Association of CAI Vulnerability and Sexual Minority Victimization Distress Among Adolescent Men Who Have Sex With Men
PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY(2021)
摘要
Adolescent men who have sex with men (AMSM) are at high HIV risk. Condomless anal intercourse (CAI) increases HIV risk and has been associated with interpersonal power imbalances, such as asymmetries in decision-making authority, social status, and emotional dependence, between male sexual partners. AMSM experience high levels of psychological and physical victimization due to their sexual minority status. Sexual minority victimization (SMV) is similarly associated with low interpersonal power and may relate to the extent to which AMSM are vulnerable to partner influences to engage in CAI. This online survey study of AMSM 14-17 years old (N = 143) tested the hypothesis that experiences and attitudes reflecting vulnerability to partner CAI influence (CAI Vulnerability) and distress in response to experienced sexual minority victimization (SMV Distress) would be positively associated with participant and partner condom nonuse during anal sex (CAI frequency). Approximately 35% reported they or their partner(s) had never or rarely used a condom. Positive correlations were found among partners' CAI frequency during sex with the participant, CAI Vulnerability, and SMV Distress. Multiple regression indicated CAI Vulnerability significantly accounted for the relation between SMV Distress and partner's CAI frequency. Findings suggest that distress in response to SMV may be associated with a diminished sense of interpersonal control resulting in CAI Vulnerability and subsequent more frequent instances of partner CAI. HIV prevention strategies designed to increase condom use among AMSM have the potential to benefit from procedures aimed at increasing interpersonal sexual assertiveness and decreasing distress associated with sexual minority victimization. Public Significance Statement Adolescent men who have sex with men (AMSM) are at disproportionately high HIV risk. Engaging in condomless anal intercourse (CAI) increases HIV risk, and condom nonuse among AMSM is common. The development of effective behavioral interventions for HIV prevention requires an understanding of interpersonal factors influencing AMSM's condom use. Past research suggests that men who have low interpersonal power in their sexual partnerships engage in CAI more frequently. Being victimized because of one's sexual minority status has similarly been associated with having less interpersonal power, and may influence the extent to which AMSM are vulnerable to partner influence to engage in CAI. The aim of this study was to test whether experiences and attitudes reflecting vulnerability to partner influence to engage in CAI and distress in response to sexual minority victimization would be associated with the frequency with which AMSM engaged in CAI. Sexually active AMSM aged 14-17 who had experienced sexual minority victimization in the past 6 months completed an online survey. The results indicated that youth who experienced more distress in response to sexual minority victimization reported being more vulnerable to partner influence to engage in CAI, and youth who were more vulnerable to partner influence over CAI reported more frequent engagement in CAI. Practitioners and policymakers designing HIV prevention strategies to increase condom use among AMSM should incorporate procedures aimed at increasing interpersonal assertiveness and decreasing distress associated with sexual minority victimization.
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关键词
condoms, HIV risk, LGBT victimization, adolescents, MSM
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