title: Health behaviors in the development and maintenance process of homosexual identity.
abstract: BACKGROUND
  Health behaviors of men who have sex with men (MSM) affect their health status in many aspects. Rate of HIV infection among Thai male prostitutes in 2005 was 15.4%. Among these, 28.3% were MSM. Thirty percent of youth suicides were conducted by gays and lesbians.
  
  
  OBJECTIVE
  To explore the health behaviors related to the development and maintenance process of men who have sex with men.
  
  
  METHODS
  This was a qualitative study. The study population was MSM in Mukdahan province. The subjects were recruited gradually, by snowball sampling, until the required data were saturated. In-depth interviews and participant observations were performed over a period of 17 months. A triangulation technique was applied to check reliability of the data. Data were analyzed by content analysis and compared with the Troiden's stages of development and maintenance process of homosexual identity.
  
  
  RESULTS
  Eleven Thai MSM were recruited and followed up. Health behaviors of them were different according to the stages of development and maintenance process regarding Troiden's theory. Physical, psychological, social and sexual aspects of health behaviors were identified in various stages. It was found that many factors affect health behaviors of MSM. These include health promoting and undermining factors.
  
  
  CONCLUSIONS
  Health behaviors of MSM varied in each stage of development and maintenance of homosexual identity. Health promotion campaigns and policies for MSM should be designed accordingly.
authors.affiliation: Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Thaidharmarose
authors.initials: T
authors.lastname: Patthum
authors.forename: Pattapong
authors.initials: P
authors.lastname: Kessomboon
authors.forename: Narumon
authors.initials: N
authors.lastname: Sinsuphan
authors.forename: Amornrat
authors.initials: A
authors.lastname: Ratanasiri
mesh_terms: D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D015438:Health Behavior; D006304:Health Status; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D036301:Qualitative Research; D012309:Risk-Taking; D012649:Self Concept; D013315:Stress, Psychological; D013785:Thailand; D055815:Young Adult