Center for AIDS Prevention Studies, University of California, San Francisco.
Department of Prevention and Community Health, George Washington University.
J Consult Clin Psychol. 2017 Dec;85(12):1122-1130. doi: 10.1037/ccp0000235. Epub 2017 Jul 17.
OBJECTIVE: This study examined whether the association between social support and condom self-efficacy would be moderated by (a) internalized heterosexism among and (b) enacted heterosexism experienced by young Black men who have sex with men (YBMSM), who contend with high HIV incidence, heterosexism, and low uptake of preexposure prophylaxis. METHOD: Participants were 1,210 YBMSM (ages 18-29) who completed measures of social support, internalized and enacted heterosexism, and condom self-efficacy in 2 large cities in the southern United States as part of a community-level HIV-prevention study. RESULTS: A significant 3-way interaction between social support and both hypothesized moderators, internalized and enacted heterosexism, showed that social support was positively associated with condom self-efficacy when both internalized and enacted heterosexism were high (1 SD above the mean; b = .177, 95% confidence interval [CI: .088, .266]). However, social support was not associated with condom self-efficacy when scores were low (1 SD below the mean) on both internalized and enacted heterosexism (b = .024, 95% CI [-.054, .101]), low on internalized and high on enacted heterosexism (b = .058, 95% CI [-.061, .117]), or high on internalized and low on enacted heterosexism (b = .039, 95% CI [-.083, .161]). CONCLUSIONS: YBMSM who are high in both internalized and enacted heterosexism may see greater benefits from social support on condom self-efficacy than would YBMSM who grapple with less heterosexism. In addition to promoting social support, interventions should aim to assess and reduce multiple forms of stigma. (PsycINFO Database Record
目的:本研究旨在检验社会支持与 condom self-efficacy 之间的关联是否会受到以下因素的调节:(a)内化的异性恋恐惧和(b)黑人男男性行为者(YBMSM)所经历的外化的异性恋恐惧,这些人面临着高 HIV 发病率、异性恋恐惧和暴露前预防措施的低采用率。
方法:参与者为 1210 名 YBMSM(年龄在 18-29 岁之间),他们作为社区层面 HIV 预防研究的一部分,在美国南部的两个大城市完成了社会支持、内化和外化的异性恋恐惧以及 condom self-efficacy 的测量。
结果:社会支持与两个假设的调节因素(内化和外化的异性恋恐惧)之间存在显著的三向交互作用,表明当内化和外化的异性恋恐惧都很高(高于平均值 1 个标准差)时,社会支持与 condom self-efficacy 呈正相关(b =.177,95%置信区间 [CI:.088,.266])。然而,当内化和外化的异性恋恐惧都很低(低于平均值 1 个标准差)时,社会支持与 condom self-efficacy 没有关联(b =.024,95% CI [-.054,.101]),内化的异性恋恐惧低而外化的异性恋恐惧高(b =.058,95% CI [-.061,.117]),或者内化的异性恋恐惧高而外化的异性恋恐惧低(b =.039,95% CI [-.083,.161])。
结论:内化和外化的异性恋恐惧都很高的 YBMSM 可能从社会支持中获得 condom self-efficacy 的益处大于那些异性恋恐惧程度较低的 YBMSM。除了促进社会支持外,干预措施还应旨在评估和减少多种形式的污名。
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