Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms: results from a prospective study of bereaved gay men.
OBJECTIVE
Minority stress is the most frequently hypothesized risk factor for the increased rates of adverse behavioral and mental health outcomes among sexual minorities. However, there is a paucity of longitudinal research addressing this hypothesis.


METHODS
Prospective, community-based cohort of 74 bereaved gay men. Participants were assessed before the partner or close friend died of AIDS and then at 1, 6, 13, and 18 months postloss.


METHODS
HIV risk behavior (unprotected anal intercourse), substance use and abuse symptoms, and depressive symptoms.


RESULTS
Hierarchical Linear Modeling analyses revealed that changes in internalized homophobia, discrimination experiences, and expectations of rejection were differentially associated with HIV risk behavior, substance use, and depressive symptoms, respectively. In contrast to the significant effects of minority stress, bereavement-related stressors (e.g., length of partner illness, quality of relationship with deceased) were largely unrelated to these outcomes.


CONCLUSIONS
The results provide evidence for the predictive validity of minority stress, even in the context of a major life stressor, and suggest the importance of targeting minority stress experiences in HIV and mental health interventions with gay men. Future studies are needed to assess the mechanisms through which minority stress is associated with adverse health outcomes.
Hatzenbuehler
Mark L
ML
Department of Psychology, Yale University, New Haven, CT 06520-8205, USA. mark.hatzenbuehler@yale.edu
Nolen-Hoeksema
Susan
S
Erickson
Sarah J
SJ
D000328:Adult; D001601:Bereavement; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008913:Minority Groups / Q000523:psychology* / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012309:Risk-Taking; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology*