational interviewing program, and suggests a continued benefit of counseling methods to promote the sexual health of higher risk populations.     

Sexual Addiction and the Internet: Implications for Gay Men

The authors present an overview of sexual addiction and explore the relationship between Internet use and sexual compulsivity. The role of Internet use in gay men's sexual behavior is described. Implications for the counseling profession are discussed, and a clinical case study is presented.