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PubMed2006

Health information and risk behaviors among lesbian, gay, and bisexual college students.

PURPOSE: To describe differences in alcohol use, marijuana use, and smoking behaviors between lesbian, gay, and bisexual (LGB) and heterosexual college students, and determine whether there was a difference in the health information each group received. DATA SOURCES: A random sample of 3000 college students aged 18-24 years who were currently enrolled at a southeastern metropolitan university on a full-time basis were invited to participate. The final sample (n = 772) consisted of heterosexuals (n = 731) and LGB (n = 41) college students. Gay and bisexual men (n = 20) and lesbian and bisexual women (n = 21) were compared to heterosexual college students. CONCLUSIONS: Lesbian/bisexual women were 4.9 times more likely to smoke, 10.7 times more likely to drink, and 4.9 times more likely to use marijuana than heterosexual women. Gay/bisexual men did not significantly differ from heterosexual men. There was no difference in the health information on alcohol and drug prevention the groups received. Gay/bisexual men were less likely (p = .02) compared to heterosexual men to have received tobacco prevention information. IMPLICATION FOR PRACTICE: Advanced practice nurses must ensure that every patient receives preventive services and anticipatory guidance at every visit. LGB clients in particular need health assessments and interventions appropriate to their individual risk profiles.

Adolescent↗
PubMed1997

Twenty years and still in the dark? Content analysis of articles pertaining to gay, lesbian, and bisexual issues in marriage and family therapy journals.

To what extent do marriage and family therapy journals address gay, lesbian, and bisexual issues and how does this coverage compare to allied fields? To answer these questions, a content analysis was conducted on articles published in the marriage and family therapy literature from 1975 to 1995. Of the 13,217 articles examined in 17 journals, only 77 (.006%) focused on gay, lesbian, and/or bisexual issues or used sexual orientation as a variable. Findings support the contention that gay, lesbian, and bisexual issues are ignored by marriage and family therapy researchers and scholars.

Bisexuality↗
PubMed1995

Predicting patterns of sexual acts among homosexual and bisexual youths.

OBJECTIVE: This longitudinal study examined predictors of patterns of change in HIV sexual risk acts among homosexual and bisexual adolescent males. METHOD: A consecutive series of 136 homosexual and bisexual males aged 14-19 years were recruited into the study. Subjects were predominantly Hispanic (51%) and African American (31%) and seeking services at a homosexual-identified community-based agency in New York City. All subjects participated in an intensive HIV intervention program. Patterns of change in HIV sexual risk acts were based on assessments at four points (intake and 3, 6, and 12 months later) and were used to classify youths as demonstrating one of five patterns of anal and oral sexual acts: protected (anal: 45%, oral: 25%), improved (32% and 28%, respectively), relapse (5% and 8%), variable (8% and 15%), and unprotected (10% and 24%). Components of the health belief, self-efficacy, peer influence, coping, and distress models were assessed as predictors of these patterns. RESULTS: Protected and improved patterns of sexual risk acts were associated with low levels of anxiety, depression, and substance use and high self-esteem. CONCLUSIONS: These data suggest that HIV interventions must address non-HIV-related issues confronting youths in difficult life circumstances, particularly emotional distress and the role of peer networks for homosexual and bisexual youths.

Adaptation, Psychological↗
PubMed2000

MDMA ("Ecstasy") abuse and high-risk sexual behaviors among 169 gay and bisexual men.

OBJECTIVE: The authors explored the association between abuse of 3, 4-methylenedioxymethamphetamine (MDMA, or "Ecstasy") and high-risk sexual behaviors among gay and bisexual men. METHOD: An anonymous questionnaire was completed by 169 gay and bisexual men at three New York City dance clubs. The questionnaire covered demographic indices, use of MDMA and other drugs, and history of high-risk sexual behaviors. RESULTS: About one-third of the respondents reported MDMA use at least monthly. MDMA use was strongly and significantly associated with a history of recent unprotected anal intercourse. This association remained equally strong even after controlling for age, ethnicity, and all other forms of drug use, including alcohol. CONCLUSIONS: MDMA abuse, and its strong association with high-risk sexual behaviors, appears to represent important unexplored public health problems among some gay or bisexual men.

Adolescent↗
PubMedDate not supplied

Stages of change and condom use among an Internet sample of gay and bisexual men.

The purpose of this descriptive correlational study using the transtheoretical model was to determine the relationship between stages of change and condom use among gay and bisexual men with primary (steady) and casual (occasional) partners. A convenience sample of 241 gay and bisexual men was recruited from the Internet. The majority of men (n = 198, 82%) never used condoms during anal, vaginal, or oral intercourse with primary partners, indicating they were in the first of five stages of change (precontemplation). Thirty percent (n = 71) of men reported using condoms every time during anal intercourse with casual partners and were in the last stage of change (maintenance). Multiple regression analysis revealed that older bisexual men who informed partners of their HIV status and who were confident and perceived more advantages in using condoms were in higher stages of change. By placing participants into various stages of change, stage specific interventions can be designed.

Adolescent↗
PubMed2003

Pros and cons of condom use among gay and bisexual men as explored via the Internet.

The purpose of this study was to conduct a survey utilizing Internet technology related to gay and bisexual men's condom use behavior as an expression of safer sexual practices. A total of 241 self-identified gay and bisexual men responded to the questionnaire in a 3-month period of time. Confidentiality was assured by utilizing an electronic system whereby the respondents e-mail address was eliminated. The study was conceptually guided by the use of the Transtheoretical Model of Behavioral Change (TMC) and the pros and cons of condom of use were explored. Fifty-six percent of the participants reported that one advantage (pro) of using condoms with casual partners was that it would make them safer from disease. About half of the respondents (n = 119, 49%) reported a history of one or more sexually transmitted diseases. There were 14 variables found to be significantly associated with using a condom with primary and casual partners among gay and bisexual men. Essentially, findings from this study corresponded to results obtained by more traditional data collection methods. Therefore, the authors conclude that electronic data collection may well be an alternative means for collecting sensitive data such as those collected in this study.

Adolescent↗
PubMed1987

Group psychotherapy for bisexual men and their wives.

A significant number of men and women experience conflict surrounding homosexual expression within marriage. As the media focuses more attention on these relationships, more bisexual men and their wives seek counseling or psychotherapeutic assistance. Based upon the author's research and clinical experience, this article outlines a group psychotherapy strategy for bisexual men and their wives. Relevant research and background data on mixed-orientation marriages are summarized. Treatment strategy explores intervention processes, resistances to treatment, the unique supportive experiences of the group, and qualities of the co-therapist who may provide assistance to bisexual men and their wives.

Adaptation, Psychological↗
PubMed1992

Addressing the needs of lesbian, gay, and bisexual youth: the origins of PROJECT 10 and school-based intervention.

This research chronicles the formation and expansion of a counseling and educational program for gay, lesbian, and bisexual youth called PROJECT 10 at Fairfax High School. A model program was tested during the academic year 1985-1986, and is now being implemented throughout the Los Angeles Unified School District and in other schools across the nation. Fifty self-identified homosexual students were interviewed in order to clarify the needs of lesbian, gay, and bisexual teenagers in relation to their school experiences. Additionally, a questionnaire study of 342 respondents from the general student population was undertaken in order to chart the beliefs and attitudinal changes of those teenagers who experienced school-based educational programs that portrayed homosexuality and bisexuality as variations on a continuum of human sexual expression and emotional attachment. Suggestions for further research are discussed.

Adaptation, Psychological↗
PubMed2000

Family and friendship relationships after young women come out as bisexual or lesbian.

To understand what happened when young women come out as bisexual or lesbian, 6 college-age bisexual or lesbian women who had recently come out, and 25 of their family members and friends, were interviewed about how the woman's coming out affected their relationships. Each was analyzed separately, using grounded theory coding techniques. The overall findings across the six relationships are presented here. Inductive qualitative analysis revealed changes in communication, relationship structure, and beliefs. Communication changes included talking about coming out, engaging in conflict, and asking questions of self and others. Changes in relationship structure included building community and negotiating closeness and distance. Changes in beliefs included testing one's own sexuality and changing one's mind about bisexual and homosexual people. Overall, coming out was embedded within the relationships and events of everyday life.

Adult↗
PubMed2002

Assessment of life stress in gay and bisexual men with the gay affect and life events scale.

The Gay Affect and Life Events Scale (GALES) was administered to a sample of gay-identified and non-gay-identified behaviourally bisexual married men (n = 186) and a comparative sample of never-married gay-identified men (n = 33). All participants in the study reported moderate levels of life stress in the preceding six months. No significant differences were found between the ever-married and never-married groups on the Overall Stress Value Score (OSV) of the GALES. Among the ever-married, those who identified as gay/homosexual reported significantly higher life stress than those who identified as bisexual. No differences were found within the ever-married between those who remained with their heterosexual partner and those who had separated. Difficulties in the use of the Nott and Vedhara (1995) version of the GALES with both gay men and populations of behaviourally bisexual men are reported.

Bisexuality↗
PubMed2002

Attitudes toward gay, lesbian, and bisexual persons among heterosexual liberal arts college students.

This research focuses on attitudes toward homosexuals and homosexuality among 692 heterosexual students at six liberal arts colleges. Attitudes, assessed in a variety of ways, are examined in relation to students' Greek affiliation, sex role attitudes, religion and religiosity, and contact with and knowledge of gays, lesbians, and bisexuals. Results suggest that attributes predicting acceptance of gay, lesbian, and bisexual persons are female sex, liberal sex-role attitudes, lower religiosity as measured both by beliefs and by attendance, membership in more liberal Protestant denominations, attendance at colleges that do not have Greek letter social organizations, and having positive contacts with gay, lesbian, and/or bisexual persons.

Attitude↗
PubMed2005

Children of the closet: a measurement of the anxiety and self-esteem of children raised by a non-disclosed homosexual or bisexual parent.

This research examined whether a parent's non-disclosure of his or her homosexual or bisexual orientation within the family unit negatively affects self-esteem and anxiety in children, as measured in adulthood. Thirty-six subjects indicated that they had not known of their parent's sexual orientation until an average age of sixteen for the children of lesbian or bisexual mothers, and twenty-two for the children of gay or bisexual fathers. This group's scores on the Rosenberg Self-Esteem Scale, the Marlowe Crowne Social Desirabilty Scale and the State-Trait Anxiety Scale were compared to scores obtained by sixty-three participants who did not have a homosexual/bisexual parent. The number of years a secretive environment surrounded the child was measured, as were participants' attitudes about the secret sexual identity. Although the study did not find that adults previously raised with a closeted parent had significantly higher levels of anxiety or lower levels of self-esteem, results indicated that those who had been raised as children with non-disclosed lesbian mothers showed a significantly higher level of self-esteem than participants with heterosexual parents. Implications of the findings for the targeted population are discussed.

Adolescent↗
PubMed2006

A model of sexual risk behaviors among young gay and bisexual men: longitudinal associations of mental health, substance abuse, sexual abuse, and the coming-out process.

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. Furthermore, 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.

Adolescent↗
PubMed2000

Secret encounters: black men, bisexuality, and AIDS in Alabama.

Black men suffer the highest rates of HIV infection in Alabama. However, little is known about the HIV risks of this sector of the population, primarily because the current public health focus is on women and children. The dearth of research on HIV risk among black men in Alabama is addressed by drawing on focus group, elicitation, and key informant data from an ongoing epidemiologic study on AIDS in that state. These hypothesis-generating qualitative interviews were used to identify three high-risk scenarios: "sex for money or drugs"; "prison sex"; and "sneaky sex" by married or nominally heterosexual men. It was found that covert and unprotected sex among bisexually active black men was commonplace for reasons that included prostitution, habituation to same-sex relations during incarceration, and the desire to maintain a facade of heterosexuality in homophobic communities. It was concluded that bisexual activity is highly correlated with secrecy and unprotected sex. The risks of bisexuality among black men are exacerbated by incarceration, homophobia, drug use, and the prison and public health focus on surveillance rather than prevention.

Adult↗
PubMed2005

Reports of alcohol consumption and alcohol-related problems among homosexual, bisexual and heterosexual respondents: results from the 2000 National Alcohol Survey.

OBJECTIVE: Few population-based studies have explored differences in alcohol consumption by sexual orientation. This study examined the prevalence of abstinence, drinking, heavier drinking, alcohol-related problems, alcohol dependence and help-seeking among homosexual and bisexual women and men compared with heterosexuals. METHOD: Data are from the 2000 National Alcohol Survey, a national population-based survey of adults (N = 7,612), a Random Digit Dialing telephone survey of all 50 states of the United States and Washington, DC. Four categories of sexual orientation were created using questions on both sexual orientation self-identification and behavior: homosexual identified, bisexual identified, heterosexual identified with same sex partners and exclusively heterosexual. Five alcohol measures (past year) were used in the analyses: (1) mean number of drinks, (2) days consuming five or more drinks on a single occasion, (3) drunkenness, (4) negative social consequences (2 or more) and (5) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, alcohol dependence. A lifetime measure of help-seeking for an alcohol problem was also analyzed. RESULTS: Few significant differences were found among men by sexual orientation. By contrast, both lesbians and bisexual women had lower abstention rates and significantly greater odds of reporting alcohol-related social consequences, alcohol dependence and past help-seeking for an alcohol problem. CONCLUSIONS: These findings suggest that alcohol dependence and alcohol-related consequences differ by sexual orientation, particularly among women. These findings also emphasize the need for the inclusion of sexual-orientation items in population-based surveys so that prevalence rates within these subgroups can be effectively monitored.

Adolescent↗
PubMed2005

[Internalized oppression and high-risk sexual practices among homosexual and bisexual males, Mexico].

OBJECTIVE: To assess the relationship between engaging in high-risk sexual practices for HIV infection and the internalized oppression of homo and bisexual males due to the prejudice and discrimination they face. METHODS: An observational cross-sectional study was carried out between September and November 2001. A questionnaire was applied to 318 males who sought services and institutions in Mexico City. The studied variables were: internalized homophobia, perception of stigma, concealing sexual orientation, and sexual practices in the six months prior to the survey. The relationship (odds ratios) between forms of internalized oppression with high-risk sexual practices was estimated using logistic regression models adjusted for confounders. RESULTS: Of all respondents, 256 reported having had at least one sexual relationship in the last six months, 50 reported having none, and 12 did not answer this question. More than 30% had not used condoms when they engaged in insertive or receptive anal sex. Internalized homophobia was associated with higher risk of drug consumption before or during sexual encounters, unprotected insertive/receptive anal sex, and swallowing semen from other men. CONCLUSIONS: Engaging in high-risk sexual practices is still frequent among homo and bisexual males. Of the three forms of internalized oppression studied, homophobia was associated with higher high-risk sexual practices. This information may be incorporated into the design of programs for promoting condom use among homo and bisexual males.

Adult↗
PubMed1992

High-risk sexual behavior and condom use among gay and bisexual African-American men.

OBJECTIVES: Little is known about the human immunodeficiency virus (HIV) high-risk sexual practices of gay and bisexual African-American men. These data are needed so that better interventions can be developed and implemented in this population. METHODS: The frequency and correlates of unprotected anal intercourse were examined among 250 gay and bisexual African-American men in the San Francisco Bay Area. The cohort was recruited in 1990 from bars, bathhouses, and erotic bookstores, and through African-American gay organizations, street outreach, advertisements in gay mainstream and African-American newspapers, health clinics, and personal referral from other participants. RESULTS: More than 50% of the men in our sample reported having unprotected anal intercourse in the past 6 months, a considerably higher percentage than that among gay White men in San Francisco through 1988 and 1989. Men who practiced unprotected anal intercourse were more likely to be poor, to have been paid for sex, or to have used injection drugs; to have a higher perceived risk of HIV infection; and to report less social support for concerns about risky sexual behavior. Condom norms, condom efficacy, and negative expectations about using condoms predicted these men's failure to use them. CONCLUSION: In the second decade of the acquired immunodeficiency syndrome epidemic, risk reduction programs are still needed for gay and bisexual African-American men.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States.

OBJECTIVES: Recent studies suggest that lesbians and gay men are at higher risk for stress-sensitive psychiatric disorders than are heterosexual persons. We examined the possible role of perceived discrimination in generating that risk. METHODS: The National Survey of Midlife Development in the United States, a nationally representative sample of adults aged 25 to 74 years, surveyed individuals self-identifying as homosexual or bisexual (n = 73) or heterosexual (n = 2844) about their lifetime and day-to-day experiences with discrimination. Also assessed were 1-year prevalence of depressive, anxiety, and substance dependence disorders; current psychologic distress; and self-rated mental health. RESULTS: Homosexual and bisexual individuals more frequently than heterosexual persons reported both lifetime and day-to-day experiences with discrimination. Approximately 42% attributed this to their sexual orientation, in whole or part. Perceived discrimination was positively associated with both harmful effects on quality of life and indicators of psychiatric morbidity in the total sample. Controlling for differences in discrimination experiences attenuated observed associations between psychiatric morbidity and sexual orientation. CONCLUSIONS: Higher levels of discrimination may underlie recent observations of greater psychiatric morbidity risk among lesbian, gay, and bisexual individuals.

Adult↗