Background Young adults in North America are at increasing risk for contracting HIV and sexually transmissible infections (STI). Racial differences in HIV or STI risk are well documented, but other cultural and demographic factors contributing to HIV or STI risk are poorly understood. Although religion may play an important role in sexual behaviour, little research has explored its association with sexual attitudes, beliefs and practices. The present study examined how ethnicity, religion, HIV knowledge and attitudes, and other demographic factors are associated with engaging in unprotected vaginal intercourse (UVI) in a diverse sample of unmarried young adults. Methods: A cross-sectional study of 666 unmarried university students was conducted from 2005 to 2007, with participants completing an anonymous questionnaire on sexual attitudes and health for course credit. Results: Approximately 50% of the respondents had engaged in any vaginal intercourse and 32.2% had engaged in UVI in the past 6 months. Multivariable analyses showed that increasing age, being in a relationship for more than 6 months, greater HIV knowledge, stronger attitudes supporting the use of condoms, and religion (but not ethnicity) were associated with engaging in UVI. Among the sexually active subset of the sample (n = 332), religion was the only predictor of engaging in UVI. Conclusion: Ethnicity, which is often considered an important variable in sexual health research, does not appear to be associated with UVI when taking into account other demographic variables, particularly religion. Consideration of religion may be important in devising HIV prevention interventions, in order to implement them in accordance with particular religious beliefs.
<p>The role of psychological factors in predicting HIV sexual transmission risk behavior is increasingly of interest in prevention research. Social anxiety, or anxiety about being evaluated in interpersonal situations, is associated with unprotected insertive anal intercourse among young men who have sex with men (MSM) and with other behavioral risk factors for unprotected intercourse, such as depression, smoking, alcohol use, and drug use. Social anxiety may be especially relevant in understanding HIV risk among HIV-seropositive men, given its stronger association with unprotected insertive than with receptive anal intercourse. In the present study, for which participants were recruited between October 2002 and May 2003, HIV-positive men attending regularly scheduled primary care medical appointments at a community HIV clinic were approached by research personnel and informed about the study topic and procedures. Ninety percent of patients approached agreed to participate, resulting in a sample of 206 patients. The sample was primarily African American, unemployed, of low educational level, and 95% of the sample had an AIDS diagnosis. The present study replicated and extended previous research from community samples by demonstrating an association between social anxiety and unprotected insertive anal intercourse with non-HIV-positive partners in a clinical sample of HIV-positive MSM and men who have sex with women (MSW). This association was maintained controlling for depression, smoking, and club drug use. Social anxiety is a relatively robust risk factor for unprotected insertive anal intercourse among MSM. Future work should examine the mechanisms by which social anxiety is associated with sexual risk among MSM.</p>
<p><strong>Background:</strong> Young adults in North America are at increasing risk for contracting HIV and sexually transmissible infections (STI). Racial differences in HIV or STI risk are well documented, but other cultural and demographic factors contributing to HIV or STI risk are poorly understood. Although religion may play an important role in sexual behaviour, little research has explored its association with sexual attitudes, beliefs and practices. The present study examined how ethnicity, religion, HIV knowledge and attitudes, and other demographic factors are associated with engaging in unprotected vaginal intercourse (UVI) in a diverse sample of unmarried young adults.</p> <p><strong>Methods:</strong> A cross-sectional study of 666 unmarried university students was conducted from 2005 to 2007, with participants completing an anonymous questionnaire on sexual attitudes and health for course credit.</p> <p><strong>Results:</strong> Approximately 50% of the respondents had engaged in any vaginal intercourse and 32.2% had engaged in UVI in the past 6 months. Multivariable analyses showed that increasing age, being in a relationship for more than 6 months, greater HIV knowledge, stronger attitudes supporting the use of condoms, and religion (but not ethnicity) were associated with engaging in UVI. Among the sexually active subset of the sample (n=332), religion was the only predictor of engaging in UVI.</p> <p><strong>Conclusion:</strong> Ethnicity, which is often considered an important variable in sexual health research, does not appear to be associated with UVI when taking into account other demographic variables, particularly religion. Consideration of religion may be important in devising HIV prevention interventions, in order to implement them in accordance with particular religious beliefs.</p>
The role of psychological factors in predicting HIV sexual transmission risk behavior is increasingly of interest in prevention research. Social anxiety, or anxiety about being evaluated in interpersonal situations, is associated with unprotected insertive anal intercourse among young men who have sex with men (MSM) and with other behavioral risk factors for unprotected intercourse, such as depression, smoking, alcohol use, and drug use. Social anxiety may be especially relevant in understanding HIV risk among HIV-seropositive men, given its stronger association with unprotected insertive than with receptive anal intercourse. In the present study, for which participants were recruited between October 2002 and May 2003, HIV-positive men attending regularly scheduled primary care medical appointments at a community HIV clinic were approached by research personnel and informed about the study topic and procedures. Ninety percent of patients approached agreed to participate, resulting in a sample of 206 patients. The sample was primarily African American, unemployed, of low educational level, and 95% of the sample had an AIDS diagnosis. The present study replicated and extended previous research from community samples by demonstrating an association between social anxiety and unprotected insertive anal intercourse with non-HIV-positive partners in a clinical sample of HIV-positive MSM and men who have sex with women (MSW). This association was maintained controlling for depression, smoking, and club drug use. Social anxiety is a relatively robust risk factor for unprotected insertive anal intercourse among MSM. Future work should examine the mechanisms by which social anxiety is associated with sexual risk among MSM.
<p><strong>Background:</strong> Young adults in North America are at increasing risk for contracting HIV and sexually transmissible infections (STI). Racial differences in HIV or STI risk are well documented, but other cultural and demographic factors contributing to HIV or STI risk are poorly understood. Although religion may play an important role in sexual behaviour, little research has explored its association with sexual attitudes, beliefs and practices. The present study examined how ethnicity, religion, HIV knowledge and attitudes, and other demographic factors are associated with engaging in unprotected vaginal intercourse (UVI) in a diverse sample of unmarried young adults.</p> <p><strong>Methods:</strong> A cross-sectional study of 666 unmarried university students was conducted from 2005 to 2007, with participants completing an anonymous questionnaire on sexual attitudes and health for course credit.</p> <p><strong>Results:</strong> Approximately 50% of the respondents had engaged in any vaginal intercourse and 32.2% had engaged in UVI in the past 6 months. Multivariable analyses showed that increasing age, being in a relationship for more than 6 months, greater HIV knowledge, stronger attitudes supporting the use of condoms, and religion (but not ethnicity) were associated with engaging in UVI. Among the sexually active subset of the sample (n=332), religion was the only predictor of engaging in UVI.</p> <p><strong>Conclusion:</strong> Ethnicity, which is often considered an important variable in sexual health research, does not appear to be associated with UVI when taking into account other demographic variables, particularly religion. Consideration of religion may be important in devising HIV prevention interventions, in order to implement them in accordance with particular religious beliefs.</p>
Despite the high prevalence of childhood emotional abuse (CEA) and adult psychological distress (depression and anxiety) among gay and bisexual men (GBM), there is little research examining the relationships among these variables. This study examined internalized homophobia (IH) as a mediator between CEA and psychological distress in a sample of 286 GBM. Controlling for demographics and childhood sexual and physical abuse, CEA was associated with self-report and clinician-administered measures of psychological distress. Concern about stigma of being gay mediated the relationship between CEA and psychological distress. Internalized antigay attitudes might be important in the relationship between CEA and adult psychological distress. Clinicians might address negative beliefs about the self as a GBM that could be exacerbated due to CEA.
en who have sex with men (MSM) account for76.3% of the HIV cases in Canada since HIV-reporting began in 1985 (Public Health Agency ofCanada, 2007). There has been a recent increase inunprotected anal intercourse (UAI) among MSMboth in the United States and Canada, which seemsto have occurred soon after the advances in antiretro-viral therapy (ART; George et al., 2006; Katz et al.,2002; Stolte, Dukers, Geskus, Coutinho, & de Wit,2004). HIV optimismdthe term given for a set ofbeliefs that ART has made HIV less of a healththreatdhas been found to be associated with HIVsexual risk behavior among MSM in a recent meta-analysis (Crepaz, Hart, & Marks, 2004), as well asin other studies on MSM (e.g., Cox, Beauchemin, A Peterson & Bakeman, 2006).However, several problems exist regarding thesupport for HIVoptimism as a current risk factor forUAI among MSM. Advances in ART, which havetransformed HIVinto a chronic and treatable disease(Sepkowitz, 2001), have been available in NorthAmerica since 1996 (Wynn, Zapor, & Smith, 2004).In the meantime, concerns that HIV optimism maynot be an important risk factor have emerged becauseofphenomenasuchasstrategicpositioning,wheretheuninfectedpartneristheinsertivepartnerandtheHIV-infected partner is the receptive partner during UAI(Prestage et al., 2005). Second, although evidencesuggests the need to examine the type of sexualpartners in studies on HIV optimism (Cox et al.,2004; Kalichman et al., 2006; Sepkowitz, 2001), fewstudies on HIVoptimism have examined the type ofsexual position, whether the participant’s partnersare HIV seroconcordant or serodiscordant with theparticipant, or controlled for HIV status of theparticipant. Finally, it is unclear whether HIVoptimism would be associated with sexual riskbehavior among MSM in Canada, as Canadianstudies have produced divergent findings regardingHIV optimism and sexual risk behavior (Cox et al.,2004; International Collaboration on HIV Optimism,2003).The primary aim of this study was to examinewhether HIV optimism was associated with UAIamong nonconcordant partners (NC partners: part-ners who are believed to be either of serodiscordant
<p>[para. 1]: “Men who have sex with men (MSM) account for 76.3% of the HIV cases in Canada since HIV reporting began in 1985 (Public Health Agency of Canada, 2007). There has been a recent increase in unprotected anal intercourse (UAI) among MSM both in the United States and Canada, which seems to have occurred soon after the advances in antiretroviral therapy (ART; George et al., 2006; Katz et al., 2002; Stolte, Dukers, Geskus, Coutinho, & de Wit, 2004). HIV optimism—the term given for a set of beliefs that ART has made HIV less of a health threat—has been found to be associated with HIV sexual risk behavior among MSM in a recent meta-analysis (Crepaz, Hart, & Marks, 2004), as well as in other studies on MSM (e.g., Cox, Beauchemin, & Allard, 2004; Peterson & Bakeman, 2006).”</p>
