Rosario Margaret, Schrimshaw Eric W, Hunter Joyce
Department of Psychology, City University of New York - City College and Graduate Center, New York, NY 10031, USA.
AIDS Educ Prev. 2006 Oct;18(5):444-60. doi: 10.1521/aeap.2006.18.5.444.
Sexual risk behaviors of young gay and bisexual men must be understood within the context of other health concerns (e.g., anxiety, substance abuse), population specific factors (i.e., the coming-out process and gay-related stress), childhood sexual abuse, and other theoretical factors (e.g., safer-sex intentions). The current report proposes and longitudinally examines a model of risk factors for subsequent sexual risk behaviors among young gay and bisexual men in New York City. As hypothesized, more negative attitudes toward homosexuality, more substance abuse symptoms, and poorer intentions for safer sex were directly associated with a greater likelihood of unprotected anal sex over the following year. Furthermore, lower self-esteem, more anxious symptoms, and childhood sexual abuse were related to more unprotected anal sex indirectly through more sexual partners, sexual encounters, and substance abuse symptoms. These findings suggest that interventions targeting sexual risk behaviors of young gay and bisexual men may be more effective if they also address mental health concerns and aspects of the coming-out process.
年轻男同性恋者和双性恋男性的性风险行为必须结合其他健康问题（如焦虑、药物滥用）、特定人群因素（即出柜过程和与同性恋相关的压力）、童年性虐待以及其他理论因素（如安全性行为意图）来理解。本报告提出并纵向研究了纽约市年轻男同性恋者和双性恋男性后续性风险行为的风险因素模型。正如所假设的，对同性恋的负面态度更强、药物滥用症状更多以及安全性行为意图更差，与次年无保护肛交的可能性更大直接相关。此外，自尊较低、焦虑症状较多以及童年性虐待，通过更多的性伴侣、性接触和药物滥用症状，与更多的无保护肛交间接相关。这些发现表明，针对年轻男同性恋者和双性恋男性性风险行为的干预措施，如果同时解决心理健康问题和出柜过程的各个方面，可能会更有效。
