Parker R David, Lõhmus Liilia, Mangine Cara, Rüütel Kristi
West Virginia University School of Public Health, 1 Medical Center Drive, Morgantown, WV, 26506, USA.
Infectious Diseases and Drug Monitoring Department, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
J Community Health. 2016 Aug;41(4):717-23. doi: 10.1007/s10900-015-0145-7.
Men who have sex with men (MSM) continue to be at higher risk for negative health outcomes including HIV, STIs, depression, substance use, suicidality, and anxiety. Associative relationships between homonegativity (internal and external) and these outcomes are used to explain the observed disproportionate impact. The current study assessed associations between internalized homonegativity and high-risk behaviours, markers of substance use and symptoms of mental illness as well as openness and level of same sex attraction. A 2013 Internet-based survey was conducted among MSM, collecting data on socio-demographics, sexuality, drug and alcohol use, mental health, suicidality, and internalized homonegativity. The sample (n = 265) had a median age of 31 years, with 85 % employed at least part-time; at least a college-level education in 43 %; and 87 % lived in an urban setting. Sexual orientation was reported as: gay, 72 %; bisexual 23 %; other 5 %. Almost all men (97 %) reported ever having sex with a man, with more than one-third (36 %) having a steady male partner. Statistically significant higher homonegativity scores were detected among men reporting any level of opposite sex attraction compared to men attracted to only men; mostly men (p = 0.001), men and women equally (p = 0.002), and mostly women (p = 0.004), as well as less openness of same sex attraction to family and friends; >50 % family (p = 0.032), no family knowing (p = 0.042), and few friends knowing (p = 0.011). Anxiety risk and increased homonegativity also had a statistically significant increasing relationship. The identified associations between homonegativity and opposite sex attraction among MSM warrants further exploration as well as the relationship with increased anxiety risk.
与男性发生性行为的男性（MSM）仍然面临更高的负面健康后果风险，包括感染艾滋病毒、性传播感染、抑郁、药物使用、自杀倾向和焦虑。同性恋消极态度（内在和外在）与这些后果之间的关联关系被用来解释所观察到的不成比例的影响。当前的研究评估了内化的同性恋消极态度与高危行为、药物使用标志物、精神疾病症状以及同性吸引力的开放性和程度之间的关联。2013年对男男性行为者进行了一项基于互联网的调查，收集了社会人口统计学、性取向、药物和酒精使用、心理健康、自杀倾向以及内化的同性恋消极态度的数据。样本（n = 265）的中位年龄为31岁，85%的人至少有兼职工作；43%的人至少受过大学教育；87%的人生活在城市环境中。报告的性取向为：同性恋，72%；双性恋，23%；其他，5%。几乎所有男性（97%）报告曾与男性发生过性行为，超过三分之一（36%）有稳定的男性伴侣。与仅被男性吸引的男性相比，报告有任何程度异性吸引力的男性中检测到统计学上显著更高的同性恋消极态度得分；主要是男性（p = 0.001）、男女均等（p = 0.002）以及主要是女性（p = 0.004），并且对家人和朋友的同性吸引力开放性较低；超过50%的家人知晓（p = 0.032）、家人无人知晓（p = 0.042）以及朋友知晓的很少（p = 0.011）。焦虑风险与同性恋消极态度增加也存在统计学上显著的增加关系。男男性行为者中同性恋消极态度与异性吸引力之间已确定的关联值得进一步探索，以及与焦虑风险增加之间的关系。
