Moderators of the Relationship Between Internalized Homophobia and Risky Sexual Behavior in Men Who Have Sex with Men: A Meta-Analysis

Department of Psychology, University of Illinois at Chicago, 60607, USA.
Archives of Sexual Behavior (Impact Factor: 3.53). 11/2009; 40(1):189-99. DOI: 10.1007/s10508-009-9573-8
Source: PubMed


Research on internalized homophobia (IH) has consistently linked it to both mental and physical health outcomes, while research on its relationships with other variables has been inconsistent. Some research and theory support the association between IH and risky sexual behavior, but much of this research has been plagued by methodological issues, varying measures, and has produced inconsistent findings. Coming to a better understanding of the utility of IH as a potential mechanism or predictor of risky sex in men who have sex with men (MSM) may help to inform future studies of HIV risk in this population as well as the development of prevention interventions. The current study used hierarchical linear modeling to perform meta-analysis combining effect sizes across multiple studies of the relationships between IH and risky sexual behavior. Additionally, the use of multilevel modeling techniques allowed for the evaluation of the moderating effects of age, year of data collection, and publication type on this relationship. Sixteen studies were meta-analyzed for the relationship between IH and risky sexual behavior (N = 2,837), revealing a small overall effect size for this relationship. However, a significant moderating effect was found for the year of data collection, such that the correlation between these two variables has decreased over time. The current utility of this construct for understanding sexual risk taking of MSM is called into question.

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    • "These results contribute to a growing evidence base with regard to internalized homophobia, other related constructs , and HIV/STI behavioral risk (Barnes & Meyer, 2012;Foster et al., 2011;Jeffries et al., 2014;Lassiter, 2015;Pitt, 2009). Nonetheless, the literature is inconsistent with regard to what variables mediate the relationship between internalized homophobia and HIV/STI behavioral risk (Newcomb & Mustanski, 2011). The results from this study help address this current gap in the scientific literature by articulating at least one path (internalized homophobia → racial/sexual identity incongruence ) by which childhood religious environments may affect adult HIV/STI behavioral risk and HIV infection. "
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    ABSTRACT: Exposure to childhood religious affiliations where the majority of members discourage homosexuality may have negative psychological impacts for Black men who have sex with men. This study tested the hypothesis that exposures to these environments during childhood were associated with adulthood human immunodeficiency virus (HIV)/sexually transmitted infection (STI) behavioral risk and HIV infection, because these exposures influenced HIV/STI risk by undermining race/sexual identity congruence and increasing internalized homophobia and interpersonal anxiety. Structural equation modeling as well as logistic and Poisson regressions were performed using baseline data from HIV Prevention Trials Network 061 (N = 1,553). Childhood religion affiliations that were more discouraging of homosexuality were associated with increased likelihood of HIV infection; however, the association was no longer significant after adjusting for age, income, and education. Having a childhood religion affiliation with high prevalence of beliefs discouraging homosexuality was associated with increased numbers of sexual partners (adjusted odds ratio = 4.31; 95% confidence interval [3.76, 4.94], p < .01). The hypothesized path model was largely supported and accounted for 37% of the variance in HIV infection; however, interpersonal anxiety was not associated with HIV/STI risk behaviors. Structural interventions are needed that focus on developing affirming theologies in religious institutions with Black men who have sex with men congregants.
    Full-text · Article · Jan 2016 · American journal of men's health
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    • "However, one meta-analysis using more than 2800 cases through & R. David Parker hierarchical linear modelling suggests there may be a decreasing impact of IH over time[8]. As social acceptance of other than heterosexual sexual orientations increases, we would expect to see a decrease in IH if there is a reduction in the negative views toward LGBQT persons. "
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    ABSTRACT: Men who have sex with men (MSM) continue to be at higher risk for negative health outcomes including HIV, STIs, depression, substance use, suicidality, and anxiety. Associative relationships between homonegativity (internal and external) and these outcomes are used to explain the observed disproportionate impact. The current study assessed associations between internalized homonegativity and high-risk behaviours, markers of substance use and symptoms of mental illness as well as openness and level of same sex attraction. A 2013 Internet-based survey was conducted among MSM, collecting data on socio-demographics, sexuality, drug and alcohol use, mental health, suicidality, and internalized homonegativity. The sample (n = 265) had a median age of 31 years, with 85 % employed at least part-time; at least a college-level education in 43 %; and 87 % lived in an urban setting. Sexual orientation was reported as: gay, 72 %; bisexual 23 %; other 5 %. Almost all men (97 %) reported ever having sex with a man, with more than one-third (36 %) having a steady male partner. Statistically significant higher homonegativity scores were detected among men reporting any level of opposite sex attraction compared to men attracted to only men; mostly men (p = 0.001), men and women equally (p = 0.002), and mostly women (p = 0.004), as well as less openness of same sex attraction to family and friends; >50 % family (p = 0.032), no family knowing (p = 0.042), and few friends knowing (p = 0.011). Anxiety risk and increased homonegativity also had a statistically significant increasing relationship. The identified associations between homonegativity and opposite sex attraction among MSM warrants further exploration as well as the relationship with increased anxiety risk.
    Full-text · Article · Jan 2016 · Journal of Community Health
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    • "Thus, outness and internalized homonegativity are of interest to researchers studying the health of lesbian, gay, or bisexual populations. This includes HIV prevention researchers focused on studying how individual factors might influence sexual risk (Kubicek et al., 2009; Newcomb & Mustanski, 2011; Ross et al., 2001; Rostosky, Danner, & Riggle, 2007; Shoptaw et al., 2009), as well as some developmental researchers. There is some evidence that outness increases with age among MSM (Ross & Rosser, 1996; Ross et al., 2008). "
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    ABSTRACT: In this study, we investigated if a single-item indicator measured the degree to which people were open about their same-sex attraction (“out”) as accurately as a multi-item scale. For the multi-item scale, we used the Outness Inventory, which includes three subscales: family, world, and religion. We examined correlations between the single- and multi-item measures; between the single-item indicator and the subscales of the multi-item scale; and between the measures and internalized homonegativity, social attitudes towards homosexuality, and depressive symptoms. In addition, we calculated Tjur’s R 2 as a measure of predictive power of the single-item indicator, multi-item scale, and subscales of the multi-item scale in predicting two health-related outcomes: depressive symptoms and condomless anal sex with multiple partners. There was a strong correlation between the single- and multi-item measures (r = 0.73). Furthermore, there were strong correlations between the single-item indicator and each subscale of the multi-item scale: family (r = 0.70), world (r = 0.77), and religion (r = 0.50). In addition, the correlations between the single-item indicator and internalized homonegativity (r = −0.63), social attitudes towards homosexuality (r = −0.38), and depression (r = −0.14) were higher than those between the multi-item scale and internalized homonegativity (r = −0.55), social attitudes towards homosexuality (r = −0.21), and depression (r = −0.13). Contrary to the premise that multi-item measures are superior to single-item measures, our collective findings indicate that the single-item indicator of outness performs better than the multi-item scale of outness.
    Full-text · Article · Aug 2015 · Archives of Sexual Behavior
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