Department of Psychology, University of Houston, Houston, TX, United States.
Legacy Community Health Services, Houston, TX, United States.
Psychiatry Res. 2018 Sep;267:102-107. doi: 10.1016/j.psychres.2018.05.081. Epub 2018 May 30.
Men who have sex with men (MSM) are at high risk for contraction and transmission of Human Immunodeficiency Virus (HIV). Increased risk of infection has been linked to high risk behaviors, such as alcohol and drug use, as well as engaging in unsafe sexual behaviors. Experiences of discrimination related to sexual orientation often experienced in this population predict risky behavior outcomes, but little research has examined the mechanisms implicated in this model. The current study examined the effect of anxiety and depressive symptoms in the relationship between discrimination related to sexual orientation and high-risk behaviors of alcohol use, drug use, using sex to cope with negative emotions, frequency of sex without a condom, and frequency of sex with an HIV+ or unknown status partner. Three hundred and eighty-nine MSM were recruited to participate in a survey based study. Results indicated anxiety was maintained a significant indirect effect between discrimination related to sexual orientation and coping behaviors (using sex to cope, alcohol, substance use), but showed no significant indirect associations with risky sexual behavior. Overall, the current study provides novel empirical evidence that discrimination related to sexual orientation is associated with increased anxiety, which in turn, is associated with certain HIV risk behaviors. Importantly, it is possible that alcohol use, drug use, and using sex to cope with negative emotions may be precursors to more risky sexual behavior, such as engaging in anal sex without a condom or having sex with an HIV+ or unknown status partner. Clinically, reducing symptoms of anxiety in the context of discrimination related to sexual orientation may help reduce HIV risk behavior among MSM.
男男性行为者（MSM）感染人类免疫缺陷病毒（HIV）的风险很高。感染风险的增加与高危行为有关，例如饮酒和吸毒，以及不安全的性行为。在这一人群中经常经历的与性取向有关的歧视经历预测了危险行为的结果，但很少有研究检查该模型中涉及的机制。本研究调查了焦虑和抑郁症状在性取向相关歧视与饮酒、吸毒、用性行为应对负面情绪、无保护措施性行为频率和与 HIV+或未知状态伴侣发生性行为频率等高危行为之间的关系中的作用。招募了 389 名男男性行为者参与基于调查的研究。结果表明，焦虑在性取向相关歧视与应对行为（用性行为应对、饮酒、药物使用）之间保持了显著的间接影响，但与高危性行为没有显著的间接关联。总体而言，本研究提供了新的经验证据，表明性取向相关的歧视与焦虑增加有关，而焦虑反过来又与某些 HIV 风险行为有关。重要的是，饮酒、吸毒和用性行为应对负面情绪可能是更危险的性行为的前兆，例如进行无保护措施的肛交或与 HIV+或未知状态的伴侣发生性行为。在临床上，在性取向相关歧视的背景下减轻焦虑症状可能有助于减少 MSM 的 HIV 风险行为。
