Article

Minority stress and sexual problems among African-American gay and bisexual men.

Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota, 1300 S 2nd St., Ste. 180, Minneapolis, MN 55454, USA.
Archives of Sexual Behavior (Impact Factor: 3.53). 09/2007; 36(4):569-78. DOI: 10.1007/s10508-006-9081-z
Source: PubMed

ABSTRACT Minority stress, such as racism and gay bashing, may be associated with sexual problems, but this notion has not been examined in the literature. African-American gay/bisexual men face a unique challenge in managing a double minority status, putting them at high risk for stress and sexual problems. This investigation examined ten predictors of sexual problems among 174 African-American gay/bisexual men. Covarying for age, a forward multiple regression analysis showed that the measures of self-esteem, male gender role stress, HIV prevention self-efficacy, and lifetime experiences with racial discrimination significantly added to the prediction of sexual problems. Gay bashing, psychiatric symptoms, low life satisfaction, and low social support were significantly correlated with sexual problems, but did not add to the prediction of sexual problems in the regression analysis. Mediation analyses showed that stress predicted psychiatric symptoms, which then predicted sexual problems. Sexual problems were not significantly related to HIV status, racial/ethnic identity, or gay identity. The findings from this study showed a relationship between experiences with racial and sexual discrimination and sexual problems while also providing support for mediation to illustrate how stress might cause sexual problems. Addressing minority stress in therapy may help minimize and treat sexual difficulties among minority gay/bisexual men.

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    ABSTRACT: IntroductionAlthough sexuality is a central feature that distinguishes nonheterosexual men from heterosexual men, little is known about how sexual orientation influences male sexual function and sexual problems. This presents a challenge for adequate healthcare for gay and bisexual men.AimThe aim of this article is to provide an overview of the literature on the prevalence and correlates of sexual health disturbances among heterosexual and nonheterosexual men.Methods PubMed and PsycINFO databases were searched for relevant studies published in English. Reference sections of selected papers were checked for additional studies of interest.Main Outcome MeasuresMain outcomes were comparative findings of the prevalence and correlates of sexual health disturbances in heterosexual and nonheterosexual men.ResultsIn total, we found nine studies of interest, five of which used a comparative design. Evidence regarding sexual orientation as a risk factor for male sexual difficulties is mixed, with more recent studies reporting nonsignificant associations. Heterogeneity of sampling strategies and indicators used to assess sexual orientation and sexual function in the studies, as well as the use of relatively small subsamples of nonheterosexual participants, preclude any conclusions about a comparative prevalence of male sexual disturbances. Several studies suggested that rapid ejaculation might be more prevalent among heterosexual than nonheterosexual men. However, a single study that controlled for frequency and patterns of male sexual activity failed to corroborate this finding. Two studies reported similar correlates of sexual dysfunction and sexual problems between heterosexual and nonheterosexual men (e.g., age and depression/anxiety symptoms), but also some sexual orientation-specific correlates (e.g., body image). Finally, significant but weak associations between minority stressors and sexual health disturbances among nonheterosexual men were reported in two studies.Conclusions There is a lack of comparative assessment of the relationship between sexual orientation and male sexual difficulties. Based on an analysis of the existing studies' limitations, we conclude with recommendations for future studies. Štulhofer A, Šević S, and Doyle DM. Comparing the prevalence and correlates of sexual health disturbances among heterosexual and nonheterosexual men: An overview of studies. Sex Med Rev **;**:**–**.
    10/2014; DOI:10.1002/smrj.31

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