Geneva, Switzerland -- An atmosphere of homophobia influences the sexual risks a young gay man will take, according to a University of California San Francisco AIDS investigator.
Homophobia in American culture has a negative impact on young people and if they can find ways to "unlearn" it and see their gayness in a positive light, they can take steps to accept themselves and live healthier lives, said Craig Waldo, PhD, a research specialist with the UCSF Center for AIDS Prevention Studies and the UCSF AIDS Research Institute.
Waldo presented research findings here today (June 29) at the 12th World AIDS Conference.
"Young gay men who are comfortable with their gayness are more psychologically healthy and are more likely to practice safe sex," said Waldo. "It's a good idea to help gay men accept themselves because it makes them less risky sexually."
Waldo emphasized that involvement in the gay community--such as participation in clubs, activities, and religious groups--and finding an atmosphere of social support increases self-acceptance of gay identity.
The International AIDS Society chose Waldo's presentation to receive one of the four Young Investigator Awards--given to presenters under the age of 35--at the World AIDS Conference.
Waldo's study focused on how self-acceptance of gay identity relates to sexual risk-taking and mental health. He and his UCSF colleagues conducted a survey of 302 gay men between the ages of 18 and 29, almost all of whom were HIV-negative. The men lived in the small cities of Eugene, Ore., and Santa Barbara and Santa Cruz, Calif. These cities were chosen because they have fewer gay community resources than larger metropolitan areas like New York or San Francisco.
Waldo used a questionnaire designed by UCSF CAPS colleagues Susan Kegeles, PhD, associate professor, and Robert Hays, PhD, research specialist. It included questions about sexual activity and statements such as "I am glad to be gay," "At times I think I'm no good at all," and "My gay male friends are good at helping me solve personal problems." Respondents were asked to rate the statements with levels of agreement.
Waldo defined sexual risk-taking as unprotected receptive or insertive anal intercourse or receptive oral sex to ejaculation. He found that in the two months prior to the survey, 35 percent of the respondents had unprotected anal intercourse.
Study findings showed that men who are most accepting of their sexuality are also more likely to score higher on scales of self-esteem and satisfaction with their physical appearance and lower on scales of depression and suicidality. In this study, Waldo found 11.6 percent of respondents had serious suicidal thoughts in the prior two months.
Using a mathematical model, he analyzed the survey responses for relationships among "social support," "gay community involvement," "psychological health," "HIV sexual risk-taking," "sexual orientation disclosure," and "self-acceptance of gay identity."
Waldo's study found:
- Young gay men who are more involved with the gay community have more social support and are more accepting of their gay identities.
- Men who are more accepting of their gay identity are more psychologically healthy, are more likely to tell others that they are gay (this is the strongest relationship of all), and are less risky sexually.
Waldo concluded from these findings that HIV prevention campaigns could be more effective if they help young gay men come to grips with their sexual orientation and foster an environment that is accepting of gay people.
"What we're seeing is a cross section of these young men's lives," said Waldo. "It's a snapshot of a process unfolding. As time passes, if they get more support for their identities, it will ultimately have a favorable effect on their health."
The UCSF ARI is an institute without walls that encompasses all UCSF AIDS programs under a single umbrella. Thomas Coates, PhD, is the director. The UCSF ARI includes a dozen research institutes, a wide range of clinical, behavioral science, and policy programs, and nearly 1,000 investigators.