Coming out and AIDS-related high-risk sexual behavior

Abstract

How the withdrawal of social support associated with the coming out of gay men influences AIDS-related sexual risk-taking among Flemish (Belgian) gay men is analyzed. Recruited via key persons, the 379 gay men in this nonclinical cohort completed a lengthy, computerized questionnaire dealing with diverse aspects of gay life and culture. Independent variables include demographic characteristics, AIDS knowledge, coming-out histories, six social support dimensions, and personal resources. The dependent variables were insertive and receptive anal intercourse with and without a condom. Stepwise regression explained, respectively, 41.2, 38.4, 18.4, and 14.2% of the variance. Absence of appraisal (the view that others approve of the way one does things or feels about things) led to higher frequencies of insertive anal sex (both with and without a condom). The experience of emotional conflict lowered the use of condoms by the insertive partner in anal intercourse. Disapproval by significant others of being gay also led to higher levels of receptive anal intercourse without a condom. Subjects with a high belief in mastery had higher frequencies of risk-taking, suggesting that the combination of the experience of negative reactions and high mastery lead to greater involvement in risky sexual behavior. Findings are interpreted within the theoretical framework of the coming-out process and gay identity formation.

PIP: Individuals who recognize and freely admit that they are either homosexual or bisexual may be rejected by their peers, families, and others. Adequate social support, however, has been shown to lead to a heightened sense of well-being and health. It has also been shown to encourage individuals to adopt and maintain healthier lifestyles. There are important correlations between social support and self-esteem, control/mastery, and stress management. The withdrawal of social support following the coming out of gay people can have serious detrimental effects on their social and emotional well-being. 379 gay and bisexual men completed a questionnaire in 1989 about various aspects of gay life and culture in the course of a study about how life stress, associated with the disapproval of being gay and the absence or withdrawal of social support, influences the level of sexual risk-taking. The men were aged 17-78 years, with 81.9% aged 21-40. Teens and men over age 50 are underrepresented in the cohort. As in most research on gay men, this cohort is more highly educated than the general population, with more than 50% having some education beyond secondary school. Men who felt that others approve of their life choices and lifestyle had higher frequencies of insertive anal sex both with and without a condom. Emotional conflict, however, lowered the use of condoms by the insertive partner in anal intercourse. Disapproval by significant others of being gay also led to higher levels of receptive anal intercourse without a condom. Respondents with a high belief in mastery took risks more often. It therefore may be assumed that combining the experience of negative reactions with high mastery leads to greater involvement in risky sex behavior.