Social Work Services, Sheba Medical Center , Ramat-Gan, Israel.
Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University , Ramat-Gan, Israel.
Soc Work Health Care. 2020 Oct-Dec;59(9-10):709-724. doi: 10.1080/00981389.2020.1859045. Epub 2020 Dec 10.
Sexual risk behaviors among men who have sex with men (MSM) have been linked to diverse demographic, psychosocial, and behavioral factors. This study assessed the association between internalized homophobia and sexual risk behavior among HIV-infected MSM and the mediating effects of safe-sex self-efficacy and depression on this association, using a theoretical framework based on the Theory of Social Action. Data were collected from 124 HIV-infected MSM attending an AIDS clinic in Israel. No significant association was found between internalized homophobia and sexual risk behavior (unprotected anal intercourse). Examination of mediation effects revealed full mediation by depression, but not by self-efficacy. Depression and self-efficacy were the only significant explanatory variables of sexual risk behavior. Diverse social work interventions with HIV-infected MSM aimed at reducing sexual risk behaviors should include routine screening of IH and its association with depression, and address depression and self-efficacy in CBT and other interventions.
男男性行为者（MSM）的性行为风险与多种人口统计学、心理社会和行为因素有关。本研究使用基于社会行动理论的理论框架，评估了艾滋病毒感染的 MSM 中内化的恐同与性行为风险之间的关联，以及安全套使用自我效能感和抑郁在这种关联中的中介作用。数据来自于以色列一家艾滋病诊所的 124 名艾滋病毒感染的 MSM。内化的恐同与性行为风险（无保护的肛交）之间没有显著关联。对中介效应的检验显示，抑郁完全中介了这种关联，但自我效能感没有。抑郁和自我效能感是性行为风险的唯一显著解释变量。针对艾滋病毒感染的 MSM 的旨在减少性行为风险的各种社会工作干预措施，应包括常规筛查 IH 及其与抑郁的关联，并在认知行为疗法和其他干预措施中解决抑郁和自我效能感问题。
