A longitudinal report of 156 gay, lesbian, and bisexual youths examined changes in sexual identity over time. Fifty-seven percent of the youths remained consistently self-identified as gay/lesbian, 18% transited from bisexual to gay/lesbian, and 15% consistently identified as bisexual over time. Although youths who consistently identified as gay/lesbian did not differ from other youths on time since experiencing sexual developmental milestones, they reported current sexual orientation and sexual behaviors that were more same-sex centered and they scored higher on aspects of the identity integration process (e.g., more certain, comfortable, and accepting of their same-sex sexuality, more involved in gay-related social activities, more possessing of positive attitudes toward homosexuality, and more comfortable with others knowing about their sexuality) than youths who transited to a gay/lesbian identity and youths who consistently identified as bisexual. Contrary to the hypothesis that females are more sexually fluid than males, female youths were less likely to change identities than male youths. The finding that youths who transited to a gay/lesbian identity differed from consistently gay/lesbian youths suggests that identity integration continues after the adoption of a gay/lesbian sexual identity.
Coming-out process; sexual identity; sexual orientation; sexual behavior; internalized homophobia; gay; lesbian; bisexual; adolescents; longitudinal; gender differences
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. Further, 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.
Sexual Risk Behaviors; Anal Sex; Child Sexual Abuse; Substance Abuse; Anxiety; Condom Use Intentions; Internalized Homophobia; Self-Disclosure
The aim of the present study was to examine racial differences in women’s attitudes toward lesbians and gay men and to offer an understanding of these differences. Participants were 224 18–30 year old heterosexual African American (64%) and White (36%) female undergraduates from a large urban university in the southeastern United States. Participants completed measures of social demographics, sexual orientation, and sexual prejudice. Results showed that African American, relative to White, women endorsed more negative attitudes toward lesbians and gay men. Also, unlike White women, African American women reported more negative attitudes toward gay men than lesbians. Implications are discussed regarding differences in cultural contexts that exist between African American and White women.
Gender; Race; Attitudes Toward Homosexuality; Lesbians; Gay Men
Drawing on social dominance theory and the contact hypothesis, we developed and tested a two-mediator model for explaining gender differences in early adolescents’ attitudes toward gay males and lesbians. Data from more than 400 ninth graders were analyzed. As predicted, gender differences in attitudes toward gay males were partially explained by social dominance orientation (SDO) and knowing a gay male. Gender differences in attitudes toward lesbians were partially mediated by SDO, while knowing a lesbian was not a mediating variable. Beyond their mediating roles, both SDO and knowing a member of the target group each significantly added to the prediction of attitudes toward each target group. Implications for policies to reduce victimization of sexual minorities in schools are discussed.
gay/lesbian/bisexual; gender/gender differences; victimization; school context; social dominance; contact theory; adolescence
Researchers have investigated heterosexuals' attitudes toward homosexuals, focusing on factors such as sex, race, religion, education, and contact experiences. However, in the context of sport, this research is deficient. We found no published literature investigating athletic trainers (ATs') attitudes toward lesbian, gay, and bisexual student-athletes (LGB).
To determine heterosexual ATs' attitudes toward LGB student-athletes in the National Collegiate Athletic Association.
Patients or Other Participants:
A total of 964 ATs employed at member institutions.
Main Outcome Measure(s):
We measured attitudes using the Attitudes Toward Lesbian, Gay Men, and Bisexuals (ATLGB) Scale. To determine the extent to which sex, religion, and whether having an LGB friend or family member had an effect on ATs' attitudes, we performed analysis of variance. To establish the effect of age on ATs' attitudes, we calculated a Pearson correlation. We used an independent t test to identify differences between ATs who reported working with LGB student-athletes and ATs who did not.
With ATLGB score as the dependent factor, a main effect was noted for sex, religion, and having an LGB friend or family member (P < .01 for all comparisons). Age and total score were related (P < .01). A difference was seen in the ATLGB scores between ATs who were aware of LGB student-athletes on their teams and ATs who were not (P < .001).
Many ATs hold positive attitudes toward LGB student-athletes, especially females, those who have an LGB friend or family member, and those who are aware of LGB student-athletes. Still, it is important to provide an open environment in the athletic training room for all student-athletes.
athletic training; diversity; sexual orientation
This study examined sexual prejudice and masculine gender role stress as mediators of the relations between male gender norms and anger and aggression toward gay men. Participants were 150 self-identified heterosexual men who completed measures of adherence to male gender role norms, sexual prejudice, masculine gender role stress, and state anger. Participants then viewed a video depicting intimate relationship behavior between two gay men, reported state anger a second time, and competed in a laboratory aggression task against either a heterosexual or a gay male. Results indicated that adherence to the antifemininity norm exerted an indirect effect, primarily through sexual prejudice, on increases in anger. Adherence to the status and antifemininity norms exerted indirect effects, also through sexual prejudice, on physical aggression toward the gay, but not the heterosexual, male. Findings provide the first multivariate evidence for determinants of aggression toward gay men motivated by gender role enforcement.
Aggressive Behavior; Homosexuality (Attitudes Toward); Male Homosexuality; Prejudice; Masculinity
Sexual prejudice and antigay anger were examined as mediators of the associations between traditional male gender norms, religious fundamentalism, and aggression toward gay men and lesbians. Participants were 201 self-identified heterosexual men recruited from the community to complete computer-administered measures of adherence to traditional male gender norms (i.e., status, toughness, antifemininity), religious fundamentalism, sexual prejudice, and frequency of aggression toward gay men and lesbians. Additionally, participants completed a structured interview designed to assess anger in response to a vignette depicting a male-male intimate relationship (i.e., partners saying “I love you,” holding hands, kissing). Results showed that sexual prejudice and antigay anger partially mediated the effect of antifemininity on aggression and fully mediated the effect of religious fundamentalism on aggression. Sexual prejudice alone fully mediated the effect of status on aggression and neither sexual prejudice nor antigay anger mediated the effect of toughness on aggression. Further, results suggested that religious fundamentalism is a multifaceted construct of which some aspects increase risk for aggression toward gay men and lesbians, whereas other aspects decrease this risk. These data provide multivariate evidence from a nonprobability, community-based sample that extreme internalization of dominant cultural values can set the stage for violence toward marginalized groups. Implications for intervention programming and future research are reviewed.
Culture; Religious Fundamentalism; Masculinity; Sexual Prejudice; Anger; Violence; Aggression; Lesbians; Gay Men
Internalized heterosexism (IH), or the internalization of societal anti-homosexual attitudes, has been consistently linked to depression and low self-esteem among gay men, and inconclusively associated with substance use and sexual risk in gay and bisexual men. Using structural equation modeling, a model framed in Social Action Theory was tested in which IH is associated with HIV transmission risk and poor adherence to HIV antiretroviral therapy (ART) through the mechanisms of negative affect and stimulant use. Data from a sample of 465 gay-identified men interviewed as part of an HIV risk reduction behavioral trial were used to test the fit of the model. Results supported the hypothesized model in which IH was associated with unprotected receptive (but not insertive) anal intercourse with HIV-negative or unknown HIV status partners, and with ART non-adherence indirectly via increased negative affect and more regular stimulant use. The model accounted for 15% of the variance in unprotected receptive anal intercourse (URAI) and 17% of the variance in ART non-adherence. Findings support the potential utility of addressing IH in HIV prevention and treatment with HIV-positive gay men.
HIV/AIDS; internalized heterosexism; homophobia; adherence; depression; methamphetamine; HIV transmission risk
One hundred and seventeen heterosexual males and females attending a sexually transmitted disease clinic and 57 homosexual males from a local "gay" club were asked to complete a questionnaire regarding their attitudes and sexual practices since the emergence of AIDS. The results show a trend towards increasing partner change rate among heterosexual males. There has been an increase in the practice of insertive anal intercourse by homosexual men with Northern Ireland contacts but no corresponding increase with contacts outside Northern Ireland. The practice of receptive anal intercourse has remained constant. Significant differences in attitudes between homosexual and heterosexual males were expressed with regard to testing of 'at risk groups' (p less than 0.001), in the uptake of testing (p less than 0.01), and in attitudes to sexual practices if they themselves became HIV positive. There was a low level of anxiety amongst heterosexuals regarding risk of HIV infection in the future. Less than 50% of the heterosexual patients attending this clinic use condoms, though more claim to intend to use them in future.
Restrictive eating attitudes and behaviors have been hypothesized to be related to processes of intrasexual competition. According to this perspective, within-sex competition for status serves the adaptive purpose of attracting mates. As such, status competition salience may lead to concerns of mating desirability. For heterosexual women and gay men, such concerns revolve around appearing youthful and thus, thinner. Following this logic, we examined how exposure to high-status and competitive (but not thin or highly attractive) same-sex individuals would influence body image and eating attitudes in heterosexual and in gay/lesbian individuals. Results indicated that for heterosexuals, intrasexual competition cues led to greater body image dissatisfaction and more restrictive eating attitudes for women, but not for men. In contrast, for homosexual individuals, intrasexual competition cues led to worse body image and eating attitudes for gay men, but not for lesbian women. These findings support the idea that the ultimate explanation for eating disorders is related to intrasexual competition.
intrasexual competition; sex differences; sexual orientation; eating disorders; body image
This study examined how disengagement coping with HIV risk mediated the association between internalized homophobia and unprotected anal intercourse (UAI) and how sexual encounters in public venues (public sex) and drug use moderated the association between disengagement coping and UAI among HIV-negative gay men. Disengagement coping included fatalistic beliefs about maintaining HIV-negative seronegative serostatus (fatalism), optimistic attitudes toward medical seriousness of HIV infection and reduced concern about HIV risk due to HAART (optimism), and negative affective states associated with sexual risk (anxiety).
A survey was conducted among 285 HIV-negative gay men at an HIV prevention counseling program in New York City.
Main Outcome Measures
Sexual risk was defined as having had UAI with non-primary partners in the past six months.
In addition to the positive association between internalized homophobia, disengagement coping, and UAI, fatalism mediated the association between internalized homophobia and UAI; and optimism mediated the association between anxiety and UAI. A significant moderation effect of public sex was found between fatalism and UAI.
The findings highlight the importance of understanding disengagement coping as it affects sexual risk practices among HIV-negative gay men in the continuing epidemic.
fatalism; optimism; internalized homophobia; gay men; coping; sexual risk
Professional psychologists who work with gay men have noted that traditional masculine ideals play a prominent role in the gay community whereby some endorse these traditional ideals and stigmatize effeminate behavior by other gay men. One hypothesis is that this behavior reflects negative feelings about being gay. This article examined this hypothesis by reporting the results of an online survey of 622 self-identified gay men. Participants completed the Gender Role Conflict Scale, Lesbian and Gay Identity Scale, the Social Desirability Scale, and questions related to the importance of masculinity. Results showed that most participants valued the public appearance of masculinity; and they ideally wished to be more masculine than they felt they were (Cohen’s d = 0.42). A multiple regression analysis showed that the degree to which they valued masculinity and were concerned with violating masculine ideals was positively related with negative feelings about being gay (Cohen’s f2 = .67). These findings highlight the importance of exploring the role that masculine ideals play in gay client’s lives given that negative feelings about oneself can adversely affect psychological well-being.
Anti-femininity; Straight-acting; Internalized homophobia; Internalized heterosexism; Self-esteem
Homophobia creates stress for gay men and women. An interview study of 28 doctors, 20 gay and eight non-gay, was performed to assess whether homophobia is strong among the medical profession, the stress it causes, and whether the advent of AIDS and HIV infection has increased the stress. The doctors, recruited by word of mouth and by a letter in the medical and gay press, were asked about their own attitudes to homosexuality and AIDS. Only one (non-gay) doctor thought that there was no prejudice against gay doctors in the medical profession. The gay doctors certainly perceived prejudice, which they claimed caused them extra stress; the advent of AIDS had increased this stress to an extent. Doctors who had not openly declared themselves to be gay feared doing so because of the effect on their job prospects, but those who had declared themselves openly reported less stress than previously. Homophobia clearly exists within the medical profession. Non-gay doctors should use the power of the profession to challenge homophobia in the profession and in society. HIV infection could then be treated as a purely medical condition; sufferers would receive wider understanding and the pressures of extra workload could be more equally shared.
This cross-sectional study assess knowledge, attitudes, and behavior towards the human papillomavirus (HPV) and the vaccination among a random sample of 1000 lesbian, gay men, and bisexual women and men.
A face-to-face interview sought information about: socio-demographic characteristics, knowledge about HPV infection, perception of risk towards HPV infection and/or cervical, anal, and oropharyngeal cancers, perception of the benefits of a vaccination to prevent cervical, anal, and oropharyngeal cancers, sexual behaviors, health-promoting behaviors, and willingness to receive the HPV vaccine.
Only 60.6% had heard about the HPV infection and this knowledge was significantly higher in female, in those being a member of a homosexual association, in those having had the first sexual experience at a younger age, in those having received information about the HPV infection from physicians, and in those having no need of information about HPV infection. A higher perceived risk of contracting HPV infection has been observed in those younger, lesbian and gay men, who have heard of HPV infection and knew the risk factors and its related diseases, who have received information about HPV infection from physicians, and who need information about HPV infection. Only 1.7% have undergone HPV immunization and 73.3% professed intent to obtain it in the future. The significant predictors of the willingness to receive this vaccine were belief that the vaccination is useful, perception to be at higher risk of contracting HPV infection, and perception to be at higher risk of developing cervical, anal, and oropharyngeal cancers.
Information and interventions are strongly needed in order to overcome the lack of knowledge about HPV infection and its vaccination. Inclusion of boys in the national vaccination program and initiate a catch-up program for men who have sex with men up to 26 years may reduce their burden of HPV-related disease.
Dr. Gary Gibson of Cambridge, Ont., went many years without identifying a single gay patient in his practice. When he "came out" about his homosexuality in 1981, about 15 of his patients revealed they were gay. Gibson, a professor of family medicine at the University of Western Ontario who is active in the College of Family Physicians of Canada, says such information is useful, because "if they don't identify, they may not get the medical advice they need." He wants medical students to receive more education in gay and lesbian issues, and recently drafted a gay and lesbian curriculum for postgraduate family medicine, which has been endorsed by the CMA.
In China, the estimated number of HIV positives in 2007 was 700,000 and the epidemic continues to expand. Because of their attitudes towards sexual behavior, young people are considered to be a group at high risk.
Eight hundred sixty-eight undergraduate students at Wuhan University were selected through stratified cluster sampling, to answer a questionnaire. They were divided into three main groups: Chinese medical students, foreign medical students and Chinese students from other faculties. Fourteen interviews were conducted in addition.
Ninety-nine percent of the students had heard of HIV/AIDS and 76% of the students could distinguish HIV from AIDS. The main route of transmission was believed by the Chinese students to be blood transfusion and sexual intercourse by the foreign medical students. The female students knew more about the routes of transmission than the male students. Medical students had a higher level of knowledge than non-medical students, and among the medical students, the foreign students were more knowledgeable than the Chinese students. Only 8 % of the students were sexually active.
The students had an accepting attitude towards people living with HIV and no extensive risk behavior. Overall, the knowledge level was found to be moderate.
HIV; AIDS; information; epidemic; ethnic.
Objectives: To determine patient attitudes toward medical students in the sexual health clinic, and to describe factors associated with patient refusal of medical student involvement.
Method: A self administered questionnaire was given to 259 consecutive patients attending the general genitourinary medicine clinic. Participants were asked to indicate their attitude to questioning and/or examination by medical students. Information was also collected on sex, age, ethnicity, and previous visits to sexual health clinics and previous exposure to medical students. The proportion of patients reporting comfort with student involvement, and association with age, sex, country of birth, language spoken, and previous experience of student and/or genitourinary medicine clinics are reported.
Results: 82.6% of patients agreed to participate. The proportion reporting feeling comfortable with students ranged from 64% for female students questioning them with a doctor present to 35% for a male student questioning them alone. Comfort levels were associated with the sex of the student and previous exposure to medical students, but not age, country of birth, language spoken, or previous attendance at a sexual health clinic. The most common reasons for feeling uncomfortable with students were privacy concerns and poorer quality of care.
Conclusion: Many patients feel uncomfortable with medical student involvement in a sexual health clinic consultation; particularly patients with no previous contact with medical students. Privacy and standard of care were the most common concerns, which are potentially amenable to change through better explanation of the students' role in the clinic.
Previous research has shown that many heterosexuals hold negative attitudes toward homosexuals and homosexuality (homophobia). Although a great deal of research has focused on the profile of homophobic individuals, this research provides little theoretical insight into the aetiology of homophobia. To examine genetic and environmental influences on variation in attitudes toward homophobia, we analysed data from 4,688 twins who completed a questionnaire concerning sexual behaviour and attitudes, including attitudes toward homosexuality. Results show that, in accordance with literature, males have significantly more negative attitudes toward homosexuality than females and non-heterosexuals are less homophobic than heterosexuals. In contrast with some earlier findings, age had no significant effect on the homophobia scores in this study. Genetic modelling showed that variation in homophobia scores could be explained by additive genetic (36%), shared environmental (18%) and unique environmental factors (46%). However, corrections based on previous findings show that the shared environmental estimate may be almost entirely accounted for as extra additive genetic variance arising from assortative mating for homophobic attitudes. The results suggest that variation in attitudes toward homosexuality is substantially inherited, and that social environmental influences are relatively minor.
Attitudes; Genetics; Heritability; Homophobia; Twin study; Homosexuality
This study examined attitudes about condoms as a moderator of the relationship between methamphetamine use and sexual risk behavior in a sample of 297 HIV-positive, methamphetamine-using men who have sex with men (MSM). To test for a moderating effect of attitudes towards condoms, an interaction term was included in multiple regression analysis along with age, income, negative condom attitudes, frequency of methamphetamine use, and Beck depression score. A post hoc analysis was conducted to determine the relations between methamphetamine use and unprotected sex for persons with more vs. less negative attitudes toward condoms. These analyses indicated that when individuals had more negative attitudes toward condoms, the relation between methamphetamine frequency and unprotected sex was significant, while among participants with less negative attitudes toward condoms, no significant association was found. Addressing methamphetamine-using MSM’s attitudes about condoms can serve as a form of harm reduction for those who are not yet ready or willing to discontinue methamphetamine use.
Methamphetamine; Attitudes; Condoms; Sexual risk; Men who have sex with men
This study examined attitudes about condoms as a moderator of the relationship between methamphetamine use and sexual risk behavior in a sample of 297 HIV-positive, methamphetamine-using men who have sex with men (MSM). To test for a moderating effect of attitudes towards condoms, an interaction term was included in multiple regression analysis along with age, income, negative condom attitudes, frequency of methamphetamine use, and Beck depression score. A post hoc analysis was conducted to determine the relations between methamphetamine use and unprotected sex for persons with more vs. less negative attitudes toward condoms. These analyses indicated that when individuals had more negative attitudes toward condoms, the relation between methamphetamine frequency and unprotected sex was significant, while among participants with less negative attitudes toward condoms, no significant association was found. Addressing methamphetamine-using MSM's attitudes about condoms can serve as a form of harm reduction for those who are not yet ready or willing to discontinue methamphetamine use.
Methamphetamine; Attitudes; Condoms; Sexual risk; Men who have sex with men
Researchers have recently begun to compare male and female physicians' attitudes toward patients, medical knowledge, and practice styles. Although women start medical school with more "humanistic views," the conservative effect of medical socialization on both male and female students attenuates these differences. While some studies suggested that men are more scientifically knowledgeable, recent studies showed no significant differences in physicians' medical knowledge. Male and female physicians also had comparable diagnostic and therapeutic behavior. In the intimate world of physicians and patients, however, there were notable differences. Women physicians seemed better able to communicate sensitivity and caring to patients, which may account for the common perception that women are more caring and empathic physicians. Medical educators may wish to study more closely female physicians' communication styles to identify these behaviors and inculcate them into all physicians.
The use of condoms to prevent the further spread of human immunodeficiency virus (HIV) infection is one of the main themes of the government's health education campaign against AIDS. A study of the use of and attitudes towards condoms in 222 heterosexual men and women attending a department of genitourinary medicine (GUM) in central London showed that 55% (50/91) to 59% (41/70) of men or women never, and 6% (6/95) to 15% (14/91) always, used condoms with their regular or non-regular sexual partners. No major differences were found in the use of or attitudes to condoms according to age, sex, social class, or civil status. Attitudes towards the use of condoms were generally negative. These attitudes, in combination with the infrequent use of condoms with regular (and even more with non-regular) sexual partners, must be a cause for concern if the further spread of HIV is to be avoided.
This study investigated relationships between Latino gay-identified men in metropolitan New York City and their non-gay-identified male partners. Phase 1 consisted of in-depth interviews (N = 33), and Phase 2 consisted of quantitative surveys (N = 120) with Brazilian, Colombian, and Dominican men who have sex with men (MSM). A majority of participants reported having had sex with heterosexually identified men, and in many cases, the relationship was sustained over time. We found mixed results concerning an attitude sometimes attributed to Latinos that sexual orientation is defined by sexual role, with receptive MSM seen as gay and insertive MSM seen as straight. Although there were no significant associations between partner sexual orientation and unprotected anal intercourse, gay men were less likely to take the insertive role in oral or anal sex with straight-identified male partners than with gay partners.
Latino; MSM; gay identity; sexual orientation; sexual behavior; sexual role
The Communication Skills Attitudes Scale (CSAS) created by Rees, Sheard and Davies and published in 2002 has been a widely used instrument for measuring medical students' attitudes towards learning communication skills. Earlier studies have shown that the CSAS mainly tests two dimensions of attitudes towards communication; positive attitudes (PAS) and negative attitudes (NAS). The objectives of our study are to explore the attitudes of Norwegian medical students towards learning communication skills, and to compare our findings with reports from other countries.
The CSAS questionnaire was mailed simultaneously to all students (n = 3055) of the four medical schools in Norway in the spring of 2003. Response from 1833 students (60.0%) were analysed by use of SPSS ver.12.
A Principal component analysis yielded findings that differ in many respects from those of earlier papers. We found the CSAS to measure three factors. The first factor describes students' feelings about the way communication skills are taught, whereas the second factor describes more fundamental attitudes and values connected to the importance of having communication skills for doctors. The third factor explores whether students feel that good communication skills may help them respecting patients and colleagues.
Our findings indicate that in this sample the CSAS measures broader aspects of attitudes towards learning communication skills than the formerly described two-factor model with PAS and NAS. This may turn out to be helpful for monitoring the effect of different teaching strategies on students' attitudes during medical school.
Several studies have found reductions in acquired immunodeficiency syndrome (AIDS) risk practices among gay men in high AIDS-prevalence cities since the start of the AIDS crisis. Much less is known about risk behavior patterns among gay men in smaller cities, where AIDS cases are less common and the prevalence of human immunodeficiency virus infection is relatively lower. In the study, men entering gay bars in three cities, one large and two small, completed anonymous surveys of sexual practices and AIDS risk knowledge. Men in high AIDS-prevalence areas were found to have had a greater number of sexual partners, were more knowledgeable about AIDS, were much more likely to engage in low-risk practices (such as mutual masturbation or body rubbing), and had unprotected anal intercourse less frequently than gay men in smaller cities. The most common sexual activity among gay men in the larger city was mutual masturbation, a low-risk practice. The most common sexual activity among gay men in the smaller cities was unprotected anal intercourse. Increased efforts are needed to educate gay men and to promote risk behavior changes among those living in smaller cities and in communities outside the prominent AIDS epicenters.